{"id":14770,"date":"2025-07-24T17:00:44","date_gmt":"2025-07-24T10:00:44","guid":{"rendered":"https:\/\/loudhdtv.com\/?p=14770"},"modified":"2025-07-24T17:00:44","modified_gmt":"2025-07-24T10:00:44","slug":"what-i-wish-i-knew-before-perimenopause-my-journey-to-hormone-replacement-therapy","status":"publish","type":"post","link":"https:\/\/loudhdtv.com\/?p=14770","title":{"rendered":"What I Wish I Knew Before Perimenopause: My Journey to Hormone Replacement Therapy"},"content":{"rendered":"<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script><br \/>\n<\/p>\n<div>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-316968 aligncenter lazyload\" src=\"https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-scaled.jpg\" alt=\"\" width=\"640\" height=\"400\"\/><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-316968 aligncenter lazyload\" src=\"https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-scaled.jpg\" alt=\"\" width=\"640\" height=\"400\" srcset=\"https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-scaled.jpg 2560w, https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-300x188.jpg 300w, https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-1024x640.jpg 1024w, https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-768x480.jpg 768w, https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-1536x960.jpg 1536w, https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-2048x1280.jpg 2048w, https:\/\/fitbottomedgirls.com\/wp-content\/uploads\/2025\/07\/shutterstock_748977499-150x94.jpg 150w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\"\/><\/p>\n<p style=\"font-weight: 400;\">I distinctly remember my first hot flash. My husband and I had stopped for breakfast on our way to Atlantic City for an overnight stay. Sitting in the booth across from him, I suddenly felt heat rising through my body\u2014like someone had turned up my internal thermostat. I started laughing. \u201cI think I\u2019m having my first hot flash,\u201d I said. Moments later, I stood up and walked outside. It was as if I had heated up the air around me and needed to move.<\/p>\n<p style=\"font-weight: 400;\">That was more than six years ago.<\/p>\n<h2>The First Hot Flash\u2014and the Perimenopause Symptoms That Followed<\/h2>\n<p style=\"font-weight: 400;\">For me, <a href=\"https:\/\/fitbottomedgirls.com\/2025\/05\/perimenopause-profit-and-pills-the-truth-about-menopause-supplements\/\">perimenopause<\/a> started with hot flashes. During the day, they struck mostly while I was eating. In mid-winter, I would jump up from the table to go stand outside. As someone who has been perpetually cold, it was odd.<\/p>\n<p style=\"font-weight: 400;\">Then came the night sweats\u2014waking up with my PJs so drenched that I would change my clothes, only to wake up drenched again a couple of hours later.<\/p>\n<p style=\"font-weight: 400;\">Next was the insomnia. I had always slept like a champ, falling asleep almost as soon as my head hit the pillow. I could still fall asleep easily (most nights), but I would wake up at 2 a.m. It was as if my body and brain were on two different rhythms. My brain and nervous system were tired, but my body was so awake. I swear I could actually feel the pulses of energy running through my legs. Sometimes I would get out of bed. Sometimes I was so tired I would just lie there feigning sleep.<\/p>\n<p style=\"font-weight: 400;\">I could handle the occasional sleepless night, but sometimes several of these nights would occur back-to-back. By the third or fourth day, I felt like garbage and my brain was mush.<\/p>\n<h2>My Symptoms Were Brushed Off for Years<\/h2>\n<p style=\"font-weight: 400;\">I mentioned the night sweats and insomnia to both my primary care physician and my nurse midwife at each visit for years. Each time, they assured me it was all \u201cnormal\u201d and \u201cpart of the transition.\u201d I trusted them. And\u2014on some level\u2014I think we all assumed these signs were an indication that menopause was around the corner and, therefore, these symptoms would come to an end anytime now. But they didn\u2019t. They got worse.