What they don’t tell you when they remove your ovaries

The hard choice between conventional and alternative medicine

Six weeks ago today, I had laparoscopic surgery to remove my ovaries and I was told recovery time would be about a week. Two weeks until I was back to 100 percent activity level. No big deal. Except, that’s not how it panned out. Instead, I went through an “interesting journey;” On second thought, that’s a generous term. I went through a temporary dark hell. But they say good things come out of dark places and I learned a lot — about the healthcare system, about becoming your health advocate, and about how much I love hormones. In particular, bioidentical hormones.

I wasn’t going to talk about this because my health is very personal. Certainly when it comes to the girl parts, right? We don’t want to talk about <hushed tone> ovaries or menopause. But guess what guys? You’re in for the ride too. P is in this and feeling the effects almost as much as I am and if we don’t talk about it, we are doing a disservice to those who are just behind us on this path.

Before we move forward, a quick step back to Wednesday, March 13. Everything was benign, and we had much to celebrate. On the drive home, we texted friends and family and I enjoyed an odd feeling of euphoria, that is until the anesthesia wore off two days later. That’s when the excitement also wore off, and I awoke to a different picture. Suddenly, all the things just days before I was so excited about weren’t that exciting to me anymore. Life lost its luster. I didn’t feel like doing anything.

So I took it easy. “I’m recovering from surgery,” I told myself. Be kind. Indulge in some daytime Netflix binging. You deserve it.

A week passed and I began to wonder if I was still “recovering from surgery” or wait — is this menopause? I turned to the Internet and Googled all sorts of things from “what to expect after having ovaries removed” to “side effects of bilateral oophorectomy.”

What I learned is I can expect to be back in action in two weeks. The incisions will heal, don’t pull off the strips until they fall off, and hormone levels will drop dramatically. It’s called surgical menopause. And they say:

“Women who have undergone surgical menopause may become less interested in sex.”

That was it. A mild understatement I might add. What the articles don’t say is that women who have undergone surgical menopause: get stupid and confused.

They might:

• Find themselves crying involuntarily at the gym or while checking out at the grocery store.
• Wake up repeatedly throughout the night wondering why they can’t sleep through the night anymore.
• Not be able to wake up in the morning because of the aforementioned lack of sleep the night before.
• Proceed throughout their day behind a heavy veil that makes it hard to focus and make decisions and even have regular conversations.
• Have no drive or ambition, unable to take any initiative or put forth any effort to do something — even put the dishes in the dishwasher.
• Make stupid decisions sometimes referred to as menopause moments, like the afternoon I was dropping off the recycling, and a pick-up truck drove by with the passenger door open and a girl inside yelling “LET ME OUT!” I stood there mouth agape and watched as it pulled behind a building across the way. So naturally, I hopped in my car to chase it and save the girls. Maybe I’ll call Patrick, so he’s on the phone while I do this. Patrick responds with “you’re not doing that. Call 911.” Like a reasonable person would do. (By the way, I did. The girls were fine)

What terrified me most was I had difficulty working because my brain wasn’t functioning. I had to double my effort to fake it and I’d get home exhausted, having worked perhaps a four-hour day. I put my podcast on hiatus. I started missing deadlines — not to the point of letting people down but I always have prided myself in delivering something when I say it will be delivered. When I had to make apologies, I knew this just wasn’t me.

Because I couldn’t sleep, I had plenty of time at night to ruminate and conjure irrational thoughts about my business failing and my health never recovering. When my alarm actually went off in the morning, I couldn’t fathom waking up.

Nice, huh?

While many women go through gradual menopause (no party there either for most), surgical menopause is like a shock to the system. On March 12, I wasn’t even in perimenopause. On March 13, hi, so not nice to meet you.

I’m not blaming anyone. I’m pointing the finger at a system. I was happy with my gynecologic oncologist. She has the credentials and understands, even lives my lifestyle. But what I learned during my somewhat futile internet research is that oncologists are focused on preventing and saving you from cancer. Check that box as a success. I do not have cancer.

In fact, before surgery, the doctor did mention I would likely not need hormone replacement because I am so close to natural menopause. Bookmark that moment as a pivotal one because I nodded, accepting her suggestion without question or concern. I trusted her and blindly followed. That’s on me.

Do not underestimate the power of hormones. Whether it’s having ovaries removed or some other health issue you are dealing with. There needs to be a better discussion and a better exploration of the facts. Our doctors have the best of intentions, but no one will be a better advocate for your own health than you.

Finding Answers

Upon complaining of my symptoms and trying to figure it out, a friend recommended Suzanne Somers’ book Ageless: The Naked Truth About Bioidentical Hormones. I bristled at the idea of taking healthcare advice from Chrissy of Three’s Company, but the subtitle of the book hooked me, so I skeptically gave it a try. I recommend the book as long as you give it a heavy dose of critical thinking. Wade through the hyperbole and seemingly groundless claims but enjoy the research and the interviews with the doctors, and you’ll learn a lot if you’re like me and haven’t heard of bioidentical hormones before.

Alternative medicine doctors and anti-aging doctors say synthetic hormone replacement is dangerous, increases risk of cancer is made with urine of pregnant mares. I had heard the first two things which is why I didn’t even question the doctor when she said I likely wouldn’t need hormone replacement. I just said “phew.”

