Tuesday, September 19, 2017

Growing Old and Medicating

Another day has blown past me. I keep reciting my three-things-a-day mantra, but some days it's less effective than others. I don't even know what I got done today, but I know I decided against hormone replacement therapy (HRT). I am post-menopausal (TMI!!), and my new doctor was all rosy about HRT when she first mentioned it to me over a month ago. She touted it as the end all be all for obliterating hotflashes, preventing osteoporosis, decreasing the risk of some cancers, and keeping your skin and boobs taut. Who doesn't want taut skin and boobs I ask you? HRT is also linked to improving mood through increased serotonin and neurotransmittergamma-aminobutyric acid (GABA) production. An end to depression and anxiety? Sign me up!

When I went in after my lab tests to see what my hormone levels were (and progesterone and estrogen were non-existent--I suppose that's normal for my age), I had an appointment with the PA as the doctor was on vacation for three weeks. The PA gave me a sheet of paper with the potential side effects of the medications and had me sign it. She didn't have any further information to offer me about HRT, and didn't say anything specific about my medical history that would argue for or against the treatment.

But then I talked to Bill, who is also a doctor and who is someone I trust implicitly, and he wasn't wild about HRT and urged me to do more research and make my own decisions. My own research led me to the Mayo Clinic site and an article on HRT and heart disease. The clincher for me was at the end: "If you already have heart disease or you have a history of blood clots, the risks of hormone therapy have been clearly shown to outweigh any potential benefits." Considering I went to see my current doctor right after an episode of extreme blood clots in my kidney, I was more than a little surprised that she thought HRT was a good idea for me. I can put up with hot flashes, saggier skin and boobs due to loss of collagen, and look for another solution to any possible osteoporosis issues. It will also be nice to not have the additional cancer risks associated with HRT. It's also time to find a new doctor. Again.

I am not ready to go the route of the new trend in medical care--a boutique doctor who takes a limited number of patients, accepts only cash (no insurance), and has a membership fee that guarantees weekend and off-hour immediate access--but I am ready to make a change. Fortunately I met a very nice family physician at a clinic very near to us who is accepting new patients when I took Jessie in for dermatitis and allergies a couple of weeks ago. Now if I can just find her card...

3 comments:

ellen abbott said...

I didn't do HRT either. I am a little suspicious of the trend to keep us forever young. we aren't young. and the body has a reason for stopping the production of those hormones and things. I do have osteoporosis but have declined the medication because I don't like the way they work, they don't really work, and the side effects are heinous. I choose physical activity and eating the right things and keeping a strong musculature system which protects the bones.

Cynthia said...

I had a hell of a time as menopause approached and eventually started HRT. I was experiencing crazy land level anxiety, sleep deprivation (mostly caused by night sweats), depression, and I am osteoporetic (but that is more easily attributed to my smoking history...too bad That didn't reverse when I quit, eh?) the HRT ended all of that disruption. I have tried to stop the meds on a number of occasions because this was only meant to be a temporary remedy...buy I would end up right back in crazytown. I have a new doc. She tells me I have to stop the HRT due to the risks it poses to my health. She prescribed a very slow taper, which I have followed over the last 10 mos., and I am down to almost a homeopathic dose level (I am exaggerating...a tiny bit). So far so good. I just wish my former doc had her approach to helping me make this work. I liked not having anxiety and depression most of all. I could live with the hot sweaty outbreaks.
If you are having troubles that are extreme due to menopause, I have heard from several women that they were taking an SNRI for the vasomotor symptoms and it worked.
Good luck with the new doc.

Bill said...

I'm glad you took the time to really look at the data. Best wishes for ongoing good health!