<\/p>\n<p style=\"font-weight: 400;\">I mean, the average woman reaches menopause (officially: the day that you\u2019ve gone a full 12 consecutive months without a menstrual period) at age 51, and I\u2019m 54 now. It made sense.<\/p>\n<p style=\"font-weight: 400;\">Only, menopause wasn\u2019t around the corner. I still get my period like clockwork.<\/p>\n<h2>Perimenopause Brought Me A Miserable Monthly Cycle<\/h2>\n<p style=\"font-weight: 400;\">In the last two years, my perimenopausal symptoms got worse and worse. And while they didn\u2019t all occur every month, I started keeping notes and realized that most of them occurred cyclically, often hitting mid-cycle. Things like:<\/p>\n<ul>\n<li>Painful ovulation and period cramps<\/li>\n<li>Constipation<\/li>\n<li>Bloating<\/li>\n<li>Red, swollen, bleeding gums<\/li>\n<li>Mouth sores<\/li>\n<li>Vulvar swelling and irritation<\/li>\n<li>Sore, swollen breasts<\/li>\n<li>Low libido<\/li>\n<li>Days when I\u2019d randomly wake up feeling anxious, sad, or pissed off<\/li>\n<\/ul>\n<p style=\"font-weight: 400;\">In short, I was miserable. The sleepless nights and revolving door of symptoms made most days feel like a complete slog. I just didn\u2019t feel like myself. (<a href=\"https:\/\/journals.lww.com\/menopausejournal\/fulltext\/2024\/05000\/_not_feeling_like_myself__in_perimenopause___what.6.aspx\" class=\"external\" rel=\"nofollow\">Little did I know how common this is!<\/a>)<\/p>\n<h2>Finally Finding Help<\/h2>\n<p style=\"font-weight: 400;\">Desperate, I found a new gynecologist and went to my visit with notes, prepared to discuss my symptoms and determined to ask if hormone replacement therapy was an option. I wasn\u2019t halfway through my list before he dismissed most of the symptoms. I didn\u2019t push\u2014who wants to work with a doctor who gaslights them?<\/p>\n<p style=\"font-weight: 400;\">After the appointment, I sat in my car and cried. I was so frustrated. And I felt like I was back at square one.<\/p>\n<p style=\"font-weight: 400;\">I\u2019m not alone.<\/p>\n<h2>The Medical System\u2019s Menopause Gap<\/h2>\n<p style=\"font-weight: 400;\">Despite the fact that nearly 90 million women in the U.S. are expected to be postmenopausal by 2060, menopause remains a profoundly underserved area in medicine.<\/p>\n<p style=\"font-weight: 400;\">Most women will spend about one-third of their lives in this stage, yet both patients and providers are often unprepared for what it brings.<\/p>\n<p style=\"font-weight: 400;\">Research shows that while 85% of women experience menopausal symptoms that significantly impact their quality of life, a staggering 75% of those who seek help walk away untreated.<\/p>\n<p style=\"font-weight: 400;\">Meanwhile, <strong>only 54% of women can accurately define menopause<\/strong>, and 32% say they lack basic knowledge about it.<\/p>\n<p style=\"font-weight: 400;\">Unfortunately, the providers they turn to may not be much better equipped: <strong>80% of internal medicine residents report feeling unprepared to treat menopause, and only 20\u201330% of OB\/GYN residencies include formal menopause education.<\/strong><\/p>\n<p style=\"font-weight: 400;\"><strong>Read that again: Only 20\u201330% of those who go to medical school to work with people who have uteruses are formally educated in menopause!<\/strong><\/p>\n<p style=\"font-weight: 400;\">Much of the confusion around hormone replacement therapy (HRT)* can be traced to the 2002 release of the Women\u2019s Health Initiative (WHI)\u2014a large, government-sponsored study that linked HRT to increased risks of breast cancer, stroke, and heart disease.<\/p>\n<p><em>*Editor\u2019s Note: <strong>Menopause hormone therapy (MHT) or simply hormone therapy (HT)<\/strong> are the currently-accepted terms from the Menopause Society and the Endocrine Society for the practice of prescribing hormones related to menopausal symptoms. As pointed out by Dr. Jen Gunter <a href=\"https:\/\/vajenda.substack.com\/p\/menopause-hormone-therapy-mht-and\" class=\"external\" rel=\"nofollow\">here in her Substack, The Vajenda<\/a>, use of the terms \u201cHormone Replacement Therapy or HRT implies that menopausal women have a disease.