His and Her Health

Hello everyone, I'm a new member here. The reason I'm here is my wife, I believe, is going through early menopause. She just turned 40 in July.

Here's the story. My wife of 14 years has told me that she no longer feels that she loves me. She says she has felt this way about a year but was afraid to tell me. She's suggested that she may want a separation/divorce. There is no history of physical/mental abuse on my part. She's broken down many times saying she's so confused and doesn't know what she wants. She can't answer my questions.

Her history is a smorgasboard of depression and addiction to demarol. She was diagnosed with depression in 1995 and has been treated with meds since. Including Wellbutrin (current) Cymbalta(current), Abilify (stopped). She has been clean and sober since 2002.

She had a hysterectomy because of Adnomyosis(lining of uterus growing into the walls of the uterus) but did not have her ovaries removed. She has been suffering with night sweats, leg cramps, feeling jittery, irritability, mood swings. Her libido has gone up and down and now is totally gone, and as well as I stated her passion for me, and her love for me. Our sex life has come in waves from meh..to WOW..to meh..to Emergency Stop!!

Her OB/GYN has suggested that she try Black Cohosh, Vitamin E and start back on the Cymbalta.
He is not a fan of Estrogen replacement therapy.

The wife and I have sought out a marriage counselor and our first meeting with her is on the 15th of Sept.

I'm at a loss. I've done so much crying the past few weeks.

I was wondering if there were any women that have experienced this or something similar. Or if any men that may have read this, to shed a little light on what helped them.

Cause I'm pretty much a pile of emotional jello now.

Thanks..

telleophone, we will see if we can help. Please visit these two websites. You will find lots of information and we hope to supply you with some answers.
www.redhotmamas.org and www.menopausewise.com

Here is a response from Red Hot Mamas Medical Expert, Dr. Mary Jane Minkin:

Telleophone-

I hope we can help. I really appreciate your concern for your wife -and clearly your devotion to her and her problems. And let's see what might be going on.

You are correct-it is unusual to go through menopause this young-however, when a hysterectomy is done, it can lead one to an earlier menopause-and actually, 1% of women are menopausal by the time they are 40, even without having undergone a hysterectomy.

It really sounds to me like your wife would be an ideal candidate for estrogen therapy. There is actually a lot of good data, showing that women who go through menopause at a very young age will benefit by estrogen replacement therapy-and since your wife has had a hysterectomy, she would not require any progestin therapy (that's only for women who have their uterus still in-to prevent overgrowth of the lining of the uterus from the estrogen.)

She would be an excellent candidate for a transdermal approach-reassure her that one could prescribe the same estrogen that her ovaries were making, when they were making a good amount of estrogen (ie, truly "bioidentical")-she could receive the estrogen either through transdermal skin patches, or gels, or even a spray. I really think that she would feel better-her hot flashes would be better, she would most likely sleep better, and it is possible that her depression might even improve. And with all that better, she would be much more likely to have improved libido, too.

Now of course it is possible that the Cymbalta could be contributing to decreased libido -but of all the antidepressants, Cymbalta actually seems to have less of an effect on decreasing libido (say, compared to something like Prozac).

The next question that I would also think about is would she benefit from the addition of testosterone for libido? There is some data to show that women who are menopausal do benefit from the addition of testosterone-the problem is that there is currently no commercially available testosterone for women in the US-but it can be obtained through a compounding pharmacy. But I wouldn't start with testosterone-I would try the estrogen first, and probably give it about three months-besides, it might require some time to adjust the dose. If she didn't respond to just the estrogen, then I would consider adding the testosterone.

I am sorry to hear that your wife's gynecologist is not in favor of estrogen therapy in this situation. I would suggest that she consult another gynecologist in the area; if you cannot locate one, please go to the website of the North American Menopause Society, menopause.org; on this site is a list of certified menopause practitioners throughout the country, and you could hopefully find someone locally to consult for you.

Best of luck to the both of you,

Mary Jane Minkin

Thank you for your reply. I will share this with her.