Last week I went for my first post-op physical. I, thankfully, found a PCP who listened to me, who didn't assume that she knew everything about me and what I needed, and who heard my needs and said she could help me. We've discussed what she can help me with, and what I will need to work with specialists on. The physical was pretty basic, but we agreed to do a full panel of hormone tests, just to see where I'm at. They would call if anything came back abnormal.
Over the phone, the nurse told me that my estrogen was low and that I should see a gynecologist. "What does low mean?" "Hang on, let me look. Your estrogen level is 6.1. Do you have a gynecologist?" "Not really. But I will find one."
Commence Googling. Turns out that typical estrogen levels for non-menopausal women are somewhere over 100, depending on where you are in your cycle. Menopausal women who are taking hormone replacement therapy are typically between 40-50. Women in menopause who are not taking hormones typically fall somewhere between 10-20. Mine is 6.*
Six.** Well, that explains a lot. If you Google "menopause symptoms" I can run my finger down the list - check, check, check. Sleeplessness, moodiness (not so much, but sure), hot flashes or night sweats, dry skin/eyes/mouth/vagina, lack of sex drive. I've definitely had a feeling that this was coming. But, I was not prepared for "six."
This was not the plan. The plan was to do excision surgery, remove any sick organs that were causing me pain, and do no harm. Going into the surgery, I knew that I would keep at least one ovary, specifically to prevent me from going into menopause. During the surgery, my surgeons realized that the endo was much more extensive than we anticipated, and did their best to correct as much as they could. One ovary was so covered with scar tissue and endometriosis that it couldn't be clearly identified, and was removed. One ovary was cleaned up, put back in place, and left there. The intention was that it would do its job, and my "normal" hormone cycle would reset itself. I would not go into menopause.
Clearly, no one told my ovary about this plan. Yet again, my body has let me down. It's not cooperating. And, I know that it is sick, and there's very likely nothing I can do to help it at this point. But, I am so frustrated and so disappointed, yet again. My periods were excruciating, I couldn't get pregnant, I was in pain every day, and now this? Menopause??!! For fuck sake.
I've been having familiar feelings of hopelessness since I found out. Of exhaustion, and woe-is-me. I can't believe I've another obstacle to face. I had been feeling so well the past few months, I thought I had turned a real corner with my health and my relationship with my body. But, now I am here again. In this place where there is a problem. I need to figure it out. I don't fit the mold/story/path of other women, and feel that I have to forge my own path. Who will show me how to do this? I feel alone. I feel frustrated. I feel sad. Really sad. I don't so much feel sad about the loss of my fertility - that's been grieved time and again. It is mostly behind me. But, I feel a different loss. Of something deeper and more womanly. Of a way of feeling and being that will simply be different now. Not so much the health complaints, but the sensuality and sexuality and feeling like a woman with desire and who is desired, which right now feels so linked to this one hormone - estrogen.
So, now I've got a lot of questions. As usual. What is menopause? Am I "in" it? Is surgical menopause different? What happens to women in premature menopause? What risk factors do I need to be aware of now? Are my bones ok? Does this count as surgical menopause, since it's really that my ovary failed? Can I take hormones? What do I do if I can't take hormones? (Here's a fun twist - taking estrogen is recommended for most women in early menopause. Estrogen feeds endometriosis. Women with severe endometriosis are often discouraged from taking estrogen. Haha!) Which of my symptoms are meno and which are endo? How do I manage my symptoms? Where on earth (literally) am I going to find a doctor who can help me with all of this? Who can see a 35 year old woman who has severe endometriosis, other chronic conditions, a hysterectomy and surgical menopause? Where is my tribe?
I need some time to sit with this. Feel my way through it. Reassure myself that I am ok, I will be ok, I can find some of the help that I need. And mourn the losses that I'm feeling. Sweatpants and Gilmore Girls, anyone?
*I am not a medical professional. I just use the internet. Please ask your doctor if you have questions about your estrogen levels, endometriosis, or menopause.
**Yes, hormone levels can fluctuate. No, I don't think mine are really going to fluctuate enough for me to feel like "Hey! I'm not really in menopause!" There's something going on here.