Authors: E
Ultimately, you and your doctor will need to decide what is right for you. Depending on your medical history, your options may be very different. A good starting point is to simply think inside the box. Ask yourself, on a scale of 1 to 10: How am I functioning? How is my life? Some shmirshkies are so used to being less than functioning that they find themselves accepting a 2 as normal. You don't have to settle. Once you know your challenges, you can begin to find the right solutions. Whatever you do, don't give up trying to be as close to 10 as possible. You deserve it!
I used to have a consistently even personality, but during my PM&M storm, David and I never knew which me we were going to wake up to. Sometimes I thought I was going to have a good day, but more often than not the storm came in and I felt out of control. No way, no how could I simply talk myself down from this. I was desperate to get some sleep, have a clear head again, and stop being the primo HS.
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Wherever I went, my mind was on PM&M. One day I was in New York taking the subway uptown during rush hour. The subway was packed. Everyone else seemed to be daydreaming or thinking about work and the challenges of their day. Not me. I gazed at all the shmirshkies on the subway and had the strongest desire to ask them about their PM&M. I sat there wondering if they were in PM, or if they had finished M. I guessed that some of the grumpy shmirshkies whose pants were so tight that their shmirshky was going to break in two (you know what I'm talking about) were smack in the middle of it.
My ears perked up whenever I heard someone on the news or a talk show speaking about HRT or PM&M. I listened to everything I could (thank you, DVR and TiVo!). I couldn't help but notice that many celebrity talk show hosts were going through PM&M right before my eyes. I saw them struggling, heard them explain that they turned the air conditioning way up as their internal thermostats went completely askew. Of course, all the non-PM&M hosts were freezing. This reminded me of David trying to sleep in our bedroom with the air conditioning on in the dead of winter. Poor guy.
Ultimately, the HRT decision was mine to make. Along with my gynecologist at the time, I decided that it would be good for me to begin HRT. I was nervous at first, but the one constant comfort for me was the support of the Sisterhood. We need to be there for each other. The more I opened up to my friends and loved ones, the more comforted I became. Their support helped me to embrace my PM&M. I stopped being in such a hurry to fix me and became calmer and more accepting of where and who I was. I was learning how to be okay with not being “fine,” and I felt a little better.
Talking with other shmirshkies who have gone through PM&M is as important as studying the most current research and conferencing with your doctor. There are all kinds of ways to get this shmirshky support. It is easy to take your morning exercise crew, book club, birthday lunch bunch, cooking club, carpool group, play group, investment club, or cocktail circle and turn it into a shmirshky support group just by talking, asking, and sharing your PM&M experience. If you aren't in any kind of club or group, start your ownâhost a Shmirshky Party!
Use the Internet to reach out to the shmirshky diaspora. Most shmirshkies' Web sites have blogs, Webcasts, and forums where you can type in what you're going through and get support and advice from other shmirshkies. Visit shmirshky.com and connect to other PM&M shmirshkies around the world. PM&M shmirshkies are everywhere, and we need each other, so don't be afraid to reach out for help.
After months on an HRT regimen, my period went from arriving irregularly to not coming at all. I thought I had graduated from PM to M. It had been thirty-nine years since my period first showed up. Can you believe that? I'd been dealing with that damn period for thirty-nine years! You'd think I would have been relieved when my period stopped, but it was oddly sad to me. I found myself going through the grieving process. I think it was more the realization that I was getting older rather than feeling sad about not having a period. That being said, I was certainly thrilled to dispose of all my period paraphernalia. I was especially joyous to get rid of my tampons and pads with wings; they, of course, flew right out of the box. Too bad there was no party or presents to go along with my period's departure, though I was thinking about putting a graduation cap on my shmirshky.
I was convinced the period and I were done until one Sunday afternoon at a summer BBQ at my house with twenty-two friends. I was wearing this wonderful white sundress and felt relaxed and carefree, until I stood up to get someone another drink and saw the horror on my guests' faces. There I was with my period soaked through my dress
and
the sofa I was sitting on. My face all of a sudden matched my dress. Where are those pads with wings when you need them, flying to the rescue? I left the party and ran to my room, showered, and put my white dress in a sink full of stain remover. The stains disappeared before my eyes. Was there a way to drink that stuff and make my period disappear?
The funny thing was, after this period I felt really good. Go figure. Still, I wanted so desperately to skip past all this PM&M madness and go right to the big finale when the heroine is dancing and smiling and living happily ever after in a beautiful dress with a chorus of singers carrying her off into the sunset. I was so exasperated with this whole process. I kept thinking that I would like to exchange my shmirshky for an erlick (good thing my mom kept the receipt in her purse!).
