Perimenopause: A Plague Upon your Hormones
- Apr 20
- 14 min read
Balancing hormones in an unbalanced healthcare system poses several challenges for women going through 'the change.'
First, a bit of 'hystery'...
I was woefully unprepared for this hormone rollercoaster I am chained to, nor was I made aware that the current healthcare system has failed to make women's health a true priority... even now... in 2026... ... .. .. . . urgh.
Imagine my shock when I found out that since the 60s, clinical trials for new medications were predominantly tested on men, not women. This, in part, was due to the thalidomide scandal that affected over 46 countries in the 50s and 60s. Thalidomide, AKA Distaval, was a sedative first intended to treat morning sickness in pregnant women, but the result was horrifying. The thalidomide scandal caused birth defects in over 10,000 babies, and 40% of those babies usually died within the first year. This prompted the US Food and Drug Administration (FDA) to implement a policy requiring drug manufacturers to demonstrate the safety and efficacy of their products.
Needless to say, after such a monumental fuck up, researchers were exceedingly cautious about testing new drugs on reproductive women; however, they consistently omitted women on birth control and women whose husbands had been vasectomized. So, between the 60s and 1993 (in the US) and 1997 (in Canada... yeah, we dropped the ball there), women were underrepresented in drug trials, which led to many medical injuries.
Understandably, women were pissed. They protested and demanded policy changes until, finally, at least in North America, women were included in clinical trials.
Ain't that some BS?
You'd think that after such an intense scandal, the medical community would get its head out of its gluteal region. You'd think...
Sadly, women's healthcare initiatives, still to this day, fail to meet the level at which researchers pour time and resources into men's healthcare. Moreover, research has always tended to lean more towards fertility and reproductive outcomes rather than our post-reproductive years. Realistically, I could go on and on about this topic because there is seriously so much to touch upon. But, to save us a bit of time, we'll delve a bit into the 2002 Women's Health Initiative (WHI) study that caused a clusterfuck in progress related to hormone replacement therapy (HRT). You might want to get comfy...
The 2002 Women's Health Initiative (WHI) study and why it matters today.
To start, it is important to note that, to this day, research into women's healthcare is grossly underfunded. I know, I know... we've heard this before. It's funny what happens when we hear the same bad news over and over again; we tend to tune it out.
It was really only in the 20th century that the issue of women's hormone depletion became somewhat important. "Hormone Deficient Syndrome" was the term used to describe clinical conditions associated with menopause, like hot flashes and osteoporosis, to name a few. In 1942, the FDA approved an estrogen treatment for hot flashes called Premarin ®. Canada approved Premarin in 1941.
In the 60s, thanks to the determination of feminists, women's healthcare began showing significant improvements. This upward momentum looked promising with many advocating estrogen as the winning treatment for menopausal women, especially in Europe.
The popularity of estrogen as a treatment for menopause became even more popularized when American gynecologist Robert A. Wilson published his book in 1966 called Feminine Forever. Wilson claimed that taking estrogen would significantly improve the symptoms of menopausal women. That was all fine and dandy until 1970, when a study was published highlighting that taking estrogen alone was spiking incidents of endometrial cancer. Great. Just what we needed.
More research was needed, and finally, researchers determined that lowering estrogen levels while pairing it with progesterone was the winning combination. This winning combo not only effectively reduced menopause symptoms, but it also reduced the risk of endometrial cancer.
In the 70s and early 80s, HRT was evolving like crazy. The medical community was fine with recommending HRT for hot flashes. Still, it wasn't until 1988 that the FDA decided that not only was HRT effective for hot flashes, but that it also helped reduce the risk of osteoporosis. Around the same time, and after more research, it was finally determined that HRT also tackled chronic diseases associated with menopause. Holy shit, right? This all sounds so promising, and yet...
"Feminine Forever" then became "healthy forever," and things were looking up for menopausal and postmenopausal women. That is, until the infamous 2002 WHI study.
I won't go into all the details about the research into estrogen, progesterone, and progestin, because it's way above my pay grade. Suffice it to say, this new field of research into women's health prompted many different kinds of studies.
However, the 2002 WHI study, which is now said to have been "...inadequately designed, evaluated, and reported."(PubMed), caused much widespread panic among women, and many opted out of receiving HRT. Seemingly, every time the medical community stepped one foot forward to improve women's healthcare, they'd then have to take two steps back because of irresponsible research.
And, why were so many women shitting themselves over this study? Well, they had good reason! Thanks to Google doing some of the heavy lifting for me, here is a breakdown of the shitstorm.
1. The 2002 Announcement and Panic
The Study: The National Institutes of Health (NIH) initiated the WHI in 1991 to confirm that HRT helped prevent chronic disease.
The Findings: In July 2002, the study was stopped early, as it appeared combined estrogen-progestin therapy increased breast cancer risk by 26% and caused a 29% increase in heart attacks.
The Panic: The announcement made front-page news, creating a "nationwide panic". Prescriptions for HRT dropped by over 70-85% in the following years.
The Misinterpretation: Media reports claimed HRT caused "de novo" (new) breast cancer, which was not accurate, and the results were treated as applying to all women.
2. Why the 2002 Results Were Flawed
Years of reanalysis and subsequent studies have shown the 2002 findings were overgeneralized and skewed by the study design.
Too Old, Too Late: The average age of women in the study was 63–64, and many were 10–20 years post-menopause. The average age of menopause is 51, and HRT is typically prescribed at that time. The risks of hormone therapy are significantly lower for women in their 50s.
Incorrect Hormone Formulations: The study used oral conjugated equine estrogen (CEE) and medroxyprogesterone acetate (MPA), which are not the bioidentical hormones commonly used today.
