Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

Dear Dr. Pat:

I am 45 years old and terrified of menopause. I am beginning to be short-tempered, and my PMS is worse. I have night sweats with my period now. I still have regular periods, so I know these symptoms could really become unmanageable.

My mother, who smoked (and drank too much on weekends), was always hot-tempered, but when she hit her mid-40s, she became a crazy person. I was 15 and no piece of cake myself, with PMS and the usual teenage miseries. I had no help from my mother with any of this. She would berate me and occasionally hit me with a wooden spoon. She became so hard to live with that my father left and got a divorce from her when I was a junior in high school. He told me how guilty he felt because he left me behind, but he tried to help, and he did take care of us financially.

I was able to talk to our school nurse a lot after this, and spent as much time as possible with the families of friends, since I never knew what kind of mood my mother would be in. I survived, though, and left home at 17 to go to  college. I did well enough academically, although I did drink a lot and had a great many sexual relationships that I always hoped would become something else. Whenever I was blue or afraid of the future or ashamed of mistakes I made in college, I always wanted a mother to talk to. I was lucky that my roommates’ mothers were kind and had some sense. I developed relationships with these women that exist to this day.

I finally saw a therapist after college, really sorted my stuff out, chose not to drink at all, and became a respected guidance counselor. I love my work and I am very gratified that I have had the chance to mentor hundreds of high school students in my career. I married a wonderful man and have two teenage daughters who are just great. My older daughter has just left for college.

I wanted to start hormone therapy before these symptoms get worse, but my mother and her sister both had breast cancer in their late 40s and my mother died from it before she was 50.  My doctor told me that hormones are not a good choice for me because of this family history.  I am more and more terrified of breast cancer—so terrified that I have not had a mammogram in two years.

These fears of becoming just like my mother, treating my husband and children badly, ending up with a divorce and children who don’t want to see me, and then dying of breast cancer are in my head all the time now. I read all the information about menopause management but am stuck. I don’t know where to start to make any change in my life. I vowed that when I married and had children I would not replay my mother’s story over again.

What can I do?

Cynthia

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