Reinforcing the “Hormonal Female” Stereotype
You’re welcome. And, I’m sorry. But I think I’m doing just that.
After a visit to the psychiatrist in which I described my symptoms (regular physical symptoms of panic/anxiety with no underlying emotional connection or distress) and he responded by refilling my Xanax prescription, and dismissed the idea of checking my hormone levels, I went back to the OB/GYN/Reproductive Endocrinologist who performed my hysterectomy last year. I described the same symptoms to him, and he nodded throughout, and said that, while he wasn’t prepared to say that I do not need psychiatric care, all of my symptoms fit the profile of someone suffering surgical menopause without enough estrogen replacement. And my bloodwork confirmed that my estrogen level was low-ish, so we increased the dosage of my estrogen patch.
Ten days later, I feel on my way to being a new woman. It is supposed to take three weeks for the effects of the dosage increase to be fully realized, but already, the 5 hours a day I was spending in a cold sweat, feeling panicky and unable to leave the house is down to a matter of minutes. And what is bugging me right now is the idea that I have, perhaps, had hormone-imbalance problems for most of my adult life, and no one to recognize them as such, and treat them accordingly.
Knowing that many mental illnesses are triggered and/or exacerbated by hormonal events such as puberty, childbirth, and menopause, why is this not factored into diagnoses more often? It’s not just women–men are affected as well. My own husband seems to have experienced the first symptoms of bipolar disorder just after hitting puberty. But with women, I have the feeling that it just gets…overlooked more often. I mean, the very word “hysterectomy” pretty much indicates the medical community’s attitude toward things female, doesn’t it? That woman is unbalanced, moody, highly emotional, downright erratic…hysterical. By removing her reproductive organs, the part of her that’s female, we can make her sane. Whatever. I’m not crafting a very good explanation of what I’m getting at here, but I think you understand. Hello, AMA? It’s almost 2008. Can we have a NEW WORD to replace “hysterectomy,” please? Ugh. And by going on a rant about this, HEY, I’ve just proven them right, haven’t I?
At least they can’t say I’m “PMSing” any more.
How about the rest of you, ladies? What is your experience with the relationship between hormonal fluctuations and your mental/emotional state, particularly as regards diagnosed, medicated mental illness? Are hormone levels checked regularly as part of your treatment regimen? Is your “femaleness” even considered…or worse, is your mental state “written off,” even in part, due to gender and the perceived instability/emotional weakness of women?
Do you ever get the feeling that a doctor is listening to your symptoms, and wondering if it’s just “that time of the month?”
November 17th, 2007 at 10:18 pm
My ob/gyn is a lady and paid close attention when I described my newly fragile mental/emotional state for the past year. I personally thought I needed head meds at that time, but hormones naturally start decreasing in your mid thirties. Imbalance can look and feel exactly like depression, PMS, and other mental states.
November 17th, 2007 at 10:19 pm
P.S. the all natural magic lotion has made me human again.
November 17th, 2007 at 11:07 pm
My wife has been taking a whole bunch of meds after her DCIS and biopsy a few months ago, which is causing ups and downs with her hormones and estrogen. She hasn’t been too happy with her male family doctor, mostly because his explanation for some of her symptoms is that “this happens to women.” I think sometimes a woman does get a different POV from seeing a female doctor, especially when medications are involved. I have a feeling if this “happened to men” more often, there would be a lot more attention paid to this subject.
November 18th, 2007 at 1:02 am
I don’t see ANY male doctors anymore. For anything. Only women. Because THEY get it and male doctors don’t. My advice? Get yourself some nice women doctors and see if that helps.
November 18th, 2007 at 2:20 am
I haven’t been factoring hormone levels into my treatment. But I do notice that if I’m manic, and it happens to be “that time of the month” that my symptoms get a whole lot worse. Suddenly aggression surfaces. Never a good thing. The same applies to depression, now that I think about it, symptoms worsen, and it is harder to get free of them.
Actually, it’s rather interesting. Since I am on Lithium, among other things, my thyroid levels are checked frequently….I wonder why they don’t include other hormones, particularily in women, automatically?
Hmm…something to think about.
November 18th, 2007 at 2:53 am
I am with Margalit. I try to see only female docs because they listen better and are more compassionate.
November 18th, 2007 at 3:51 am
oh GAWD yes. i am downright miserable the week before my period. if i was that depressed the rest of the month it would be a bad, bad thing. also, i hate my husband for a few high hormone days. he bugs the living shit out of me and i swear he is doing it on purpose when i’m in that state. when i’m not PMS’ing (or pregnant), these things don’t faze me. i know everyone says they “suffer” from PMS but i actually do- my depression triples one week every month.
November 18th, 2007 at 8:16 am
Belinda, you’re so right. Most medical research is done on men, in order to keep the number of factors that need to be controlled lower. Mixed gender studies, and women-only studies, are the exception, not the rule. I actually spend a lot of time volunteering for medical studies and encouraging my friends to do the same just because I am in the Boston area, and hey, I figure it’ll be a worthwhile study.
I have PCOS on top of the bipolar, so my hormones are pretty effed up. If I don’t take the birth control that I don’t want for the children I won’t have, I become “hysterical” the last two weeks of the month. Even with the pill, my hormone levels are up & down the last week, and it’s something that still catches me by surprise sometimes. Fortunately, I have always been lucky enough to have (mostly) women GYNs, primaries, and shrinks, and they listen to me and work together.
Surprisingly, the worst primary I ever had was a very butch lesbian, who got disgusted with me one time while discussing my depression, and called me a “breeder.” The “feminine complaints” stereotype ran deep there, too. I called her on it and reported her to their practice manager, and you can bet I switched primaries– to a gay man who was great.
Your post is a great reminder about how vigilant we need to be about our own care, and how we have to be prepared for our doctors’ humanity, biases, and limitations.
November 18th, 2007 at 12:49 pm
After reading this post, I may have my hormone levels checked– I may even start requesting it annually along with my mammogram. I have a long history of irregular periods and other stuff that might indicate hormonal imbalance.
November 20th, 2007 at 5:10 am
Ive been contemplating getting my hormones checked for some time now..
I think its time to demand it.
I have PCOS and am a Major Depressive, It sucks for about Half a month when I do get my period and when i don’t—– forget it seer clear of my wrath & wallow.
I agree with having women docs, they just relate, they consider, THEY GET IT.
November 20th, 2007 at 8:26 am
There is a wonderful book called Women’s Moods: What Every Woman Must Know About Hormones, the Brain and Emotional Health by Deborah Sichel, MD that touches upon just this issue. I read it after having my second child and going through my second round of post-partum depression (first round untreated–second time I was prepared). Suddenly, so much of the history of my own mental health fluctuations made sense. I highly recommend it.
November 24th, 2007 at 9:42 am
My hormones affected my bipolar so badly that my gyn suggested hormonal period suppression. Now, I use Nuvaring for four weeks, take it out, and immediately put a new one back in. I haven’t had my period in over a year, and my doctor says I don’t need to. I can’t imagine going back to the hormone roller coaster; I love my smooth ride.