The choices we make

Because this blog, among other things, is intended to discuss aging, I decided to write about something I hadn't been sure I ever would, but it is something all of us face-- male and female-- in one form or another as part of getting old-- hormonal changes. Since we are all different, my experience is not any guidepost but simply what it was for me as an aging woman.

When I was 54, I finally got a diagnosis for something that had been troubling me for several years. The pain reached a point where I went in for a series of tests which determined I needed a complete hysterectomy. It was a shock as that was not jotted down in my life plan; but the doctors (two opinions) thought it was possible it was cancer and there was no putting it off. It was not cancer, and I made a great recovery from the surgery; however, it led to something else I had also not been thinking I'd do-- hormone replacement therapy.

I could have gone into surgical menopause but opted instead to take the prescription the doctor recommended, and we worked out the dosage by how I felt. Which was incidentally better than I had for years before that time. (Perimenopause-- the time before menopause-- is an interesting time. Mostly women don't know a lot about what to expect other than books and word of mouth experiences of others. Some doctors are a help but others appear to know less than we do.)

Since then, I have read whatever comes along regarding taking hormones. To begin with, it was mostly positive; but starting a few years ago, came one article after another on negative test results for HRT. I read what I could find which didn't define much, asked my doctor about it, evaluated it all carefully. Mostly it has been-- If I do this, I increase my risk. Oh wait, if I do that, I decrease risks. Your risks are increased by this percentage over what they were before-- whatever that was. The reading alone can cause a person to age 10 years, but I did it because I wanted to be responsible in my choices.

One thing I evaluated was the age people live to be today and how many of those years did I want to live without estrogen and progesterone? Then I considered quality of life vs quantity. I didn't want to do herbal remedies as most of those are not as well tested; and to me if you take anything to a medicinal level-- in other words enough of it to impact your body-- you are taking a medicine-- whatever it's called.

A year ago I finally did enough research on bioidentical hormones and worked out from online sources what my dosage should be to match the artificial ones. I found out there was a compounding pharamacy close to where I live, which is what you really want if you are taking bioidentical as ideally you take the estrogen twice a day. The bioidentical doesn't last as long as the chemical.

When I went in for my physical last year, I requested the new prescription and changed over to them this winter. Before I began, I had a saliva test at the pharmacy to determine my current hormone levels and it was decided the dosage I had calculated was correct for now anyway. I paid for that test myself and never had any doctor offer to do one in the clinic where I go. Probably other doctors would have done it differently, but it was worth it to me to pay for that test which will be repeated about 6 months after the first to see how the bioidentical compares. I also am now paying for my own hormones and not getting them through an insurance plan anymore as it seems insurance plans are less happy with compounding pharmacies. By the time the co-pay was figured in, my cost is not much increased.

I do plan to someday go off these but not right now. I don't kid myself that bioidentical hormones could not have the same risk as the others. I am taking a medicine that impacts my body; but I also am not ready to give up estrogen just yet. I am not taking mine to prevent hot flashes, as I really never had many of those so don't know that would have been; but it has been for an overall sense of well being. They do not prevent aging, but maybe for me they are part of aging gracefully or is that gradually?

Anyway I would be happy to answer questions if anyone is still facing this choice for themselves. I certainly am no expert and can only discuss my own experiences. No women in my family before me took hormone replacements. It's not the natural way, but first my body and then I opted to interfere with natural. Whether that was wise or not is yet to be determined.

The picture above is from last week-end up the Molalla River in Oregon. It's my most recent which was one reason to use it, but it is also of a river which is fast moving, many rocks in it, some rapids, pools, who knows what lies around the bend-- kind of like life.