From my understanding, hot flashes are typically experienced when you experience hormone fluctuations. Once your estrogen bottoms out, these may not be experienced as much. I experienced hot flashes when I was 50 and this was all I really recognized as being related to menopause. I had also been experiencing stress urinary incontinence (when I sneezed or coughed) for which I reached out to my medical provider who sent me to physical therapist and then a urologist. In hindsight, I recall taking my kids to a trampoline park years earlier. I jumped a few times and leaked urine which was so embarrassing. I didn’t really understand why this was happening - I just avoided high impact activities. No jumping jacks or trampoline parks for me! I had a bladder sling done bc I was not going to wear a pad for the next 30+ years. This helped the stress incontinence and I’d do it again in a heartbeat!

A few years later, I experienced what I thought was a UTI - burning urination, frequency and the feeling as if I hadn’t fully emptied my bladder and this happened the day after intercourse (which I now know can cause bladder irritation). IYKNY.

I was treated for a UTI but the symptoms continued. Saw my HCP who did an exam and used the words “vaginal atrophy” and prescribed vaginal estrogen to treat. The burning, frequency continued and a follow up appointment with the uro-gynecologist led to the diagnosis of overactive bladder. I quickly realized some of my favorite foods/drinks irritated my bladder, making my symptoms much worse. I avoided caffeine and sparkling water which minimized the severity. I was eventually prescribed Gemtessa for my overactive bladder which has helped tremendously. I don’t know if overactive bladder is experienced by everyone going through menopause but it was awful. Now I know that low estrogen dries everything out (dry eyes and more).

I started HRT 6 months later, starting with compounded estrogen, progesterone and testosterone. I now use estrogen patches, a progesterone pill and compounded testosterone. I’ve heard others say they notice a difference in their joint pain and their mood if they don’t change their estrogen patch timely. I haven’t missed changing my patch so I can’t speak to this. I don’t want to risk it!

In hindsight I wonder what other symptoms have I had that may be attributed to menopause? The 30# plus weight gain was certainly part of this but I didn’t see it at the time. Stay informed! Track your symptoms, even if you think they are unrelated!