His and Her Health

Well, today is the gyn visit. We'll talk about the symptoms I've been having, and see where it goes from there. I can't decide if I hope the tests will conclude I am entering the beginning phases of menopause, or that they'll come out negative. I don't really have any desire to go on HRT at this age, but then again, a full night's sleep without night sweats would be great. If it's not the start of menopause, that also leaves me trying to figure out what else it could be. I have several symptoms (very regular hot flashes and night sweats, mood swings, more joint pain than normal, weird weight issues, and a total indifferenc eto sex--though that last is definitely at least partially mental I have no idea if it could also be partially physical?), but I suppose they could be something else, as well. Wish me luck!

Chronic emotional stress is a possibility. Chronic infection or certain types of cancers are other possibilities.

Chonic emotional stess, while a big issue in my life 2 years ago, is no longer in the picture. The last many months have been some of the least stressful time I've had in my entire life, actually. And, I am fine regarding chronic infection and cancers, unless it's something fairly obscure. I am, for the most part, in excellent health (knees aside). Unless something really bizzarre shows up on my pap, of course, but she said everything looked good to the eye, at least. I am religious about my annuals, and for a very long time had paps evey 6 months due to some other issues (that was several years ago). <P>She did, however, say she suspects I am indeed perimenopausal, especially as there's a family history of it (Akham's razor: the simplest explanation is usually the correct one), and that my bc pills are likely to already be keeping some of the other or more extreme symptoms at bay. For the moment, she's leaving me on the same bc until the test results come back. She tested *everything* including thyroid and diabetes, hormone levels (even T and free T), and a bunch of other things I am not entirely sure about. She asked me to take some natural steps to begin helping to alleviate some symptoms, one of the biggest being to really increase my phytoestrogens (say hello to more soy) intake. I already excersize, don't smoke, drink very little and don't partake of caffiene more than maybe once every 2 months. She gave me some excellent literature to read, as well, on natural ways to control estrogen levels and perimenopausal symptoms. She doesn't want to start me on estrogen/progesterone replacement therapy right now if there is any way around it at all.<P>She did say that she suspects my T levels will come back low for a variety of reasons. She talked with me about 2% T cream, and it's role in osteo-related concerns. In my case, she's particularly worried about this because of my already omnipresent bone/joint issues. Especially since I've been on the pill so long, which can bind the free T. The bloodwork was done by a lab that works directly with her and a comounding pharmacy, and should be back within about 1-1.5 weeks. Actually, it'll be back within 72 hours, but it has to go to her first and she has to review it. She's asked me to up my calcium intake, and perscribed 2% testosterone cream for me 2 times a week to help with bone mass, cognitive functions, and help with the fatigue I've been experiencing. She uses T mostly in short "spurts" with her patients in menopause or who are perimenopausal to help duplicate more naturally the body's natural hormone balance. Once my results are back, she'll let me know what the on/off schedule will be. It may also happen that I will switch to the bc patch, and use the T cream very sparingly or not at all for a few years after this initial dose, since the patch doesn't bind the T. I'll know more in a few days. My one concern, and one she addressed with me, is that the T might raise my libido, as might the patch. Her own husband has medical prostate issues that render him impotent, so she understands how difficult it can be. It might happen with any HRT regimine, it appears, and she's said to let her know if it become troublesome and she'd see if the dose could be changed, etc.<P>On a totally unrelated note, she had some other reading materials available, most notably on that new product out that the company bills as a wonderdrug for women like the little blue pill for men. She's not impressed, and the literature in her office is very cautionary and was quite thorough. It also mentioned damiana (hope I am spelling that correctly) and the positive studies they've had going on that, though it was mostly talking about rats. She mentioned, too, that there are 2 new drugs coming out for premature ejaculation in men. She wasn't sure whether either of these would help my husband, but both apparently deal with PE from a sensory-oriented perspective, so who knows? That wouldn't help with desire, and it may not work for people who's dysfuction is caused by neurology, but I'll still give it a look.<P>In short, I love my gyn. She's amazing. She's very up on things, always takes time to answer questions and almost always gives me reading material on anything she changes in my health-care regimine or discusses with me (HRT, birth control methods, libido concerns, etc.), reviews my chart *before* coming into the room, does the most complete exams I've ever had or heard of, and never dismisses questions. I wish I could duplicate her and send copies out to all those who have had such bad gyn experiences. She's expensive, but fortunately covered by insurance.<P>The pharmacist at the compounding pharmacy was also incredibly helpful. I didn't realize there even was a compounding pharmacy nearby. He went over *everything* from how to use the T-cream, to how many mgs each dose provided, to how to determine if I needed to lower my dose, to what was in the cream, etc. He took a good 15 minutes with me, and I wasn't even asking questions--I didn't have to. He also sent me home with literature about T replacement, it's goals, it's side effects, dosages, what to expect and when, and all in a comprehensible format (not those endless brochures no one ever reass because they are too technical, written in print so small you need the Hubble lens to read it, and way, way too long). <P>So, now I wait.

Dona - <P>The "Hubble" huh? Man that *would* be a pain huh!? LOL (I loved the imagery!<P>I'm very glad it went well.<P>You make some very important points about BMD (bone mass density) and the problem that stem from that. (This is one of the primary reasons for Estrogen HRT.) There is some speculation that low E levels in post menopausal women are actually low T levels, and that because of low T, the aromitization of T to E doesn't produce enough E. Thus, perhaps part of solving low E and BMD issues may have a T component.<P>Also, if I recall correctly, T is shown to increase BMD more significantly than E. I'll have to dust off a few studies in the PDF library, and review them again. I'll send them your way at some point.<P>Anyway - I'm happy things are well, and that perhaps you may find some answers for things that have continued to be problematic.<P>Three Cheers!<P>Greg

I'd love any info you can bring up from the cellars ) Your comments jibe quite well with what my gyn said. She does want me to increase my E naturally for now via extra soy, etc., as well; but, in my case is very concerned about the BMD because of my life-long joint deterioration issues.

BMD can be measured using a special bone scan. Don't recall the name...<P>I recommend having the scan done so you can know for sure if your BMD is low. There are quack min-scans around and I was advised to avoid those and get the proper scan.