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The story I’m about to share is sadly not unique, no matter how egregious it is. In fact, it seems to be the norm rather than the exception. According to a 2022 SHE Media survey, over 70 percent of female respondents experienced medical gaslighting. Over 70 percent were also told by a medical practitioner that their symptoms were made up or imagined. To make matters worse, other research suggests women are twice as likely as men to be diagnosed with a mental illness when their symptoms are consistent with heart disease. The violations of trust seem to be endless. If women can’t have faith in healthcare providers to truly listen and provide conscientious care, where does that leave us?
Welcome to Menopause
Two years ago, as I turned the corner to forty-six, my brain exited stage left without warning. As someone with a voracious appetite for reading, the most unusual thing happened; my vocabulary dried up. In meetings I found myself grasping for words a toddler would have on the ready and it was a wonder I remembered the ABCs. Soon after, my intermittent work-induced insomnia became a permanent condition. Two to three days straight without sleep became the weekly norm.
Although my sanity was degrading, I remained committed to daily HIIT workouts and a sugar and carb-free diet because I believed staying healthy would offer me a lifeline. My reward? Oddly placed pockets of fat and an extra ten pounds. Add to that night sweats, zero interest in the no pants dance (which was miserably painful when it did happen), and my period now consistently arrived a full week early. Something was clearly off.
Is This Mic On?
Consulting my OB-GYN should have felt like the obvious next step. Yet it wasn’t. A few years prior I requested she take out an uncomfortable IUD that was causing embarrassing health issues, to which she replied, “it’s all in your head”. After an argument, she reluctantly removed it and mockingly waved the IUD in my face before leaving the room. It seemed unlikely this woman would offer much compassion and I had no intention of giving her another opportunity to shame me.
Instead, I took my chances with my general practitioner who seemingly paid close attention to my health having recently suggested I ease up on my somewhat neurotic fitness regimen. As I prattled off my list of ailments, she encouragingly nodded her head in what I believed was sympathetic agreement but then began wrapping the exam without a diagnosis or follow-up questions. Desperately, I shared my perimenopause self-diagnosis and asked if we could discuss hormone replacement therapy. I was not prepared for her response.
Rather than confirm my suspicions, offer bloodwork to get insight or any other validating or helpful insights, she shut me down. Not only did she tell me to eat healthier and exercise more - behaviors she had just cautioned were too extreme - she firmly said she was not allowed to discuss HRT with patients. And that was that.
It should not have come as a surprise that my doctor was so unsupportive. A 2019 Mayo Clinic Proceedings survey found that just 7 percent of new physicians in family medicine and gynecology felt adequately prepared to deal with menopause, with 20 percent reporting they had not received a single lecture on the topic during residency. However, that does not excuse what comes next.
Bad Medicine
When all else fails, Google, right? In my quest for relief, I was drawn to an online hormone replacement therapy provider with comforting branding and promises of rejuvenation. Doctor-prescribed, science-backed, and testimonials galore, I took a chance. After a short quiz and 5-minute doctor chat room consult, a prescription was delivered regularly to my doorstep for the next year-and-a-half. While I never entirely lost the weight and occasionally struggled with insomnia and libido, I did feel better. I never thought to question the fact that I’d never had my hormones tested, or an in depth conversation with a clinician, or any follow-up outside of approving the next charge to my credit card. However, in retrospect, the whole thing should have been suspect from the get go. I’d been let down once more.
After speaking with Wellcore Chief Medical Officer Dr. Mihnea Dumitrescu, I learned healthcare providers use hormone test results combined with other factors such as patient symptoms and medical history to reach a diagnosis and customize a treatment protocol. Prescribing a treatment without first reviewing a person’s unique data and having a live discussion is essentially treating a woman’s health like a guessing game. Beyond that, ongoing testing allows a provider to responsibly monitor treatment response and adjust for hormone fluctuations due to stress, lifestyle changes, etc. I was in a place in my life where all those things were occuring.
With this new information, I immediately ordered a hormone assessment test which confirmed my fears - I was being treated incorrectly. The Wellcore specialist who reviewed my results noted my testosterone was extremely low, yet I was receiving estrogen which was testing above normal. Too much estrogen can cause weight gain, fatigue and loss of sexual desire among other things. And I was currently struggling with all three.
Avoid Becoming a Passive Patient
It can be uncomfortable to advocate for yourself. However, if Oprah can have her first menopause symptom misdiagnosed by five different doctors, how can the rest of us feel confident we are being heard? There are over 30 symptoms of menopause due to hormonal imbalances and fluctuations, including brain fog, anxiety, joint pain, loss of libido, and bloating. This leaves a tremendous amount of room for mistakes, especially with a woefully uneducated medical community.
In spite of what may feel like insurmountable challenges, there are measures women can take to help ensure they receive the care they deserve such as these tips curated by .the New York Times:
After spending the majority of my forties feeling like I didn’t have a voice when seeking medical guidance, I am finally learning what it takes to have my own back. Gender bias in healthcare is a real thing. And, intuition can be a powerful tool. If something doesn’t sit right, women should feel empowered to investigate their options, secure additional opinions or find another provider. Joining a community of women experiencing menopause such as the Menopause Support Group, which has over 130,000 members, can also provide encouragement and advice through their shared experience.
Women unknowingly risk their health every day due to laziness, greed and lack of empathy. There is no acceptable reason for a healthcare provider to take shortcuts and it’s time we flip the script.
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