\u201d <a href=\"https:\/\/vajenda.substack.com\" class=\"external\" rel=\"nofollow\">We highly recommend every midlife woman subscribe to Dr. Gunter\u2019s Substack.<\/a><\/em><\/p>\n<p style=\"font-weight: 400;\">The findings were broadcast widely and prompted millions of women to discontinue HRT, while physicians were advised to prescribe it sparingly. What many headlines left out, however, was the nuance: the average participant in the WHI was 63 years old, over a decade past the average age of menopause. Most had pre-existing health conditions, and the hormones used in the study\u2014oral Premarin and synthetic medroxyprogesterone\u2014are now known to carry higher risks than the currently prescribed bioidentical hormones delivered transdermally.<\/p>\n<p style=\"font-weight: 400;\">In the years since, follow-up studies and re-analyses have shown that when started closer to the onset of menopause, HRT\u2014especially formulations using bioidentical estradiol and micronized progesterone\u2014can be not only safe but beneficial, improving quality of life and reducing risk of cardiovascular disease and osteoporosis. Yet the stigma and misinformation from the early 2000s continue to influence medical guidelines, media narratives, and public opinion.<\/p>\n<h2 style=\"font-weight: 400;\">Finding the Right Doctor is Key<\/h2>\n<p>The weekend after my disastrous appointment, I met a couple of friends for breakfast. I filled them in on my worsening symptoms, my frustration, and the disappointing visit with the new doctor. One of my friends\u2014Jen\u2014had been just as frustrated with her perimenopausal symptoms and told me she\u2019d found a local practitioner on a <a href=\"https:\/\/thepauselife.com\/pages\/recommended-physicians\" class=\"external\" rel=\"nofollow\">list of recommended practitioners<\/a>. She had already scheduled an appointment with <a href=\"https:\/\/coastalwomensmedical.com\/\" class=\"external\" rel=\"nofollow\">Dr. Mary Ann Yehl<\/a> and would share her thoughts after.<\/p>\n<p style=\"font-weight: 400;\">\u201cGals: Two thumbs up for this menopause doc I saw today,\u201d Jen texted after her appointment.<\/p>\n<p style=\"font-weight: 400;\">That was all I needed to hear. I promptly scheduled an appointment with <a href=\"https:\/\/www.instagram.com\/drmaryannyehl\/\" class=\"external\" rel=\"nofollow\">Dr. Yehl<\/a>.<\/p>\n<p style=\"font-weight: 400;\">Afterward, Jen and I talked more about our mutual frustrations navigating perimenopause in a broken healthcare system. \u201cBetween the two of us, we had to cycle through six doctors just to find one who had the knowledge\u2014and the willingness\u2014to talk about what we knew was happening to our bodies,\u201d she told me. \u201cOne doctor literally said, \u2018We don\u2019t give hormones just so someone can sleep.\u2019 That might be the most enraging thing I\u2019ve ever heard from a doctor.\u201d<\/p>\n<p style=\"font-weight: 400;\">What stuck with her most was the inequity of it all:<\/p>\n<p style=\"font-weight: 400;\">\u201cI\u2019m lucky to have a supportive partner and the means to afford out-of-network care\u2014but I kept thinking about all the women who won\u2019t get the help they need because they don\u2019t have the same privilege. I was relieved to find Dr. Yehl\u2014but also furious. It just shouldn\u2019t be this hard to get basic care.\u201d<\/p>\n<h3><strong>The Appointment<\/strong><\/h3>\n<p style=\"font-weight: 400;\">My appointment with Dr. Yehl was everything a doctor\u2019s visit should be. She asked me to tell her my story\u2014and then truly listened. She didn\u2019t just focus on the obvious symptoms; she asked about diet, exercise, and my emotional, mental, and physical health in equal measure. The validation she offered was priceless. And she was so thorough that she caught something both my primary care doctor and previous gynecologist had missed: uterine fibroids. (But that\u2019s a story for another post.)