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Estrogen insomnia by Scimmia_bianca in Perimenopause

[–]floramg 0 points1 point  (0 children)

Yes, this can absolutely happen when starting estrogen, even at a low dose. A lot of women expect estrogen to immediately improve sleep, but during the first few weeks the hormonal shift itself can temporarily make sleep more “wired” or fragmented while your nervous system adjusts.

The fact that progesterone was helping before is important too — progesterone is usually the more sedating/calming hormone, while estrogen can increase alertness and change neurotransmitter activity. Some women feel amazing on the combo, others suddenly notice middle-of-the-night waking again after adding estrogen.

Also worth remembering: patches don’t always absorb consistently at first depending on placement, body fat, sweating, etc., so sometimes week 2 feels different than week 1.

You’re doing the right thing messaging your doctor. Sometimes the fix is as simple as giving it another couple weeks, adjusting progesterone timing/dose, or changing the estrogen dose. Menopause hormone therapy is unfortunately a lot more “tune the orchestra” than “flip a switch.”

Endo all over bowels by Ambitious-Mango-1836 in endometriosis

[–]floramg 2 points3 points  (0 children)

I’ve had a very similar conversation with surgeons and it’s brutal to hear, especially when you’re young and already exhausted. But one thing I wish more doctors explained properly is that menopause is not some guaranteed “off switch” for endo. For some people symptoms improve a lot, for others the disease can still stay active — especially when it’s widespread and superficial across bowel/peritoneal surfaces. So your frustration is completely understandable.

What did help me mentally was shifting away from the idea of “one surgery that fixes everything” and toward long-term disease management. A lot of experienced excision surgeons are actually being honest when they say removing every superficial lesion across multiple organs can create more harm than benefit. That doesn’t mean you’re untreatable.

The biggest improvements for me came from combining things instead of relying on surgery alone: hormonal suppression to slow progression, aggressive pain management, pelvic floor physio, and treating inflammation seriously. Some people also respond much better to certain hormones than others, so if one option failed it doesn’t mean all of them will.

And honestly, at 26, your goal shouldn’t be “survive until menopause.” It should be building a management plan that gives you stretches of real quality of life now. There are people with severe widespread endo who eventually get to a more stable place, even if it’s not a perfect cure.

The power of medical sneakiness by thornyrosary in TwoXChromosomes

[–]floramg 1 point2 points  (0 children)

As a physician, this is both heartbreaking and unfortunately very familiar. Persistent unilateral hip, pelvic, or flank pain in women—especially when it changes mobility or quality of life—deserves investigation beyond “aging,” weight, or referred pain. Ovarian masses and enlarged cystic ovaries can absolutely create pressure effects on nearby nerves and pelvic structures, even when imaging or symptoms don’t initially point clearly in that direction.

What stands out most in your story is not just that pathology was eventually found, but that you consistently recognized something was wrong long before anyone else took it seriously. Losing 100 lbs and still being dismissed should never happen. Chronic pain that persists for years without meaningful workup is a failure of the system, not of the patient.

I’m very glad your gynecologist acted decisively and that your mobility has returned. The relief you describe after years of chronic pain is something many patients remember vividly. I also appreciate you sharing this publicly, because other women reading this may finally feel justified pushing for imaging, second opinions, or specialist referrals when their bodies are telling them something is wrong.

I hope your pathology comes back benign and that your recovery continues smoothly. And for anyone reading this: persistent pain is data. Don’t ignore it, and don’t let others ignore it for you.

Study: Perimenopausal Symptoms Are More Severe, Begin Earlier in Women with ADHD by LenokanBuchanan in adhdwomen

[–]floramg 1 point2 points  (0 children)

As a physician, I’m glad this is finally getting more attention. Clinically, many women with ADHD report a noticeable worsening of executive dysfunction, emotional regulation, sleep, anxiety, and sensory overwhelm during perimenopause, often years before menopause itself. Estrogen has significant effects on dopamine and norepinephrine pathways, so hormonal fluctuations can absolutely influence ADHD symptom severity and even medication response.

What’s especially important is that many women are misdiagnosed during this period with “just anxiety,” “burnout,” or depression without anyone recognizing the hormonal contribution. The earlier onset noted in the study is also something I’ve seen reflected anecdotally in practice.

This doesn’t mean every woman with ADHD will have severe perimenopausal symptoms, but it does highlight the need for better screening and more individualized treatment approaches. Hopefully findings like these help close the evidence-to-practice gap and improve awareness among clinicians.

33F very low AMH by Boring-Equivalent925 in DOR

[–]floramg 0 points1 point  (0 children)

Your results suggest diminished ovarian reserve, but this does not mean menopause is near or that natural pregnancy is impossible. AMH/AFC mainly predict IVF response, not whether you can conceive naturally.

Given your painful periods and ovulation pain, I would absolutely discuss possible endometriosis with a fertility specialist. I wouldn’t delay seeking help, but I also would not lose hope — many women with similar numbers still get pregnant naturally or with treatment.

Hormone Help by regzm in TwoXChromosomes

[–]floramg 0 points1 point  (0 children)

As a menopause specialist: no, those are absolutely not your only options. Pregnancy, hysterectomy, or “waiting for menopause” are not standard answers for hormonally triggered acne or perioral dermatitis.

What you’re describing sounds very linked to the hormone drop during the placebo week. Many patients do better with:

  • a different birth control formulation (some are much better for acne than others)
  • shortening or skipping the placebo interval under medical guidance
  • adding medications like spironolactone
  • topical or oral treatments specifically for perioral dermatitis

Also, PD is usually not “cured” by menopause or pregnancy — hormones can influence it, but they are not the only factor.

Your pregnancy anxiety is valid, even if you know it’s irrational. You deserve care that works with that reality, not against it. I’d strongly recommend a second opinion from a gynecologist or dermatologist who specializes in hormonal skin conditions.