¶ Intro / Opening
Welcome to the Dear Menopause podcast , where we discuss the menopause transition to help make everyday life a little easier for women . Hi , this is Sonya and I am the host of Dear Menopause . Today , you are going to be listening to part two of my conversation with Alex Isaac , and we are focusing today on Alex's journey after her surgically induced menopause .
Now , if you missed part one of my chat with Alex , I do recommend that you go back and listen to last week's episode Before you settle into listening to this episode . Everything will make a whole lot more sense if you do . I have loved chatting with Alex .
Her openness , her transparency , her willingness to share her story so that others can learn from her and be inspired by the journey and research that she went on has been incredibly courageous and I am incredibly grateful Enjoy .
So , alex , when we finished the last part of our conversation , we had just touched on the fact that you had finished up having your preventative surgeries that had put you into your surgically induced menopause .
I did a lot of research before my hysterectomy oopherectomy into HRT , because I am actually didn't even want to consider the preventative surgery unless I knew there was treatment options that would help me navigate menopause , surgical menopause . So you know , a lot of my research touched on , obviously , estrogen , testosterone , you know progestogens .
So I had done a lot of the research beforehand so I knew , going into the surgery , what to expect . But there is nothing quite like feeling . It is there . I proposed the concept to my surgeon that maybe I would start HRT before the surgery . She didn't think that was worthwhile , which I understand now .
But she proposed that I start my HRT a few days after my surgery , which I challenged because my understanding was that really my ovaries would stop producing the hormones within about 12 to 24 hours . So I proposed the idea that we start HRT on day one because I couldn't see why not . And she said go for it if that's what you want to do .
So that's I feel , and I feel like this is a common thread with surgical menopause . Menopause , hrt is a lot of the advice out there . You know you have to be well researched yourself and you have to get your head around your own menopause journey because a lot of the advice out there is patient driven .
A lot of self-advocacy .
And so yeah , which is a bit scary for a lot of people when me included . You know this is a new area of research for me the whole menopause and hormones . I've learned a lot , but I really felt like I was driving conversation with a lot of medical professionals I was talking to . I had the surgery started , hrt on day one , I think .
Really , I started on estrogen only because I've had my uterus removed , so I would not need to do the progestogens if I don't want to . I probably could if I wanted to . That's something that we'll discuss a little down the track .
But yeah , so I started with the estradiol gel or Sandrina is now what I've moved over to because it's just a little bit easier in the sachets . I found within about two weeks I didn't have any hot flushes , but I started feeling some heart palpitations at night and having some sleep disturbances and I started feeling anxious , which for me was completely new .
I've never had these feelings before , ever in my life . So it was very clear to me that it was hormone related . Spoke to my GP I don't know if I'm allowed to say a name .
That's just like that , as you spoke to your GP , I spoke to my GP , who's phenomenal , and she said well , let's step up your dosage by about another half on what you're on , and that fits in . But that fixed it immediately . So to me I feel like it's the anxiousness , those feelings , the sleeplessness , the heart palpitations .
It's so clear for me that they are related to hormones and nothing else , because I literally went into hormone and into menopause overnight . So it really can't be anything else , given . I've never felt those feelings before .
Yeah , there was such a clear line in the sand view , wasn't there , of I had these hormones and now all of a sudden I don't have these hormones . Well , when siding with that , is this symptomology ? Okay , there has to be a correlation between the two . And I think also the other great takeaway from that is you know what you ?
You've got such a great relationship with your GP and I know your GP . She is so well educated when it comes to using hormone therapies with her patients . The big takeaway with that is walk to your GP , get a good GP .
That is across using hormone therapies , because every woman's experience is going to be so unique and you have to be able to tweak your hormone therapies .
So , it might be that you need to either up or pull back on one , whether it's the progesterone or the estrogen or the testosterone , if you're you know that's something that you've added in with the mix as well . It's never , it's not a cookie cutter prescription .
Absolutely . I couldn't agree more . That's another thing that my GP suggested , which is really nice to be relying on a GP that is making suggestions , because up until this point again , as I mentioned , the conversation had been driven by me .
She proposed the idea that we try out some testosterone , because up until two weeks ago my body was naturally producing good , solid amounts of testosterone and now it wasn't . We started with that as well and that's helped immensely .