<\/p>\n<p style=\"font-weight: 400;\">Two months into hormone replacement therapy, I could cross off every single symptom on my list. No more sleepless nights. No more constipation. No more mouth sores or bleeding gums. No more feeling like I was unraveling mid-cycle.<\/p>\n<p style=\"font-weight: 400;\">As Dr. Yehl later shared with me:<\/p>\n<blockquote>\n<p style=\"font-weight: 400;\"><em>\u201cIn an ideal world, we\u2019d sit down with women around age 35 to give them a preview of perimenopause and menopause\u2014what symptoms to look out for and how to prevent chronic disease. So many women feel like they\u2019re losing themselves as anxiety, depression, cognitive changes, and physical symptoms creep in. It\u2019s a very isolating time for many women when their bodies and minds change in unsettling ways. If they only knew that there are doctors who understand\u2014and can recognize and treat these symptoms. There is hope, and there is help.\u201d<\/em><\/p>\n<\/blockquote>\n<h3><strong>The Cost of Going to a Menopause Specialist<\/strong><\/h3>\n<p style=\"font-weight: 400;\">Most menopause specialists are out-of-network for health insurance. The few practices I reached out to charged anywhere from $400 to $975 for an initial visit\u2014though things are admittedly pricey in the NY\/NJ area.<\/p>\n<p style=\"font-weight: 400;\">Add to this the fact that most health insurance companies only cover some forms of estradiol and often don\u2019t cover progesterone or testosterone at all. At present, I shell out $67 a month for HRT.<\/p>\n<p style=\"font-weight: 400;\">Many women don\u2019t have the resources to jump through the hoops necessary to get the care all women should have access to. That\u2019s the part that\u2019s hardest to swallow.<\/p>\n<h2>You Are Not Alone<\/h2>\n<p style=\"font-weight: 400;\">If you\u2019re struggling with perimenopausal or menopausal symptoms and feeling dismissed or confused, you\u2019re not alone\u2014and you don\u2019t have to suffer in silence. The lack of menopause education in our healthcare system leaves too many women untreated and unheard. But there are providers who are knowledgeable, compassionate, and ready to help. To find a menopause-informed practitioner near you, visit\u00a0<a href=\"https:\/\/menopause.org\/\" data-start=\"500\" data-end=\"546\" class=\"external\" rel=\"nofollow\">The Menopause Society.<\/a><\/p>\n<p><strong>How has your perimenopause journey been going?<\/strong> <em>\u2014Karin<\/em><\/p>\n<hr\/>\n<p style=\"font-weight: 400;\"><strong>References<\/strong><\/p>\n<ol style=\"font-weight: 400;\">\n<li>Coslov, N. (2024).\u00a0<em>\u201cNot feeling like myself\u201d in perimenopause\u2014what does it mean? Observations from the Women Living Better survey<\/em>.\u00a0<em>Menopause: The Journal of The North American Menopause Society<\/em>.\u00a0<a href=\"https:\/\/journals.lww.com\/menopausejournal\/fulltext\/2024\/05000\/_not_feeling_like_myself__in_perimenopause___what.6.aspx\" class=\"external\" rel=\"nofollow\">https:\/\/journals.lww.com\/menopausejournal\/fulltext\/2024\/05000\/_not_feeling_like_myself__in_perimenopause___what.6.aspx<\/a><\/li>\n<li>Cuyuna Regional Medical Center. (n.d.).\u00a0<em>Addressing the knowledge gap in menopause<\/em>.\u00a0<a href=\"https:\/\/www.cuyunamed.org\/knowledge-hub\/addressing-the-knowledge-gap-menopause\/\" class=\"external\" rel=\"nofollow\">https:\/\/www.cuyunamed.org\/knowledge-hub\/addressing-the-knowledge-gap-menopause\/<\/a><\/li>\n<li>AARP. (2022).\u00a0<em>Menopause knowledge gaps report<\/em>.\u00a0<a href=\"https:\/\/www.aarp.org\/health\/conditions-treatments\/menopause-knowledge-gaps-report.html\" class=\"external\" rel=\"nofollow\">https:\/\/www.aarp.org\/health\/conditions-treatments\/menopause-knowledge-gaps-report.html<\/a><\/li>\n<li>Pal, L., &amp; Santoro, N. (2022).\u00a0<em>Menopause medical education around the world: The way forward to serve women\u2019s health<\/em>.\u00a0<em>Case Reports in Women\u2019s Health, 36<\/em>, 00385.