Hormones: Surviving ‘Amy-geddon’ Part 1
Over the past year or so, and especially during the past few months, I have been riding an emotional roller coaster as I desperately try to figure out what the heck is going on with my crazy hormones. I’ve struggled with painful menstrual cramps and acne my entire adult life. My OB-GYN while I was in my 20s was always urging me to try another type of birth control to help alleviate these symptoms. But nothing ever worked. Everything continued as usual, except the birth control would add minor mood disturbances. So finally one day, I told my doctor I was done. Nothing was working. I was better off not trying to control my natural cycle. Interestingly, a decade or two later, I’m finding myself starting to think the same thing all over again: Why in the world did I start trying to control my natural cycle? I did so because I again gave in to the desire to be done with acne and cramps once and for all, but also because Dr. Dale Bredesen told me I should if I want to prevent Alzheimer’s disease.
He wrote in “The End of Alzheimer’s” that an important step in following his ReCODE protocol to prevent Alzheimer’s is to make sure your hormones are at optimal levels. Hormonal imbalance is one of his causes for type-2 Alzheimer’s, in which the brain is not getting enough nutritional and hormonal support to maintain healthy synapse formation and function.
In the spring of 2017, my OB-GYN was trying yet again to convince me to take another birth control. She said my previous bad experiences with the pill could be the result of too high doses. She recommended a low-dose progesterone-only medication that was intended specifically for managing symptoms and not as a contraceptive as it only blocked ovulation about 50 percent of the time. A little wary and not convinced it would work, I agreed, thinking of how tired I was dealing with acne and cramps.
Lo and behold this progesterone worked! My acne completely disappeared within a month and my cramps, when coupled with eliminating dairy the entire week before and week of my period, almost completely disappeared. They were mild enough not to need pain killers, and I could ignore them for the most part. As for the dairy, OB-GYN Christiane Northrup in her book, “Women’s Bodies, Women’s Wisdom,” suggested dairy as a potential cause of menstrual pain. I had tried giving it previously without it helping my symptoms. Additionally, when I was taking the progesterone but eating copious amounts of dairy, the cramps would hit me hard. But cutting the dairy coupled with this low-dose progesterone seemed to do the trick! Additionally, my sleep and mood improved!
I was quite pleased with my new-found freedom from the misery that used to be my constant companion. However, Northrup’s words from another of her books, “The Wisdom of Menopause,” were reverberating in my head: If you’re going to do hormone therapy, make sure you do bio-identical as it has none of the usual side-effects and health risks that come from traditional therapies. It should be noted that bio-identical hormones are not human hormones taken from another person. They are derived from plants and engineered in a lab to be identical to the hormones produced in the human body. The traditionally prescribed non-bio-identicals are taken from an animal, typically from a horse, so they are not identical to human hormones. Then in the fall of 2017, I read “The End of Alzheimer’s” and Bredesen echoed Northrup’s words. Have blood tests done to learn exactly where you stand on your hormone levels, and if they do not fall within his optimal range for preventing Alzheimer’s, work with a compounding pharmacist to create the right bio-identical therapy for you.
I had made my decision. I would get the blood tests to learn my hormone levels, and I would continue the low-dose progesterone but make the switch to bio-identical. Surely this would be the final step in solving my hormone issues. I met with my OB-GYN in the spring of 2018 and told her my plan. I had my blood tests and set up the appointment with the compounding pharmacist. I was happy to learn my blood tests showed my progesterone, estrogen and testosterone levels were right in the middle-to-high end of Bredesen’s optimal range. I assumed this was the result of the progesterone I had been taking. The pharmacist worked with my doctor to set me up with a bio-identical. And then the fun began.
The pharmacist told me I would need to give the hormone a full six months for my body to adjust and to learn whether it was the right dosage for me. At Northrup’s recommendation I requested a transdermal cream instead of a pill. Northrup said hormones are better absorbed transdermally because they go straight to the bloodstream, whereas taking it in pill form, the hormone must be digested and processed by the liver before it can go to work. Therefore, much smaller doses are used in transdermal creams. My first issue with this new cream therapy was application. The instructions said rotate application among the forearms, chest and tops of feet and to change the location each time to ensure optimal absorbency. The problem was this cream would not absorb. I would rub and rub, 10-15 minutes straight without it fully absorbing. It eventually would dry out and pill up and I was forced to brush the pills into the trash can. I then was instructed to not let any clothing or other skin touch the application area for about 10 minutes, so I was forced to sit with the application area exposed and continuously fend off my cats who invariably want to climb all over me and sit on my lap whenever I sit still that long.
