Our Blood, Brains, and Bones: On Hormones, Health, and Happiness

There’s a term for what happens when a woman’s hormones are stripped away overnight. It’s not gentle, and neither is the aftermath. Almost three years ago, I went into menopause overnight due to the radiation. I immediately began to develop symptoms of what I now know is Sjögren’s Syndrome: excruciatingly dry, red eyes, dry mouth, and my kidneys and bladder felt like they were on fire. The day before I graduated with my master’s, I was in the ER thinking I had a kidney stone. At that time, doctors advised me not to do hormone replacement therapy because I have a genetic mutation called Factor 5 Leiden which increases my risk of blood clots. Over the next two years, without the hormones my body, brain, and bones needed to function, my mental, emotional, and physical health declined. I ended up with severe spinal stenosis and a cyst in my spine that caused debilitating sciatica. I could barely walk, let alone run. I had no idea that hormones had such an impact on the musculoskeletal system. 

A year ago, I made the decision to go on hormone replacement therapy or HRT and worked with my naturopathic doctor to take a supplement that reduces my risk of blood clots. Over the last year, it has taken time to find the right formula and the right dose. For a while, the estrogen was too high. I kept seeing colors in my field of vision, I would get out of breath with very little exertion, and my mood fluctuated wildly, so the doctor lowered the dose. The morning after taking a half dose, I felt like someone had turned the lights back on. For the first time in almost three years, I now sleep through the night, I can focus, my mood is stable, and the spinal cyst is gone. I can walk, even run again. When it comes to treating mental, emotional, and physical health, we cannot discount the importance of hormones.

Estrogen is crucial to the health of our brains, bones, and hearts, but also our mental and emotional health and wellbeing. I have friends who have survived breast cancer. I have another who survived ovarian cancer, but she can’t take estrogen because she has a rare disease that is made worse by taking estrogen. Her doctor told her she had experienced “female castration.” That hit home for me. I realized that’s what I had experienced too. Women are suffering. When hormones are suddenly stripped from a woman, we go through rapid aging. Each year is equivalent to five. As a society, we have invested so much into fighting cancer, but women who cannot take hormones are left with severe mental, emotional, and physical health issues. Our friends and family celebrate when the cancer is cured, but they don’t understand the suffering we endure afterwards. And survivors feel like we can’t complain because we should be grateful to be alive. We are grateful. But we don’t just want to be alive. We want to thrive. We want to be healthy. Emotionally, mentally, and physically healthy. It’s not enough to kill the cancer. We need to find solutions for women who can’t take hormone replacement therapy that support our wellbeing so we can be well. 

Progesterone is crucial to keeping estrogen in check. Excess estrogen, or “estrogen dominance,” plays a factor in gynecological cancers and breast cancer. This is why we see so many women getting breast cancer in their forties and fifties: they are going through perimenopause and menopause, and their progesterone is declining, creating estrogen dominance. Progesterone also improves mood, reduces anxiety, and promotes better sleep by increasing levels of GABA, a neurotransmitter that has calming effects on the brain. I take micronized progesterone. It is the “bioidentical” form, meaning it is chemically identical to natural progesterone, and I notice a difference from when I took the synthetic version, which left me with a headache in the morning, almost a “hungover” feeling. With micronized progesterone, I wake up feeling refreshed. 

Testosterone, in addition to boosting libido and sexual health, is the foundation of muscle mass and strength and bone health, as well as boosting mood, cognitive function, and energy levels. Crucially, it is necessary for healthy formation of red blood cells. Since treatment, my blood levels have been low — low enough that for three years, I spent a few hundred dollars a month on a blood-building supplement just to keep my count from dropping further. Every few months, more blood work. Every few months, the same numbers, barely holding. It became its own quiet, exhausting job, on top of everything else. And then I tried testosterone. Over time, I didn’t get out of breath as easily. My core strength came back. I can do a headstand in yoga again, and my friends comment on my muscle tone, saying “You look really fit.” Most significantly, my mood completely stabilized. Too much estrogen made me more moody and reactive. Testosterone enabled me to feel like me again. And I was able to give up my expensive supplement in exchange for a $75 testosterone formulation that lasted six months. 

I tend to believe everything happens for a reason. The women in my family really suffered mentally and emotionally in menopause. Perhaps going into menopause rapidly, and now getting on the correct hormone regimen, spared me a decade of unstable moods. In the last three years, I’ve endured the death of my sister, the loss of my brother, the last of my four siblings, cancer diagnosis and treatment, managed the resulting physical health issues, and a pending separation. During this time, I also managed to graduate from grad school, tackle two new jobs as a clinical therapist, launch a new business and brand, and give all I can to my kids and clients. On balance, I’ve done pretty well. Can’t wait to see what I can do with balanced hormones. For now, I have my health and my happiness. And that’s a great start.