I know they say the grass is always greener on the other side, but it just seemed to me that erlicks have it easy. All they have to do is decide if their erlicks should dangle to the left or to the right. I could do that, no problem. I've been wearing earrings and necklaces all my life, and they all dangle. How hard could this be?
From the moment erlicks are born, someone is caring for their erlick. Our son, Jack, found his when he was a baby, and after that, he never wanted to let it go. When he was a toddler, he even answered the door holding it. My mom was appalled. I explained to her that it was natural and we shouldn't mention it, as that would bring attention to it. I thought he would outgrow it. But do erlicks ever outgrow it? Not really. Someone (if not themselves) is always holding the erlick.
In all seriousness, I know you erlicks have your share of health issues as well. There is, in fact, such a thing as male menopause, although that term is a bit flimsy, since erlicks don't menstruate. While a shmirshky's PM&M is all about the slowdown and eventual shutdown of her reproductive system, erlicks can typically produce sperm well into their eighties (I think there is a story about Moses making use of this feature). Still, some erlicks do experience hormone fluctuations that may cause symptoms similar to PM&M, like fatigue, depression, physical weakness, and a lower libido.
Menopause-like symptoms in erlicks are not to be ignored or laughed offâthey may be the result of dropping testosterone levels or a thyroid condition. If you're an erlick who is struggling, don't suffer in silence. Reach out to your internist, endocrinologist, and the people you love to get the help you need.
I must admit, when I first heard about male menopause, it reminded me of the first time I was pregnant, when I started to get these ravenous cravings for strange food combinations. That was probably my favorite part of being pregnantâI ate everything in sight! Being the ever-supportive husband that he was, it didn't take long before David started to get cravings of his own. He gained ten pounds during both of my pregnancies. I guess he just really wanted to get in on the experience (or the pickles and ice cream).
With David's sympathy cravings in full swing, I was thrilled to have an eating partner in crime. Years later, his hormones began to fluctuate around the same time as my PM&M. Of course, menopause isn't contagious, it was just a coincidence of age, but the thought of two hormonally imbalanced people living side by side was downright frightening.
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It began with the thyroid for David, just like me. All of a sudden, he was lethargic. I thought, well, maybe he's just so exhausted from dealing with me, it's finally catching up to him! In addition to being tired, he was getting forgetful and his libido was dropping. We talked about how he was feeling and he decided to go to the doctor. David got his thyroid and hormone levels checked and found out that he had a minor thyroid condition
and
his testosterone levels were taking a nosedive. What a great husbandâif it wasn't pickles and ice cream, it was testosterone and synthroid.
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While you're at it, don't forget to check the rearview mirror. Shmirshkies and erlicks have the same next-door neighbor, which we all have to get checked out with a colonoscopy,
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usually when we hit our fifties. Don't forget to do this; it's very important for everyone. In addition to prostate cancer and all the other health issues erlicks have, you really do go through PM&M along with us shmirshkies. At least there isn't an “erlickogram,” where you have to put your balls between two flat, cold metal slabs to be smashed together as tightly as possible while you hold your breath!
My period was like gum on a shoe, and I still was not functioning well. I wasn't sleeping, my night sweats persisted, and my breasts were growing like water balloons. My boobs got so big that one afternoon, while sitting in a boardroom meeting with four other people, a button actually popped right off my blouse and onto the table! Everyone pretended they didn't see it, which I suppose is the polite thing to do when a shmirshky's bra is suddenly exposed during a business meeting. If I had known I was going to give a show that day, I would have worn a much sexier bra. I was mortified! Luckily, I was wearing a blazer to cover up my big hips, so I was able to use the blazer to conceal the gaping hole in my blouse.
Needless to say, I started to question my HRT regimen. It seemed that my gynecologist at the time had a “one-size-fits-all” way of handling patients. I kept thinking that there must be a better way of determining how to home in on my specific needs so that I would function at a more optimum level. I was intent on finding a new doctor.
I had to go through
several
gynecologists and different courses of action until I eventually hit the jackpot. I was at a dinner party with a very revered and wonderful retired gynecologist. We were loading the dishwasher, and all of a sudden I just unloaded all my PM&M challenges. As tears streamed down my face, frustration and sadness poured out of me. Our host was so sweet, comforting, and reassuring. He told me that I did not have to feel this way. He assured me that he had a gynecologist for me to go to, one who understood that there isn't a one-size-fits-all answer for every shmirshky. This doctor had been studying PM&M for quite some time and would find the answers that were right for me.
