In Part 2 of the Menopause Journals, Christina Ioannidis gets a diagnosis and a revelation that changes things.
November 20 – March 21
Grief. Trauma. Depression. The sudden loss of my beloved mother throws me into the depths of an unfathomable pain. I am inconsolable – crying at every turn. I wake up in the middle of the night with the vision of her final moments replaying in my mind. My body is in shock. My emotions numb. My sleep is extremely disturbed – middle of the night meanderings are common. Quite simply, my cortisol levels, the stress hormone our body secretes, are in overdrive. My depression is worse than ever. I am an anxiety machine, ready to attack anything and anyone. I feel like a sprung coil.
I become secluded, withdrawn. But slowly my sleep improves and my mood starts to lift. Slowly I am able to do more than one thing a day – the laundry, washing up, or other minute chores. They are tiny things but I feel like I have conquered Mount Everest.
I note that my pre-menstrual symptoms are getting even more acute. My mood swings are so extreme, I feel like a metronome. It is said that stress can affect the timings of your period, but mine are like clockwork. At least, one thing seems to be working normally. Ha!
I feel a surge of energy hit me. I am what I would call productive (compared to the previous periods of complete inactivity, that is). I start work on my new website and book. Things are looking up. I am able to work out in the mornings. All of a sudden, my body is ready to really move. Just like magic, the stiffness lifts, and I am back to my normal work-out routine.
And then, the climax. My period this month is the most painful EVER. My flow is extremely heavy. Ibuprofen does nothing. I take Codine in vain. Any over the counter painkiller I try does nothing to help. I go to bed, watch Neflix. I live five complete days in bed with the warm electric pillow practically on my stomach or back practically non-stop. And then, another thing which has never happened before. My pain does not stop at the end of my period, it continues. Constant pain in my lower back, like the vertebrae have been soldered together. I know I have to see a specialist. In a new country I need to find a new gynaecologist. So, I turned to the one to whom I had been referred and who is considered highly specialist in his field.
Two weeks into the month, I have my appointment with my new gynaecologist. I am looking forward to seeing him (yes, I went to a man, given he was referred to me by people I respect), like the first day of school. (I loved school!)
First impressions are of a successful practice. Big, clean, airy. Despite waiting for 1.5 hours, my excitement does not falter. I am ushered in to speak to his nurse as part of the triage. A note of all my symptoms and history are taken. All great. Then I am invited into the examination room. Upon seeing the dreaded ‘chair’ with the stirrups, I go cold. Straight into this? ‘Take your underwear and trousers off, pls, and sit yourself on the chair’, I am instructed. I follow the instructions, petrified.
‘Is this how I will meet the doctor?’ I ask. ‘He will see my vagina before he sees my face?’ I let out a nervous laugh but I am mortified.
Things do not get better. The examination shows that there is nothing wrong with me, apparently. My uterus is perfect. I ask about the excruciating pains and am told: ‘It was just an acute pelvic inflammation. It can happen’.
So, if this is normal’ I ask, ‘what about looking at how my hormones are doing – surely we need a hormone test of sorts’? (I point to the bottle of bio-identical Progesterone brought with me). ‘No need. You have a timely period, so you are fine. I would even stop the Progesterone if I were you’. I freeze. And then I start fuming. This ‘doctor’ had no concept of the complexities of the female body (and psyche). I leave his office livid.
I get onto the sisterhood, and ask for a referral; a wonderful friend recommends a female gynaecologist who has excellent reviews, and I duly book with her. I ignore the male doctor’s advice. I need a second opinion, and I am ready to wait the 1 month to see her. I have to go to someone who could understand.
The first of this month is the day my world changed. I see the new gynaecologist, a woman this time. Within 10 minutes of talking about my symptoms she is very clear. She diagnoses me with endometriosis. My level of pain, the heaviness of my flow, the symptoms I feel during my period reveal to her that I am suffering from this painful condition. Which is, also, how she explains the extended debilitating back pain episode I experienced 2 months prior.
There is no doubt in her mind that I have it; in fact one in 10 women suffer with endometriosis but it is often misdiagnosed. Immediately she refers me for blood hormone tests – cortisol, oestrogen, progesterone, thyroid, serotonin, among others. I also sign up for the Dutch test, considered one of the best hormone diagnostic tools. It involves peeing on a set of paper-based urine collection devices at specific times of day. It is simple enough as the instructions are very clear. The paper-based urine collection devices are then sealed, and sent to the US for analysis.
The blood test has to happen on the 21st day of the cycle, after ovulation. I undertake them as advised. Within days I receive the results, along with a follow up call from the gynaecologist. There are 2 main takeaways – I have extreme oestrogen dominance and need to up by four my progesterone intake. I also have low serotonin, which explains why I have been so depressed. She added L-trytophan for the latter, chaste-berry.
Within days, I feel better. Along with the diagnosis, I get my period on time. And this time, it is a breeze. I have mild pain, for which I take 3 ibuprofens during the first day of my cycle. I am even able to have my daily walk – something I have not been able to do for years during my time of the month, as I am normally bed-ridden. I am enthused. I can’t believe the difference. Something is working! And I am sure that this is the moral of this story.
It will be hard to pinpoint just ‘one thing’ that is working or making a difference. I suspect it is all I am doing that is working in tandem: my diet, my exercise, the abdominal manipulation. But I am writing this because I don’t want anyone else to suffer like I did. Get the right diagnosis and the right supplements and spare yourself the gloom and the agony!
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