I will say probably a lot of your listeners out there might be struggling to find a GP that will have these conversations with them . I still find it's quite difficult in Sydney , australia , to find a GP that is confident enough to talk about the various different types of HRT and to talk about HRT at all or needing HRT .
I really searched hard to find a GP that would welcome that discussion . I looked on the I think it's the Australian Menopause Society website . I've got a website with some GP's that are across this . I looked there . I asked friends , family , women are the local area . It took me a good six months to find this amazing GP who is across it .
That's interesting . I'd like to just step back from that a moment , because obviously you were seeing a specialist , a surgeon . Obviously she was your first prescriber of your hormone therapy . What support did you get from her after that initial prescription ?
I received the initial prescription , we knew I would have a surgical follow-up . I suppose the assumption is that I would mention any symptoms if I had any Other than the initial script that she gave me for just Easter dial . That was it . I prompted the discussion about testosterone . She said we could discuss testosterone in the future if I had a lowered libido .
That was the end of the discussion with this specialist about HRT . Really , all the other information that I gathered was through my research and from the GP . That was basically where the HRT discussion ended was after Easter dial .
Would you say that you felt that that side of the conversation was lacking , considering she was the person , maybe not lacking , but was perhaps not as supportive as it could be , considering she was the person that took away your hormones ?
Yeah , I mean , who is responsible for this discussion ? I suppose you think it would be your gynecologist Ultimately . Maybe that specialist doesn't ? I mean , they feel that they're responsible for getting you off the ground , but ultimately they're a surgeon , right ? So I don't know . I guess there's a shortfall there . Who ?
There is , isn't there ?
Yeah , that was my experience with the medically induced menopause .
Mine was caused by my oncologist , if you like . So he was the one that administered the chemo which was the drugs that created my medically induced menopause . But then there's this gap that you all through when you leave their care to you . Know , and like you , I had to go on my own journey of discovery and find it .
You know , ultimately a GP , and I'm still struggling with the whole being denied hormone therapy argument which we're not going to go into here today . There is a gap , after your care from these specialists , of making sure that you're being cared for and looked after from a menopause perspective that I think we need to do a whole lot better for our women .
Well , like you know , like you said , it's actually also not just HRT , right it's . Then , you know , bone density scans . Oh , it's yeah , right . And dietary and exercise and menopause is not just a point in time . And then you're done and you're over . This is it ? I'm going to be menopause .
I will be longer in menopause in my lifetime than out of menopause , absolutely Right . And so then , is it the next step ? Is it an endocrinologist ? Well , why do I need to be seeing an endocrinologist for the rest of my life ? That's insane .
But it's also , you know , menopause puts all women , and so the earlier that you go into your menopause , the more these things become important . You know , yes , you've touched on the bone health . Cardiovascular health becomes very important because women's risk of dying from heart disease increases once you're in a menopausal state .
Risks of dementia are increased , and particularly if there's family history there . I know there's still some research being done around that , but there is believed to be a link there .
¶ Menopause Treatment and HRT Impact
Someone like yourself that has gone into their menopause at such an early age . We have to be considering these factors , and that's where I find that this gap that exists between being handed over by the surgeon to finding a GP that was confident and competent enough to be able to care for you should not exist .
Right , and so the GP should be the person confident enough to manage this , because otherwise what's going to end up happening is few years down the track will , hopefully not a few years . Hopefully women are onto their symptoms . But , for example , mental health .
So let's say a woman's struggling with her mental health and her anxiety and she goes to see a counsellor or a psychologist or psychiatrist . Should they then be informed and trained with HRT , or at least with hormones and hormones ? Absolutely Right . So then also , yeah , as you said , the cardiologist .
So let's say , a woman presents with heart issues , so do they need to be trained with menopause treatment , hrt treatment , bone specialist , you know , as you said , insulin resistance , diabetes , dietitians , you know , I mean , it's just the impact is so far reaching . So either do all these specialists need to be trained .
Can the GP be up to speed so that we can avoid these people needing to see a specialist to start with ?
But we definitely need to remove the onus from the woman being the one that has to go and do the research and be the advocate for herself , to join all these dots and put the pieces together herself .
Right , correct , Because we put a certain amount of trust in our medical experts you know and professionals , and we should be able to . Of course , we need to make the decision for ourselves , but it'd be lovely to have the guidance and the trained expertise to give us the right advice .
Absolutely . So how are you feeling today ?
