Factory Closed

Please Note: This is for informational purposes only.  It should not be taken as medical advice or used as a substitute for professional medical advice, diagnosis, or treatment.  You should always consult with your own physician before implementing this information.

When I worked on a skilled nursing facility as a nurse, I remember caring for this ninety-two-year-old patient. While doing my rounds one evening, I noticed that her call light was on. Upon entering her room, I could tell that she wasn’t feeling well. “May, what’s wrong?”

The woman brought her hand to her forehead and closed her eyes, “My stomach, I feel nauseas.”

“Oh no.” I sat down in the chair next to her bed. “When did this start?”

She pressed the button on her hospital bed control and slowly rose to a thirty-degree angle as she responded. “About an hour ago. I don’t know, maybe I have gas or something.”

Knowing my patient I commented, “Well, maybe your pregnant!”

After a moment of shocked silence May smiled. “Ha! I would cry a bucket of tears if that was true!” We both laughed, thankful that it truly was a farce.

Thinking back on that memory, I totally get the reaction from May. Today I too would cry a bucket of tears. If not for the reason that I was actually with child but because I would think God had played a joke on me and I had just been transported back in bible time becoming Sarah, Abraham’s wife.

At age sixty-two I am thankful to be past the fertile stage and happily refer to my uterus as an abandoned baby making factory.

A few months ago, I started on hormone replacement therapy, HRT. I have been doing well on this. Being on estrogen was like being given back a workable body that I could live with. If anything, just being able to get up in the morning and not feel like an old lady struggling with painful joints is a dream come true.

But there is more to the HRT story. Because I have this uterus there is maintenance that must be kept up while enjoying the benefits of estrogen replacement. Evidently those shriveled up ovaries had another purpose beside producing estrogen. They used to supply my body with progesterone.

So, what’s the big deal, I thought. All I need is some estrogen to help me feel better. Why must I take another hormone and add to the pills I already consume?

During my reproductive years, progesterone was working in tandem with estrogen to help prepare the lining of my uterus for a possible baby in the making. Okay, that’s good but why do I need to take it with estrogen now? 

Evidently if I only take estrogen by itself while I still have a uterus, the hormone can cause thickening of the lining (endometrial hyperplasia) and increase my risk for uterine cancer.

Whoa! Who wants cancer. Give me the progesterone!

FYI, women who no longer have a uterus do not need to take progesterone. Lucky them!

Subsequently, when I began the HRT, the instructions read to take the progesterone at bedtime. Well, I thought, I’ll just take the pill with my other dinner medications. Who wants to take another capsule later. Right?

After my evening meal I normally go out to the fitness room and spend an hour on the stationary bike. This is so I can work off the chocolate I had just consumed and keep my heart and joints in shape. But something weird was happening. About twenty minutes into my virtual bike ride in Italy, I started getting dizzy. Now this wasn’t just a swirling of the head, this was a full onset of drunkenness. Have you ever tried riding a stationary bike while feeling drunk? It’s the weirdest sensation.

Then when I tried walking, I had to hold onto objects or brace myself against the wall in order to stay upright. Giggling I hollered to my sister, “I feel like a drunken sailor!” Too bad we don’t have cameras in our home because I think my little jaunts from the fitness room to my bedroom might have been pretty comical.

While trying to keep myself upright and avoid falling, I had this incredible desire to go to sleep. The problem was it was only seven thirty in the evening. Before I knew it, I was changing into my pajamas, brushing my teeth and getting into bed. It was like the sandman had thrown a full bag of sleep dust in my face and said, “Off to Lala land you go!” Yes, I slept really well.

After a couple weeks of this intermitted feeling of drunkenness and desire to sleep, I did a little research and learned that a common side effect of oral progesterone is drowsiness & dizziness. Then I took a closer look at the progesterone bottle. The label read, take at bedtime. Oh yeah, I thought, maybe I should try taking it at bedtime like it says.  Perhaps I could avoid the lightheadedness and delay the sleepiness feeling until I actually want to sleep.

After trying this for a few days, I discovered that I didn’t have the drunk feeling, probably because I was already horizontal, and within ten to fifteen minutes I was asleep. I was feeling quite proud of myself that I had discovered this solution thinking even the famous medical scientists would have praised me for this new finding.

So, what part of bedtime in the instructions did I not understand? All I can say is that it’s a Gwen thing. I sometimes go full throttle then read instructions later! For crying out loud, I’m a nurse! I guess it was good for me to experience it so that I could let everyone know what an idiot I am and how it felt!

Anyways, if you have a uterus and are thinking about HRT then you will want to take progesterone.  Oral Pills is the most common form to take. There is also the Intrauterine Device (IUD). Transdermal Patches are also available but are not effectively absorbed through the skin. Injections are less common. I also read that you can have a custom topical progesterone made but the debate is if that cream is adequate enough to protect the uterine lining.

The downside is there is an estimated 10-20% of women who experience progesterone intolerance, leading to side effects like mood swings, anxiety, depression, acne, bloating, and fatigue. My advice to you is if you start HRT and you’re experiencing some side effects, please communicate with your physician. Everyone is different. The whole point of HRT is to feel better, right? So, don’t suffer through it. Find solutions so you can enjoy being in your menopause phase.

Please note that not all woman are candidates for HRT. This is a conversation that you MUST have with your physician when considering HRT.

I’m not certain how long I will be able to take HRT.  As I read more about HRT, I realize this requires an individualized approach that is tailored to each woman’s symptoms, health risks, and personal preferences. This means that I will need to remain aware of my body and of any symptoms that may arise, stay in communication with my physician, and be consistent with my regular check-in visits.

Honestly, women give so much of themselves in their early years. Having the baby making factory close should be a cause for celebration; a rite to passage to the older years. Struggling with our bodies should not be a part of this scenario.

So, let’s be smart about our aging body and utilize all the available resources that are accessible to us to enhance the quality of our later years.

“So many women I’ve talked to see menopause as an ending. I’ve discovered that this is your moment to reinvent yourself after years of focusing on the needs of everyone else.” – Oprah Winfrey

Image by Vadym Pastukh on iStock

Gwen