Within the first month of using the cream, my acne returned, though not as bad as it was before, my cramps worsened, the mood disturbances of so long ago returned and, a new, lovely phenomenon, my ankles started swelling up like water balloons every month during ovulation and menstruation. I told myself this must be just part of the six-month transition period and I would just have to wait it out. I decided I’d had enough of the cream after a couple months and called the pharmacist to ask about switching to the capsule. She said absolutely, but warned me this method has been known to cause acne. Oh, goody. Still, I really hated the cream, so I made the switch. Surprise, surprise, the acne compounded. Pizza-Face-Amy returned in all her glory.
The pharmacist called me once the six months were up to ask how I was doing. I told her my acne was terrible and none of the symptoms had abated. I also mentioned the swelling ankles that forced me into compression socks once sandal season had come to an end. She brushed off the swelling, saying this was my body producing more estrogen in response to the progesterone. She said this and my other symptoms simply meant I just needed a higher dose of progesterone. OK, I said, not really believing her, and sure enough I was right. The higher dose only worsened my symptoms. It did nothing to help. By this time, my next annual OB-GYN appointment this past spring was right around the corner, and I once again was fed up. I no longer cared whether or not bio-identical was the healthier option. I told my doctor of the symptoms and said I wanted to switch back to the low-dose birth control pill – to what I knew worked for me. She agreed and said it was perfectly safe to do so. I also requested and was granted another blood test to see where my hormone levels stood.
I opted to wait a few months on the blood test, knowing I would need that time for my poor body to adjust back to non-bio-identical. I switched pills. The acne cleared up almost immediately but nothing else abated. My mood swings, cramps and ankle swelling continued. But the special cherry on top of this sundae was still to come. Sometime during my first month back on birth control, in less than one week, I packed on 8 pounds. You couldn’t really see the weight gain by looking at me and all my clothes still fit (thank God), but I felt like the Stay Puft Marshmallow Man. I felt swollen, stretched, bloated, etc. And no matter how well I ate or how much I exercised, nothing helped. Then in May I gained another pound and in June another pound, taking my total weight gain to 10 pounds. This was completely unacceptable. Especially since I am in my niece’s wedding this September and no longer fit in the gorgeous dress that fit me perfectly in February.
But wait! There’s more! My mood swings in May and June became increasingly volatile and were almost uncontrollable. I would have days when I would completely blow up at the tiniest things and other days when I just couldn’t stop crying. And, of course, my poor significant other, Charlie, bore the brunt of it all. He lovingly called these days “Amy-geddon.” In times when I have been genuinely upset for a real reason, he had been very comforting and supportive. But during Amy-geddon, he was a bit more like a deer in headlights. He wanted to be there for me, but he didn’t know how to react to someone sobbing uncontrollably because she bought the wrong size box of plastic wrap. I think he was afraid that if he tried to hug me, I might deck him. I was that unpredictable.
Needless to say, it had to stop. I had the blood tests done to check my hormones a few weeks ago. My progesterone and estrogen were optimal, but my free testosterone was a bit low (5 ng/dL – Bredesen’s optimal is 6.5-15 ng/dL). My doctor was at a loss as to why the birth control would have worked so well the first time and so terribly the second. I told her I wanted to completely stop the progesterone and hold off on taking any action on the testosterone at present. I have long been someone who has touted the importance of listening to her body and choosing the natural flow of things. I decided it’s time to start practicing what I preach again. I may choose hormone therapy again sometime in the future if my symptoms become unbearable and my levels fall below Bredesen’s optimal, but for now, I’m going to trust my infinitely wiser body and allow my natural cycle to take over again. I will have the blood tests done again next spring after my next annual exam, particularly watching the testosterone and will go from there.
In the mean time, I am now just over one week completely off of progesterone, and it’s so far so good! I’ve already warned my niece to be prepared for Pizza-Face-Amy just in time for her wedding, and she turned me on to a great skin-care product that might just keep it at bay. And even better, I have lost 6 of the 10 pounds in less than a week. My moods swings have abated so far and I’m finally starting to feel like me again. Why in the world did I ever start trying to control my natural cycle? I really should have known better.