Hi! Grace here. I’m an Elektra Guide who’s had the pleasure of working 1:1 with many members over the past year. But what you may not know is that I’m also in my late 40s and perimenopausal myself! I recently started on my hormone therapy journey and figured I’d share more about what the decision-making process looked like for me and how I’m feeling now that I’m a few months in.
But first, I want to reiterate that whether or not to pursue hormone therapy is a deeply personal decision that should be made with your healthcare provider after consideration of your health history and risk factors. In sharing my story, my goal is not to convince you to do the same. Rather, it’s to shine a spotlight on what can be a very confusing topic and hopefully inspire you to at least have the conversation with your doctor. We deserve to make well-informed decisions about our health to live well during this transition and in the decades that follow.
Here’s to more women speaking up and out to smash the menopause taboo.
To start, a little bit about me…
I am a Holistic Health Counselor and have spent many years working in the perinatal space from prenatal to postpartum support and education. I am Afro-Latina, born in the Dominican Republic, but raised mostly in New York. My husband and I have two daughters, nine and eleven years old — so needless to say, it’s a very hormonal household. We love to do easy, picturesque hikes right outside of the city, go to the beach, play board games, and attend cultural events.
The menopausal symptoms I’ve been experiencing…
I’ve had pretty bad joint pain. It’s mostly been in my knees, hips, and lower back — but I also started having weird shoulder pain back in January. In addition, I’ve been experiencing cyclical breast pain, irritability (a much shorter fuse, which makes me feel ashamed to not be able to control it at times), and brain fog (that makes me wonder how I come across to my co-workers and Elektra members…I literally forget words!). To top it off, I started having night sweats, which would interrupt my sleep — but I also had the 3am random wake-ups even without the night sweats. And let’s not forget the gut I’ve acquired over the past five years!!
What I tried to improve or alleviate my symptoms…
It feels like I’m doing all the lifestyle things I recommend to members:
- Time-restricted eating
- Eating more protein and veggies
- Cutting back on caffeine, alcohol, and sugar
- Attempting to get more sleep
- Trying to manage my stress
- Taking supplements
All of these things have helped a bit — especially to shrink my middle — but are not really cutting it.
So I started to think about hormone therapy…
I feel extremely well-informed about perimenopause and have a great clinical support team both within Elektra and outside of it, and I STILL have taken a long time to decide if HRT is right for me. I have no risk factors, meaning I’m eligible to take hormone therapy, but part of my hesitation has been my reaction to birth control pills in the past; I tended to feel very depressed and gained weight every time I tried them. I wanted to avoid that happening again. It eased my mind to know that the dosage for menopause hormone therapy is way lower than for birth control pills, and that the hormones I would be taking are not synthetic and more like the ones my body produces and recognizes.
I made the decision to start HRT knowing that if it made me feel weird, I could change the dosage or delivery system…or stop altogether if I needed to.
Plus, at this point I have nothing to lose but the pesky symptoms. I don’t want to be a martyr in service of doing things more “naturally” and then spend the next five or 10 years feeling awful. I want to thrive, I want to have energy, I want my brain to work the way it used to, I want to be able to sleep and feel refreshed, and I want my body to stop aching.
At this point I have nothing to lose but the pesky symptoms. I don’t want to be a martyr in service of doing things more “naturally” and then spend the next five or 10 years feeling awful. I want to thrive, I want to have energy, I want my brain to work the way it used to, I want to be able to sleep and feel refreshed, and I want my body to stop aching.
My experience on hormone therapy…
Protocol #1: progesterone pill
Days 1-3: no night sweats, yes body aches
I started by taking a progesterone pill at night. And while I was sleeping fairly well, I still woke up in the middle of the night due to my husband’s snoring. That left me feeling a bit foggy on the first day, but days 1-2 were much better. I didn’t have night sweats, but I did still have some body aches (which I was hoping would get better once I started estrogen).
Days 10-12: I’m remembering my dreams!! But unfortunately, my body aches are worsening.
I finished my first round of progesterone. The only meaningful change I noticed was that my quality of sleep had improved — I had fewer wake-ups and my dreams were far more vivid. I didn’t realize how long it had been since I had memorable dreams!
My body aches continued and actually got worse (bad knee pain caused me to cut back on walking), and I started to feel PMS symptoms on day 11, but no bleeding.