Good , I'm feeling great . I'm on my Easter Jen , easter Dal , and I'm on my tea . I've got it all . I'm feeling great . I'm feeling really good . It's definitely settling in . So , yeah , I'm feeling maybe even better than I was , who knows ?
Wow that's awesome yeah .
Yep , I'm great . Back on my game . I'm 11 weeks post-surgery , so almost the 12-week mark is post-historic to me is when you can really just do anything you like . So I'm almost there . Next week I'll recommence my netball career . Woohoo , I'll be jumping around the court with the best of them .
Excellent . So you are definitely leaning into the powerful post-menopause all years .
Absolutely . I like how you've phrased that , that's for sure .
I wanted to touch on quickly , if it's okay , before we wrap up . Your experience with your surgically induced menopause has been very different to Sarah's , your sister's .
Definitely .
In what way ?
Given her breast cancer history , was not offered HRT . In fact , when she questioned it and asked if she could do HRT , she was told she couldn't at that point , obviously , that was very disappointing . That was after she had her uforectomy hysterectomy . She was told she couldn't do HRT because of her breast cancer history , even though she had a double mastectomy .
In effect , she had no breast tissue left in her body .
Nothing Technically . Her risk of developing breast cancer was down to between 2% and 4% the general population risk of breast cancer . I think now we're up to 11% or 12% , am I right ? She's statistically speaking .
Definitely lower than the average woman that is sitting at home drinking two glasses of wine every year .
Quite right , insane , still couldn't do HRT , even if she wanted to . I don't understand how they could have that sort of control . She challenged it for years , has finally found a GP that is on board with her Now , after experiencing significant menopause symptoms unfortunately for her for years , has now started her HRT journey , finally with me .
We're doing it together . How is she feeling ? She's so much . She's wonderful , so good , brilliant . We both love the estradiol , we love the testosterone . It's brilliant . She was advised , though , not to rub the testosterone on the inside of her leg for fear of transfer .
Turning into a horny 16 year old boy .
So yes , so she's been advised , not so naturally , we're both rubbing it on the inside of our legs .
Of course you are Much to your husband's delight , I would imagine .
Can't keep a good woman down .
No , I mean we laugh , but I'm so happy to hear that Sarah has found a doctor to work with that is giving her that relief and after years of really struggling with what I could imagine with probably some pretty severe symptoms , she's doing so Seeing the light .
Is she seeing the light physically present so much better ? She's got this pet in her step and a bounce and she's looking fit and fabulous and I know in terms of her health she's now moved away from she had started on a tablet and I spoke to her when I started on an astrodial and we're kind of in the journey together .
I recommended that she consider the gel because of there , when you take a tablet it can increase your risk of cholesterol , so obviously your body has to process it through the liver . So that's been a big benefit for her as well , going on the gel .
So we'll see what impact over the next couple of months that has on her cholesterol and reducing stomach , because she does have some high cholesterol issues there , which is another marker that does elevate for many women .
Definitely big impact for both of us and you know what , and we can edit this out if you would like me to , but I know how big an impact it's had on the two of you , because your mum is also considering taking some hormone therapy for the first time .
I want to get her across the line , dad wants to get her across the line , but I don't want to know . La la , la , la , la , la , la la .
Your mum's looking at you two going . These girls are having way too much fun .
I need to be in on this We'll get her some mum HRT for Christmas .
Oh my gosh , there is a pharmaceutical company out there that is going to run with this marketing idea there's going to be an HRT advent calendar . Thanks . Oh my God , I love that , and that is a brilliant note to wrap up on . Let's leave that for the pharmaceutical companies to run with . Alex . Thank you so much for your time .
I am so appreciative of you for sharing your story . You know you are glowing . It has been such a pleasure to sit down and chat with you . I really hope that there are others listening that will learn from this and that will perhaps be inspired to go and take their own action as a result .
Thanks so much for having me , sonia , it's been a pleasure .
Thank you for listening today . I am so grateful to have these conversations with incredible women and experts and I'm grateful that you chose to hit play on this episode of Dare Menopause . If you have a minute of time today , please leave a rating or a review .
I would love to hear from you , because you are my biggest driver for doing this work If this chat went way too fast for you and you want more , head over to stellarwomencomau slash podcast for the show notes . And , while you're there , take my midlife quiz to see why it feels like midlife is messing with your head .