I misdiagnosed my own perimenopause…
How can that be, you ask?
When I was in my 40’s, I was a busy OBGYN, still delivering babies at all hours of the day and night. I was tired all the time. I started having menstrual migraines on my birth control pills, so I started taking them continuously to avoid the drop in hormones that caused the headaches. This was great–no bleeding, no headaches. I also assumed that I could ride that train all the way into my early 50’s, when I could switch to menopausal hormone therapy. I wasn’t supposed to have any menopause symptoms on birth control pills, right?
What I did not realize, and did not understand until several YEARS later, was that the anxiety I had developed, the palpitations that accompanied the panic-attack feeling, the loss of the ability to remember words or to multitask (my superpower when my kids were young), or even the increasing fat around my belly, were perimenopausal symptoms. The pill did not prevent them. I was just: not exercising enough, eating too much, drinking too much, too stressed out, and burned out. (I was also burned out…, but that’s a whole other story.)
I talked to my therapist about going on a low dose SSRI for my anxiety. She supported the idea, but could not prescribe. So I wrote myself a Zoloft prescription. She never mentioned perimenopause (after all, I was the gynecologist, right??)
I told my husband I thought I was developing dementia. He reminded me that I had tested negative for the ApoE4 mutation on 23&Me. That was only mildly reassuring.
I secretly went to get cool-sculpting to get rid of some of the belly fat.
I went to PT to work out the decreased range of motion in my shoulder. (Why couldn’t I fasten my bra all of a sudden??)
I took a trip to Canyon Ranch to work on my burnout and redirect my purpose.
When I started to get some subtle hot flashes, I was so confused! I went to my computer and searched “hot flashes on oral contraceptives” and came up empty. WTAF?!
So I switched at that point to Estrogen and Progesterone. But it was not until I did a deep dive to further my understanding of perimenopause and menopause that I realized what had happened to me, right under my own nose.
I am happy to say that there is a reason why these symptoms can happen even while taking birth control pills. Pills contain ethinyl estradiol; it’s not the exact same molecule as estradiol, so it does not act exactly the same on the estrogen receptors in the body. Similar, but not the same.
So if you are gaslighting yourself like I gaslighted myself, or your doctors are telling you your symptoms are nothing to worry about, or they want to prescribe you an SSRI, please advocate for yourself, and seek out the answers you deserve. Don’t assume that your long-term ob-gyn knows enough to recognize and/or manage the complexities of your care. Ten years ago, I was that doctor. I tell you this story to make the point that if I didn’t even know what was going on, how can your doctor who has 15 minutes with you ever scratch the surface.