Protocol #2: adding an estradiol patch
Days 1-10: some bleeding and cramping
Before I dive in, some clarification notes:
- While we’re technically approaching day 14 here, the clock “starts over” at day one since the protocol was designed as if I was in my luteal phase. That’s why I started with progesterone first, and once I had my period it would start the cycle over with the addition of the estradiol patch.
- Together with my provider, I chose to use the estradiol patch because it bypasses the liver and goes right into the bloodstream, which lessens the risk of blood clots. It’s also more convenient and easier to remember.
I started the estradiol patch and didn’t notice any specific changes other than menstrual cramping. I did end up bleeding on day 15 (after a two-month absence), which I expected since this protocol was meant to give me a bleed after the first 10 or so days of progesterone. The period was lighter than my usual, but I cramped a LOT. (Weirdly enough, I’ve noticed that, for the past year or so, I cramp after I get my period whereas in the past, it used to only be before.) The bleeding/spotting lasted seven days.
But…and this is big…no more night sweats! Besides one night of horrible sleep (I swear I got up to pee at least five times!), I sleep comfortably and only wake up occasionally, especially if a certain someone is snoring next to me.
I’ve noticed less body aches, and less brain fog and anxiety but still find it difficult to concentrate at times.
Month 2: some emotional sensitivity, my first real period, and a change in protocol
During the second month, I noticed that I was feeling a bit more emotionally sensitive — I would cry much more easily when watching videos or touching movies and shows. My emotions are more…tangible. I can feel the rush of cortisol and adrenaline when I take my dog out and he goes wild after seeing another dog. I can feel the rush of love when I see my kids after school, and gladness when I run into friends or speak to family members. This was not something I expected as a side effect.
Also, I got my actual period and not breakthrough bleeding from the cyclical progesterone. It was definitely more intense than it had been in the past, and I also noticed I was feeling, well, more hormonal — like I did in my 20s when part of my PMS involved feelings of inadequacy and generally feeling uncomfortable in every social situation. The return of these feelings led me to believe that my estradiol dosage was too high for now, so after speaking with my provider, I decided to cut the patch in half to see how I felt on .025mg rather than .005mg.
The result: I felt better emotionally and more in control of my emotions. But unfortunately, my night sweats started to come back. I couldn’t tell if it was just me or the result of temperature changes in late spring (or both). But instead of adding the other half of the patch, I used lighter sheets and turned on the fan before going to bed, which solved the issue. So I decided to keep going with the half patches for now — if I find I need more, I’ll reach out to my provider about finding a middle ground (like .0375mg).
Month 3: better sleep & better libido
Come month three, I was convinced that half a patch of estradiol was my sweet spot (plus the cyclical progesterone). Together, they help me sleep so much more deeply, and as a result I feel more refreshed in the mornings (which leads to better mornings for everyone in my household).
Part of this health journey is making sure that I’m not just thinking about hormones, but my overall health. To that end, I went in for a pap smear to make sure my cervix is healthy and that any bleeding that happens is due to my cycle and the hormonal changes. Fortunately, I got a clean bill of health, and my new doctor was supportive of me taking HRT.
As far as symptoms go, I no longer (or rarely) experience night sweats, irritability, urge incontinence, joint pain, and hair loss. Plus, my libido — which I didn’t think was low — has increased. Looking back, I guess I was feeling less desire and didn’t notice. I was still responsive to my partner, but less likely to initiate intimate moments…but now I’m back! And I’m happy to report my orgasms have more oomph than in the past six-eight months.
Month 4: some dosage tweaking to ease night sweats & irregular periods
In month four, my provider and I did more tweaking of the dosage because my night sweats started to come back (especially as the weather warmed up). So now I’m on a .0375mg estrogen patch.
And because my periods are SO out of whack, we decided that it made more sense to do 100mg of continuous progesterone rather than 200mg cyclical. I’m still responding well to the progesterone, and it has helped with my sleep so much that I’ve been able to skip the sleep gummies most of the time.
The bottom line
Hormone therapy is not a panacea. It has not resolved every perimenopausal issue I have — my hair is not much thicker and my period is still all over the place. I still have brain fog if I’m tired, I have not lost weight, and I still have bouts of anxiety here and there. Also, I want to be very clear about the fact that HRT is not for everyone, and some people will have vastly different experiences than mine.
However, the benefits have been very apparent. It has alleviated my joint pain so I’m able to be as active as before. I sleep better, my skin does not feel as dry, and I don’t have night sweats. I can hold my pee WAY better, and the breast soreness is gone.
All of these benefits increased my quality of life so I feel more vibrant, resilient, and positive about the “change of life” experience.