Suddenly, Menopause: Dealing With the Psychological Impact

For today’s post, Dr. Patricia Yarberry Allen has asked psychologist Cecilia M. Ford to comment on the problem that Dr. Allen addressed in this week’s Medical Monday column, “Surgical Menopause Before 40: What to Do When Standard Treatment Fails.” Dr. Ford, who writes regularly for Women’s Voices, is a clinical psychologist with more than 30 years’ experience as a psychotherapist in New York City. She is a specialist in women’s emotional health; her areas of expertise and interest include marriage and relationship therapy, parenting, sexual health and menopause, eating disorders and addictions, and body image. She also researches and advises women over 40 about Internet dating.


Here is the note to which Dr. Allen responded on Monday.

Dear Dr. Pat:

I had a complete hysterectomy for a terrible pelvic infection when I was 38, shortly after the birth of my only child, a son who is now 2 years old. When I had the hysterectomy, my ovaries were removed as well because they were involved with the infection. My gynecologist told me to wait six weeks until I had recovered from the surgery and prescribed an estrogen pill to “control menopause and protect my bones.” He said because I was young I should start out with a dose that would be “normal” for a young woman. He prescribed three different pills over six months and I could not tolerate any of them. I tried Estrace, Estratab, and Premarin. All of these hormone pills gave me breast tenderness, breast enlargement, nausea, water retention, and seemed to worsen my depression. I had never tolerated the birth control pill for the same reasons, actually. I next tried a patch, but was allergic to the adhesive. I tried the Femring, but I had constant yeast infections from that ring in my vagina all the time. After nine months of this, both the gynecologist and I just threw up our hands and I decided to tough it out.

But I have no libido, painful sex, constant flashes, flushes and sweats, no sleep, fatigue, and terrible moods. I have gained 30 pounds, don’t have the will or energy to exercise, and I certainly feel bad about myself. I was always fit and energetic. My husband has been understanding, but he wants me to just “pull out of this” after two years, so my marriage is starting to suffer, my child is suffering, and I barely manage to stay employed at my job of 10 years in HR, because I just do the minimum. I have little interest in seeing people or doing things that used to interest me. I have tried acupuncture, herbal, and over-the-counter menopause remedies and nothing is helping. It has been two years since my hysterectomy. I don’t have any other medical problems, and no one in my family had cancer or heart disease. I live in a small Texas city and don’t have access to a big medical center with a menopause expert. My gynecologist is a decent but overworked man, and he doesn’t have much interest in dealing with a woman like me who seems to have a bad reaction to everything he prescribes. I need help, and I don’t know where to find it.


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