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Sunday, May 26, 2013

A Change of Life

The following post is about surgically induced menopause. Guys, don't say I didn't warn you! If you can't handle the hot flashes, get out quick... before it's too late! 

Menopause. Eeeek. Talking about the Change of Life is NOT something I planned to do at this stage of my life. Honestly, I thought I'd be heavily pregnant right about now with Baby #6, not sizzling in Hot Flashes and losing my memory, motherly charm, and youthful skin and bones. According to most things I've read, menopause occurs around age 51 in most Western Women. The ovaries no longer respond to the controlling hormones released by the pituitary gland of the brain. As a result, the ovaries stop releasing an egg each month and no longer produce the female sex hormones estrogen and progesterone. With the plummet in hormone levels in the bloodstream here come  the symptoms of menopause. In a typical woman, this is a gradual process. Over time, a missed period here and there, hot flashes etc.. I don't speak from experience on that one because, well, you know. Women who need to undergo complete removal of their ovaries, either as a preventative measure or as treatment for cancer or other diseases of the ovary, enter what's known as, Surgically Induced Menopause. Some treatments, such as chemotherapy for breast cancer, can also cause menopause. Surgically induced menopause is completely different from "normal" menopause. It's not gradual or natural. Premenopausal women who experience surgical menopause have more intense and sudden symptoms and therefore the emotional impact of induced menopause is significantly more intense than natural menopause. It just happens, BOOM!, the second you're out of surgery, BAM! Hot flashes!  That's what I remember first, waking up feeling hot and like my cheeks were tingling and flushed. Thankfully, it was the end of July, and the air-conditioning in my room, at Shaare Zedek hospital, worked well.

So, why am I writing about this? Menopause is probably one of those subjects that most people don't really want to talk about. It's ovaries and hormones, and some of the symptoms are pretty inappropriate topics for polite and proper conversation.... but you know what?! I would have really liked to know about all these unpleasant things that were going to happen to me back in July, 2012. I'd heard of hot flashes and learned about the risks of diminished bone density and increased risk of heart disease. Nobody told me that I'd lose my mind or experience bouts of extreme depression and memory loss let alone intense morning sickness and nausea, headaches, and joint pain. I'm 37 not 60. I'm not ready for any of this.

There are treatments to ease the effects. Anti depressants and HRT aka hormone replacement treatment. I refuse to take anti depressants. HRT is great, in theory, but for now it's not working. There are hormone patches, creams, and pills... all of them can increase risk of breast cancer. The risk depends on the woman and her own personal risk factors. Obviously all of this requires multiple doctors and experts and trial and error. I'm still in the trial and error phase.

The point of this post is to help get the information out there. Less than two weeks ago, Angelina Jolie, did a huge service to women at risk for hereditary breast and ovarian cancer. By sharing her story,  maybe a thousands or even hundreds of thousands of women at risk will take charge and consider genetic testing. Perhaps women with gene mutations will feel encouraged and inspired to consider taking steps to prevent cancer, like AJ did. I didn't know. I was clueless. Lots of people have taken to social media, Facebook, Twitter, everyone has an opinion on the subject. Some response is very negative and it's painful to read and experience the thought processes of others but I say GREAT! People are aware and discussing an issue that I didn't even know existed a year ago! Talking is awareness. The fact that this issue is in the mainstream media, lead by one of the world's most beautiful and recognized woman, is nothing but positive for women at risk for ovarian and breast cancer. "With this publicity and her speaking out, I have a feeling there will be increased requests [for BRCA testing]," Sandra M. Swain, MD, president of the American Society of Clinical Oncology, told Medscape Medical News.  I want people to know that early, surgically induced menopause is a serious challenge. It's not Cancer. It's not life threatening but it's life changing and it can be a debilitating ailment when it's not managed or balanced. Sadly, due to risks of other cancers, many women are not at liberty to take HRT and are left to suffer through the sometimes crippling side effects. It's a real thing and something to think (talk?) about.

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