QuestionDear Dr. Rappaport,
I'm 48, have two children, and am in reasonably good health. I had a hysterectomy in 2001 due to a long history of problem periods from fibroids. They were lengthy, with lots of blood lost, huge clots, and cramps so bad I'd almost pass out. I wish I'd done it YEARS earlier! My right ovary was removed because of cysts; I kept the left one which, at the time, was working OK.
For a few years before my surgery I had occasional hot flashes (maybe a couple a month), and was told it was pre- or peri-menopause. Now I'm having them daily, and just dripping sweat from my face and upper body. When I'm home that's fine, but...! However, I am not having night sweats, yet.
My husband just changed jobs and we do not have medical insurance right now, and money is very tight. My question is: Is it OK to not see a doctor until I get the night sweats and other symptoms? Since I don't have a cervix my ob/gyn said she'd "see me in 4 years", and I haven't really had a reason otherwise to make an appt. and go. So if I don't go for another year, would I be doing myself any harm?
One other thing, and I REALLY do appreciate your time! I've been doing a lot of reading, and understand why that hormone study was ended and that it may not apply to me, or everyone. If I decide to try and self-medicate nutritionally, what else is there except soy and soy derivatives? I am allergic to soy and can't take anything with that ingredient.
Thank you for taking the time to answer questions on this web site. It is greatly appreciated!
Sincerely,
Linda
AnswerLinda, there is no danger in not seeing a gynecologist for menopausal symptoms. YOu probably are starting to get the hot flashes due to a decreased production of estrogen by your remaining ovary. If they do not bother you too much, you do not even have to treat them. You may, or may not, get the other symptoms of menopause (flushes, night sweats, vaginal dryness, memory loss, etc), and the only proven therapy is estrogen replacement therapy. There are now very low doses of estrogen that we give every day (0.3mg) because so many women became apprehensive due to the WHI study. If you are reading the correct reports, we are realizing that there is not as much risk of breast cancer in hormone use, but we do know that the hormones will not prevent heart disease. Soy and soy derivatives do not seem to help too much. Try Primrose oil or Black Cohosh if you want, but they, too, are not as good as estrogen therapy.