As soon as I got home, I went right to my computer and began reading all I could about this referral. In addition, the next morning I called other shmirshkies to see if any of them had heard of this doctor. Then I made an appointment for David and me to interview him. I was anxious for this appointment and hopeful that there were better days ahead for me.
I LOVE LOVE LOVE this doctor! He was truly a godsend. He gathered detailed information about all of my symptoms in a manner and depth that no other doctor had ever done. By doing this he was able to zero in on my personal needs; he treated me in a very specific and conservative fashion. At long last, I had a partner helping with my decisions. I had finally hit my shmirshky jackpot!
Shmirshkies love to redecorate. We change our hair color at the drop of a hat, the length of our dresses, the color of our walls, and the layout of our living rooms. We love to remodel things. Often if we don't like something, we just get rid of it.
Let me stop right here and say that if you think that all is solved if you redecorate the shmirshky by having a hysterectomy,
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you are in for a rude awakening. If you're told by your doctor to have a hysterectomy,
please, please, please
be sure to get a couple of opinions before you book the surgery. Remember, reaching out is IN; suffering in silence is OUT.
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shmirshky party alert!
My friend Joan found out she was estrogen dominant
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(see chapter 15, “To HRT or Not to HRT?”), and her gynecologist immediately told her that she needed to have a hysterectomy. Instead of rushing into surgery, she got a second opinion and ultimately decided against surgery.
Gloria's experience was very similar, although it happened thirty years earlier. Gloria was estrogen dominant as well, and her doctor told her, “If you were my wife, your uterus would be in a jar.” That's pretty harsh language. I wonder how he would react if someone told him, “If you were my husband, your testicles would be in the trash.” Gloria canned the doctor and the surgery. Remember, second opinions are always a good idea.
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Many shmirshkies do not do this; they just get one opinion. Listen carefully: when you have a hysterectomy
and
your ovaries are removed, your body goes immediately into M. As you can imagine, this can be quite a shocker to both your body and your soul! Other potential side effects of a hysterectomy may include incontinence
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and pain during sex. It's important to be sure you
really
need to do this. Discuss your options and the potential side effects with your doctor. I read a wonderful article in
More Magazine
's December 2008/January 2009 issue called “The Endangered Uterus” by Peg Rosen (love the title!). Take a look at this before you redecorate.
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shmirshky party alert!
Erin had a complete hysterectomy in 1991. “I did not think this surgery was going to be so devastating to my way of life,” she says. Erin is now sixty-three and recently had to have a second surgeryâfor incontinence. She describes the surgery as “The kind most women apparently do not like to talk about.” Incontinence is not entirely uncommon for shmirshkies who have had their uterus removed, because the uterus holds up other organs in a shmirshky's body. As Beth Battaglino Cahill puts it in “The Endangered Uterus” article, “Removing [the uterus] is like pulling out the cork from an upside-down wine bottle. Unless the woman has strong muscles, her bladder or her bowels can descend into her vagina.” I admire Erin for sharing her experience. It's a good reminder that surgery can sometimes cause as many problems as it solves.
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Not all shmirshkies experience the devastating side effect that Erin did. After several consultations, Darby and Monica each found that they needed to have a hysterectomy. Their doctors spent time preparing them for the post-surgical hormonal responses. Together with their doctors they developed a customized plan for post-surgery shmirshky health.
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shmirshky party alert!
Darby was thirty-nine years old, married for two years, and was “Deliriously happy with a perfect sex life.” She told me, “I had a period that came every twenty-eight days like clockwork, blessedly light flow, no cramps, bloating, or other problems. Then suddenly it all changed and I began having erratic periods, heavy flow with spotting in between, insomnia, mood swings, and cramps.” It turned out that Darby had endometriosis
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and her ovaries were in cell change.
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“My doctor prepared me for surgically induced menopause,” she said. “I was put on HRT immediately after surgery. I have been completely free of menopausal miseries ever since, and have the bonus of not having to worry about contracting ovarian, uterine, or cervical cancer.”
Monica was in her late fifties when she redecorated. Her doctor had a tremendous amount of problems balancing her HRT. As she explained, “I was turning into a crazy personâbleeding and possessed. I had a hysterectomy in my late fifties (eight years ago). It was done laparoscopically. I am not a bit disfigured by it, and in fact, I have a perfect menopausal body. This surgery saved my life and my marriage.”
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It's important to be cautious like Joan and Gloria, but if you find, after getting multiple opinions like Darby and Monica, that a hysterectomy is the
only
solution for you, then be sure to find a doctor who will take the time to tell you what you'll be experiencing and help you understand your options. Peg Rosen's article also gives you a list of all the different styles you can choose from. You can't pick from traditional, contemporary, or California classic, but you have choices. Read about them!