Conversations about menopause have become common on social media, but three women in Bloomington-Normal say doctors are not talking about it enough.
Jennifer Funk from Normal had stopped having a period after getting the COVID-19 vaccine. Her doctors tested her hormone levels and told her she was in menopause. She was 42.
Funk said a doctor told her over the phone she was in menopause and hung up. But she had questions.
“Do I need any kind of hormone replacement therapy? What are my bones going to do? It's just I had no idea what to expect and there is this weird sort of grief that you are losing a part of yourself," Funk said.
Menopause is characterized as the cessation of menstrual periods, typically occurring among women ages 45-55. Declining estrogen production and fertility in the lead-up to menopause, a life phase called perimenopause, can result in symptoms like hot flashes, insomnia and mood changes.
After Funk was definitively told she was in menopause, her menstrual cycle came back.
“I went into this perimenopausal limbo," she said.
It went like this for a few years: in and out of menopause, conflicting test results, second opinions.
"I would go months and then I would be surprised with a cycle. And for me those would just be painful, and heavy, and horrific," she said.
Brain fog was Laura Edwards' first indication that something was different.
"It was awful," said Edwards, an Italian professor at ISU. "I was working on my dissertation and I found myself in meetings, with colleagues who are really smart, and unable to express what I wanted to say. I could feel it but the words wouldn't come."
Edwards started journaling, writing down everything she was experiencing.
“When you go to the doctor you only have a certain amount of time to discuss things with them, so I made a list and I told myself I am not leaving this appointment until I've gone through the entire list," she said. "I went through the entire list and at the end they said 'Yeah, that sounds about right.’”
“They didn't tell us anything when we were in med school," said Dr. Sherri Thornton, an OB-GYN at the Women for Women clinic in Normal. Thornton is certified through the Menopause Society—and personally experiencing it herself.
"They said, ‘You get hot flashes night sweats and it lasts about two to three years,’" Thornton said. "Well, come to hear, all these new studies—that's a big fat lie."
Until the 1990s, women were largely excluded from clinical trials. The National Institutes of Health now requires all federally-funded research to include women, but the medical field is essentially playing catch-up. And relatively little is known about something that nearly half the human population will experience.
Thornton said symptoms can be "unbearable," affecting sleep, mood and physical activity, which can lead to secondary impacts of menopause like weight gain. She and primary care doctor Mfowethu Langeni with OSF Healthcare in Bloomington prescribe hormone replacement therapy to ease menopause symptoms. They also recommend a healthy lifestyle and talk therapy.
Langeni wants his patients to understand their symptoms are real, caused by physiological changes in hormone production and thermoregulation. But they can also be subjective, making menopause "hard to decipher, diagnose and treat," he said. “But there are treatment options out there."
Hormone replacement therapy
Langeni and Thornton said taking supplementary hormones like estrogen and progesterone can ease the most visible symptoms of menopause. It can also help delay bone decay and provide relief for secondary symptoms like vaginal dryness, urinary tract infections and low libido. Early research indicates taking low doses of testosterone helps some women, though this isn't covered by most insurance policies.
Langeni said it can take time to figure out the right dosage and combination of pharmacological interventions. He doesn't count out homeopathic remedies and other supplements if they aren't counter-indicated by other medications or medical conditions.
Katie Quigg of Bloomington said combining therapy and medication has been a game changer for her. She entered menopause in her 30s when a medical emergency required removal of one of her ovaries.
“With that does come the risk of going into menopause," she said. "It doesn't happen to everyone, but they did say that it could happen."
Quigg said she experienced symptoms almost immediately. It started with joint pain and fatigue. Then weight gain and hair loss. Then anxiety, depression and overwhelming panic.
“I followed up with my gynecologist at the time. He told me that I probably had anxiety and needed a vacation,” Quigg said.
She got a second opinion. Four after her first symptoms, Quigg's providers got on board with the idea that she was in perimenopause.
“It was devastating," she said. "I was set to get married, right before we were kind of planning this chapter of wanting to have kids. And so it did feel like the story was being rewritten from what I had envisioned at the time.”
Quigg, Edwards and Funk said they've found support from talking to other women, both online and in friend groups. Edwards created the pamphlet she wished her doctor would have given her. Quigg found women her age going through menopause on Reddit.
And Drs. Thornton and Lengeni said the research is starting to catch up. Last month, a "black box" label was removed from hormone therapies used to treat menopause, which lacked a nuanced understanding of the risk-benefit balance for women under 60.
Right now, hormone replacement therapy isn't an option for Funk, but she's gotten more confident advocating for herself. After decades of pushing for a hysterectomy, she got one. Her uterus was riddled with endometriosis scarring, confirming her suspicions all along.
“Being loud about how women's healthcare is largely ignored, and women are invisible especially once they hit this stage, and the fact that young girls and young women have a right to know that it is OK to speak about how your body feels, and speak up for yourself when you are in the doctor's office, and to be proactive in getting the care you need—all that is like, let's be loud about that,” Funk said.