Conventional physicians like my oncologist try hard not to twist their face in ridicule when I ask them their opinion on bioidentical hormones. They say there is no science behind bioidenticals. They are not FDA-approved. They are no different than synthetic.

The search for truth, for a credible source

Eventually, I’d learn there is no right or wrong answer. Medical professionals are making educated guesses. Look, and we don’t definitively know many of the long-term effects of so many solutions. Smoking, birth control pill, high carb/low-fat diet. Case made about not knowing until we do know.

I wondered: Why aren’t bioidentical hormones approved by the FDA?

I learned: Because they are natural, say the naturopaths. They can’t be patented so big pharma, and no one for that matter can make big money with them.

I spent hours reading through Harvard Medical’s opinion, Mayo Clinic, Cleveland Clinic. I looked at Dr. Mercola’s interviews on the matter. I read Dr. Jonathan Wright’s interviews …. -

The bottom line is I can’t find enough evidence to choose to put synthetic hormones in my body. I can’t, in a clear-eyed manner, put foreign substances in my body when there are pharmacies who are replicating hormones using natural ingredients.

My trusted psychologist and friend referred me to a naturopathic doctor in Missoula who has a great deal of experience in bioidentical hormones. I started the paperwork process and patiently waited to hear back from the office to set an appointment.

In the meantime, I moved through my days inside an invisible bubble that seemed to have dimmed the light and weighed me down ever so slightly. Everything took more effort — to move, to speak, to take the initiative on anything, to make decisions.

I tried to meet my friends for our morning run and set the evening before intending to do so. Instead, I ended up opting for sleep which finally came. I started every morning by checking in with that ND in Missoula; then I meditated with a focus on gratitude. Remember, it’s NOT CANCER! I did what I could — yoga, strength training (half the workout I typically do), took naps, drank my detox (Reishi) tea and my CALM and I waited for the incoming call from Missoula.

I researched with an obsession and discovered a report written for physicians. In it was this gem about how to manage patients who ask about bioidenticals.

“We have found that it is important to acknowledge the use of the bioidentical formulations without appearing to be judgmental or dismissive. Many patients are well versed in the topic and have often conducted an exhaustive online investigation before they present with questions.” National Center for Biotechnology Information

So far, the most significant argument I can find against BHRT (bioidentical hormone replacement therapy) is that “No evidence currently suggests that custom CBHT formulations offer clinically relevant benefit over the FDA-approved products available to treat the symptoms of menopause.” (Mayo Clinic )

That’s not a strong enough argument for me.

… quickly glances at phone to make sure a call hasn’t come in from Missoula to set that appointment …

When Night Turned to Day

That phone finally rang, and they set my appointment for early the following week, less than five weeks out from my surgery date. I met with Dr. Stegmaier of Providence Health — Women’s Care and Family Wellness.

I cried tears of joy in her office. She listened patiently to my list of symptoms that I had written down because I couldn’t remember things or connect dots anymore, so I had kept track in the days before our appointment. She listened and pointed back at my notes — “what else?” as she furiously scribbled on a piece of paper. Then she talked about hormones and what they do. She showed me a diagram and how simple it is that a sudden drop in hormones will cause almost all my symptoms.

I filled the prescription she wrote me for bioidentical progesterone, testosterone, and estrogen at the compounding pharmacy next door. When I asked how long it would take to feel a difference, they ventured it could be as soon as the weekend. I slept that night the same as I had for weeks — like crap. So when I woke up, I did not anticipate that I would have returned to myself. That literally, the difference was like night and day. That heavy curtain had been lifted, and I remained cautiously optimistic. Six days later as I type this, I have improved every day. My energy returned to normal, colors were bright again, I cared about things again, I was able to run meetings and make presentations. I could run with my friends. My brain was not lost as I so feared in those dark nights. Overnight. That’s all it took.

TL;DR

Conventional medicine vs. alternative medicine: the former is an eco-system of doctors regulated by a standard of care where pharmaceutical and insurance companies have a great deal of power as well as the money to fund studies that back drugs to get them FDA-tested and approved or to fund lawsuits to keep alternatives from reaching the market.

Alternatives solutions (like bioidentical hormones) don’t have that kind of financial backing because they are natural ingredients, can’t be patented and therefore have no profit margin. Thanks to this, when we ask our trusted doctors about them — they have the classic argument to lean against: “There is no science to back that up” or “They aren’t FDA-approved.”

Hey, guess what? The birth control pill is FDA-approved and look where that’s gotten so many women.

Conventional doctors use the science argument and point at alternative doctors as being quacks. Alternative medicine doctors tell us conventional pharmaceuticals cause cancer and all sort of other things that scare the hell out of us.

We patients are left confused like the donkey between two buckets of water, paralyzed by indecision. There is no right or wrong; it depends on the case. We each have to make the decision that makes the most sense for us.

Here’s the twist

If I had known all this stuff decades ago, I think I could have prevented the multitude of circumstances that eventually led me to my oophorectomy six weeks ago today.

Hormones. I can’t even find the words right now to express how important they are, and I’ve only just begun on this. Go learn about them. Both men and women — if your hormones are out of balance, they might be causing those mysterious things you can’t fix about your own bodies.

Stay tuned because I have more to say on the matter.