Before and after my hormone therapy
+ 'My husband is fine with me doing a threesome without him — but am I OK with it?'
I’ve come a long, sweaty way, baby
Finally: Winona stopped my perimenopause rollercoaster ride
If Winona existed six years ago, I would have saved a lot of time, confusion, and sleepless nights. When I came out as perimenopausal in 2019, the world was a different place. Perimenopause was barely a topic of conversation, and hormone health platforms didn’t exist.
At the time, I was 42 and going through the hell of telltale perimenopause symptoms, but I couldn’t get a doctor to take me seriously. I went to several general practitioners and an OB-GYN, who quickly dismissed me as “too young to be in menopause.” But that’s the point. I was and still am in perimenopause, the period leading up to menopause.
With each doctor visit, I felt like I was teaching medical professionals about perimenopause and quickly learned that most American doctors do not receive robust education about menopause in traditional medical schools. Fewer than 2,000 doctors specialize in menopause care today.
All of this is to say that I’ve been through the wringer to confirm my initial hunch that I was in fact in perimenopause. Along the way, I’ve earned an unofficial bachelor’s degree in How to Do Perimenopause by reading books, attending events, and connecting with pioneering women in the menopause awareness space.
Now that I’m 49, here are the morals of my Adventures in Perimenopause story:
1. My experience with hormone therapy has made a night-and-day difference in reducing my perimenopause symptoms, including severe night sweats and insomnia.
But it didn’t happen overnight. After being dismissed by “regular doctors,” I saw multiple menopause specialists and tried several combinations of hormone therapy, ranging from just Progesterone to Progesterone + the Estradiol patch, then continuous cycling of The Pill (that worsened my symptoms), and then stopping The Pill cold turkey (long story). The switcheroos stressed me out, but in retrospect I learned a ton about the importance of getting the right hormone therapy for you.
2. Don’t ride a rollercoaster if you don’t have to.
If you're experiencing perimenopause/menopause symptoms — which range from hot flashes to anxiety and unexpected weight gain — make your life easier and join Winona.
How does Winona work for women in peri/menopause?
Winona provides personalized menopause care for women who live in the United States. After a virtual consultation, Winona’s team of board-certified doctors can prescribe medications including progesterone and estrogen and mail them directly to you.
Start with an online consultation: You’ll take a detailed health assessment, including your symptoms, medical history, and lifestyle.
Get a personalized treatment plan: A licensed Winona physician will review your health assessment and develop a tailored treatment plan, usually within 24 hours.
Medication will be delivered directly and discreetly to you: Treatment often includes bioidentical hormone therapy in the form of pills, creams, or patches.
Ongoing care: Winona emphasizes ongoing support and follow-ups to ensure the treatment plan adapts to your evolving needs. You can also message your doctor with questions or concerns.
Join the Winona community: Learn more in a safe space for menopause support, events, and educational courses.
Winona is particularly beneficial if you:
Have issues getting hormone therapy from your primary doctor or OBGYN.
Are allergic to ingredients in FDA-approved hormone therapy. Winona prescribes bioidentical hormone therapy that uses plant-derived hormones and are chemically identical to those naturally produced in the body.
Are already on hormone therapy and don’t need to see a doctor in person regularly. You just need to refill or modify your prescription.
How hormone therapy helps my perimenopause symptoms
These were my most frustrating symptoms:
Night sweats, er, more like sweating buckets while I’m sleeping
Before hormone therapy: Night sweats were at the top of my complaints list because I sweated through my sheets and pajamas every night and changed my pajamas up to three times in eight hours.
Now that I’m on hormone therapy: I very rarely get night sweats — maybe once or twice per month, usually before I get my period.
Moodiness and irritability
Before hormone therapy: Second on my list because moodiness is the worst part for my family.
Now that I'm on hormone therapy: I’m rarely moody or irritable, except the day before my period (oh, PMS).
Bloating
Before hormone therapy: I was asked if I was pregnant.
Now that I'm on hormone therapy: Still happens but not as frequently and not as severely.
Sleep issues
Before perimenopause, I prided myself on being a champion sleeper.
Before hormone therapy: As a perimenopausal woman, I often shot up in the middle of the night, disturbed by the above-mentioned night sweats or an insatiable craving for carbs.
Now that I'm on hormone therapy: Paired with Trazodone, I’m an overnight sleeping success story.
Belly and midsection fat
Before hormone therapy: I started perimenopause shortly after giving birth to twins, and even though I got right back into my running routine, my belly kept growing.
Now that I'm on hormone therapy: Ugh, I still struggle with losing belly fat, but luckily, I haven't gained any more fat since I started HT. Now that Winona prescribed DHEA, I have more energy and feel like exercising more, so I’m hopeful!