\u00a0<a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2451965022000722\" class=\"external\" rel=\"nofollow\">https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2451965022000722<\/a><\/li>\n<li>Carr, D., &amp; Manson, J. (2019).\u00a0<em>The controversial history of hormone replacement therapy<\/em>.\u00a0<em>National Library of Medicine<\/em>.\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6780820\/\" class=\"external\" rel=\"nofollow\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6780820\/<\/a><\/li>\n<li>UR Medicine Menopause and Women\u2019s Health. (2014).\u00a0<em>Was the Women\u2019s Health Initiative good or bad?<\/em><a href=\"https:\/\/www.urmc.rochester.edu\/ob-gyn\/ur-medicine-menopause-and-womens-health\/menopause-blog\/december-2014\/was-the-women-s-health-initiative-good-or-bad\" class=\"external\" rel=\"nofollow\">https:\/\/www.urmc.rochester.edu\/ob-gyn\/ur-medicine-menopause-and-womens-health\/menopause-blog\/december-2014\/was-the-women-s-health-initiative-good-or-bad<\/a><\/li>\n<li>Lobo, R. A. (2005).\u00a0<em>WHI clinical trial revisit: Imprecise scientific methodology disqualifies the study\u2019s outcomes<\/em>.\u00a0<em>American Journal of Obstetrics and Gynecology, 193<\/em>(4), 1030\u20131036.\u00a0<a href=\"https:\/\/www.ajog.org\/article\/S0002-9378(05)01186-5\/fulltext\" class=\"external\" rel=\"nofollow\">https:\/\/www.ajog.org\/article\/S0002-9378(05)01186-5\/fulltext<\/a><\/li>\n<li>PubMed. (2023).\u00a0<em>Needs assessment of menopause education in United States obstetrics and gynecology residency training programs<\/em>.\u00a0<em>Menopause, 30<\/em>(10), 1150\u20131158.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37738034\/\" class=\"external\" rel=\"nofollow\">https:\/\/pubmed.ncbi.nlm.nih.gov\/37738034\/<\/a><\/li>\n<li>Contemporary OB\/GYN. (2023).\u00a0<em>Survey shows menopause curriculums lacking in residency programs<\/em>.\u00a0<a href=\"https:\/\/www.contemporaryobgyn.net\/view\/survey-shows-menopause-curriculums-lacking-in-residency-programs\" class=\"external\" rel=\"nofollow\">https:\/\/www.contemporaryobgyn.net\/view\/survey-shows-menopause-curriculums-lacking-in-residency-programs<\/a><\/li>\n<li>North American Menopause Society. (2023).\u00a0<em>Lack of menopause education for residents<\/em>.\u00a0<a href=\"https:\/\/menopause.org\/wp-content\/uploads\/press-release\/lack-of-menopause-education-for-residents.pdf\" class=\"external\" rel=\"nofollow\">https:\/\/menopause.org\/wp-content\/uploads\/press-release\/lack-of-menopause-education-for-residents.pdf<\/a><\/li>\n<li>AARP. (2023).\u00a0<em>Menopause symptoms: Doctors, relief, and treatment<\/em>.\u00a0<a href=\"https:\/\/www.aarp.org\/health\/conditions-treatments\/menopause-symptoms-doctors-relief-treatment\/\" class=\"external\" rel=\"nofollow\">https:\/\/www.aarp.org\/health\/conditions-treatments\/menopause-symptoms-doctors-relief-treatment\/<\/a><\/li>\n<\/ol>\n<\/div>\n<p><script async src=\"\/\/www.instagram.com\/embed.js\"><\/script><br \/>\n<br \/><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script><br \/>\n<br \/><a href=\"https:\/\/fitbottomedgirls.com\/2025\/07\/perimenopause-and-hormone-replacement-therapy\/\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I distinctly remember my first hot flash. My husband and I had stopped for breakfast on our way to Atlantic City for an overnight stay. Sitting in the booth across from him, I suddenly felt heat rising through my body\u2014like someone had turned up my internal thermostat. I started laughing. \u201cI think I\u2019m having my &hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-14770","post","type-post","status-publish","format-standard","hentry","category-fitness"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/14770","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14770"}],"version-history":[{"count":0,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/14770\/revisions"}],"wp:attachment":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14770"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14770"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14770"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}