Chronic headaches
Before hormone therapy: Headaches were so bad and frequent that I’d often miss at least one day of work per month and would be out of commission for hours at a time.
Now that I’m on hormone therapy: I rarely get headaches, except sometimes the day before my period.
My Winona perimenopause treatment plan
Estrogen Patch
I was already happy using an estrogen patch, so I stuck with it instead of using estrogen cream.
Benefits in Winona’s words: As we age, women’s bodies produce less estrogen, which contributes to some of the clear signs of aging including the lines on our skin, our sore muscles, and other symptoms that can be incredibly disruptive including: Tired of being tired? Want your hot flashes to chill out? Bio-est cream can be the way to reduce the perimenopausal and menopausal symptoms that are vexing you.
Bio-est can help prevent:
1. Weight gain
2. Sleep disturbances like insomnia, night sweats, and early awakening
3. Hot flashes and excessive sweating
4. Anxiety, moodiness, irritability, and depression
5. Vaginal dryness, irritation, urinary urgency, and frequent UTIs
6. Sexual discomfort and/or pain, and decreased libido
7. Brain fog, memory problems, and acuity disruptions
8. Aging of the skin, hair, and nails.
9. Low energy that turns into overall fatigue
Progesterone 200 MG capsules, 1 at bedtime
I’ve been taking Progesterone since I started hormone therapy, but I was previously on a lower dosage (100MG) nightly.
Benefits in Winona’s words: Progesterone, with Estrogen, can decrease the menopause symptoms that can be adversely impacting your days and nights. If you have a uterus and are taking estrogen progesterone is prescribed in order to prevent thickening of the uterus lining (endometrial hyperplasia).
DHEA, compounded and plant-derived
I recently did bloodwork at OneMedical to check my iron and cholesterol levels and learned that my testosterone level was on the low side as well. When Winona prescribed DHEA, I was curious and happy to give it a go — especially because I struggle with low energy and DHEA can help with that.
Benefits in Winona’s words: DHEA supplements + Anatrozole may increase the levels of testosterone for women just enough to slow the signs of aging, improve muscle strength, increase metabolism, boost bone strength, help with thinning vaginal tissue, and even enhance memory.
Estriol Cream with Tretinoin
I’ve been wanting to try estriol face cream, so I treated myself. I applied nightly and saw positive results within two days. Winona’s Estriol Cream with Tretinoin has made my skin smoother, less oily, and also helped reduce acne, although that isn’t listed as a benefit. Because I live in a dry climate, I’ve been applying a light moisturizer on top of the estriol cream.
All in all, I feel really good about my Winona hormone therapy regimen. It took years to get here, but I finally have a holistic treatment plan that gives me more energy, less moodiness, way fewer headaches, and I sleep all night without sweating. All of that’s worth its weight in gold.
Learn more about Winona here.
Happy belated Orgasm Day
Yep, it’s a thing — the official holiday was on Thursday. It got me thinking about sex and how you might have missed some of our stories from our early days. Here’s one of my faves — a letter from a Midst reader and my mentor Dixie James’ advice.
My husband is fine with me doing a threesome without him — but am I OK with it?
Dear Dixie,
I’m 46, married, a mom of two, and a busy career woman. I've been married to my husband for 20+ years, and our intimate life has been going downhill for several years (he’s almost asexual now). I still have my needs, which are even stronger than before!
Due to his lack of interest in sex, we agreed a few years ago that I may selectively seek pleasures outside of the marriage, as long as it doesn't affect our family dynamics and I keep it 100% discreet.
He was fine with the “don't ask, don't tell” policy. However, after two brief intimate dates with men (both during my work travels), I found that was too risky. Instead, I preferred “no-strings-attached” relationships with women who were also seeking discreet relationships to enjoy lesbian sex. I was fortunate to meet some amazing women in the last few years (who were also married and wanted to keep things discreet) and enjoyed those beautiful moments with them thoroughly ;).
Because of the “don't ask, don't tell” policy I have with hubs, I didn't feel the need to share any of this with him. I may have mentioned some in passing casually, but he never wanted to know the details. I was also managing these relationships well despite being a busy career mom, and it didn't impact our family dynamics in any way.
But now I’m dealing with a new situation where the woman I’m seeing would like to open our relationship with her husband and possibly include him. I never had to deal with a similar situation before because the women I’ve dated were fine with keeping things discreet from their husbands.
Xo,
Madison
You could spend $100+ on an Essentials Fear of God hoodie or you could support an independent woman-owned business and invest in an I’m Essential hoodie for yourself or a friend. :)
Glad Winona was able to help you. My wife is post menopause and was brushed off by her PCP and gyno for years. She finally went to the Center for Menopause and Woman’s Sexual Health at Northwestern University (founded by Dr. Lauren Streicher) and got the help she needed. Women make up about half of the population and need better care, especially when it comes to menopause.