Misrepresented Statistics (Relative vs. Absolute Risk): The "26% increase" in breast cancer was a relative risk, which sounds high, but the absolute risk was very small (an extra 8 cases per 10,000 women per year).
Non-significant Findings: Some of the reported harms were not actually statistically significant, yet were presented as conclusive.
Misleading Data on Breast Cancer: The study's own data eventually showed that women taking estrogen alone (who had hysterectomies) had a reduced risk of breast cancer, a finding heavily overshadowed in 2002.
3. The Consequences: "A Generation of Women Denied"
Suffering from Menopause: Millions of women were taken off hormones, leading to severe, untreated hot flashes, night sweats, insomnia, and mood changes.
Unnecessary Fear: A "hysteria" was created that persists in some medical practices today, where both patients and doctors fear that even low-dose, short-term use is unsafe.
Increased Mortality: Some researchers argue that the abrupt cessation of hormones actually led to higher mortality due to unmanaged cardiovascular issues and increased osteoporotic fractures.
Now that we've travelled through time, let's discuss where we are today...
4. The Current Understanding
Today, experts generally agree on a more nuanced view of HRT, often called the "timing hypothesis."
Safety for Younger Women: Women under 60, or those within 10 years of menopause, generally have a much higher benefit-to-risk ratio.
Individualized Care: The current recommendation is to treat menopause symptoms individually, using the lowest effective dose for the shortest time, rather than a blanket prohibition.
The "Scare" Was Unjustified: The 2002 interpretation that HRT should never be used is now considered a "misinterpretation of its own data" by the original study.
The 2002 WHI scandal serves as a cautionary tale on how a single study, when prematurely released and broadly interpreted, can negatively impact public health for decades.
HRT and Me
Disclaimer (of sorts): Each woman receiving HRT arrived there for her own reasons. We are all built differently, and on some level, it takes courage to seek care that is still stigmatized. To all the women who had to experience perimenopause/menopause before 2026, my hat goes off to you. Most of you likely suffered in silence and didn't receive the best care possible, and most of you likely had kids, spouses, full-time jobs, and extended family to care for. How you managed it all must have taken everything you had, and though I may not know you, I'm sure as shit proud of you. What a fucking hellscape this can be.
Onto my journey...
STRESS, if unmanaged, will kick you right in your lady-junk. What I encountered was the perfect storm of stressors at my most vulnerable time.
At the time my perimenopause began, roughly around the age of 40, I had a relatively new doctor, and we'll call them Dr. Nard. My previous doctor had been my doctor for ten years before he retired, and that's when Dr. Nard stepped in. Dr. Nard's appointments generally lasted no more than five minutes, and it was obvious that Dr. Nard wanted to treat the symptom, not to learn about the patient or how the symptom may have manifested due to lifestyle choices or family history. My gut was sounding alarm bells, but what choice did I have? There was, and still is, a shortage of good doctors and, of course, an extremely high volume of patients, especially after COVID. At first, I didn't think about whether or not Dr. Nard was good at their job because, at the time, my biggest issue was sleep, and Dr. Nard was more than willing to prescribe Zopiclone, the mother of all sleeping aids. I will discuss my lack of sleep and dreams in another post, because that in and of itself is another saga, but I digress...
I had consulted Dr. Nard about heart palpitations in 2022, and was prescribed an at-home blood pressure machine and a referral to test the health of my heart. I had mentioned to Dr. Nard that I was putting on weight, too. Never once did Dr. Nard ask about my medical history. In 2023, I got COVID for the second time (the first time occurred in 2021), and it unleashed fury on my body. If my body was already struggling to maintain homeostasis, COVID lit the match that set off an explosion in my entire system. In fact, COVID vaccines have been linked to causing women's hormones to fluctuate in unhelpful ways. The vaccine basically introduces a stressor to the body, and by the time December 2023 rolled around, I had already been injected with five COVID vaccines. As I mentioned, it was a perfect storm.
(No, I am not against COVID vaccines, but I think women should have been better informed.)
I began bleeding from my ass, like, a lot. Whoa, Mme Duthier, TMI! Well, sorry, we have to go there. I would just shit blood. Dr. Nard was on holiday break when this started, so I consulted a free, online medical service that utilizes the expertise of nurse practitioners about my symptoms. I was prescribed a single dose of a steroid to get me out of my butt-jam until I could speak to my doctor. The bleeding didn't stop, and then I began to menstruate... every two weeks. When Dr. Nard was back from vacation, I went to them with these symptoms, expecting them to have a competent, reasonable action plan. What was prescribed to me was time off work and a brochure that his office created, very basic, indicating what foods to eat to alleviate my symptoms. It was mostly the BRAT diet (bananas, rice, applesauce, white toast), and it started with white bread. Before I could move on to other foods, I had to stop having bloody poops, and this was supposed to happen following this diet. I followed Dr. Nard's recommendations to the letter, but nothing improved, and I never made it past the first step, which consisted mainly of white bread. I was severely bloated all day long, developed skin rashes on my hands, could barely move because of joint pain, continued to bleed, and couldn't get out of bed despite having over 12 hours of sleep. Over six weeks had gone by with no improvement. Dr. Nard told me to take another month off work, and to bugger off basically. All I wanted to do was to get better, and Dr. Nard had no interest in investigating further. I went so far as to prepare him a document outlining the foods I had been eating at the time I got sick, along with my exercise routine, sleep, and information about my menstrual cycle. Dr. Nard never looked at it, though, because what would I know? I was told to stop researching and to stop listening to nurse practitioners, like the one I had consulted online through our province's healthcare system. Dr. Nard chalked it all down to having irritable bowel syndrome (IBS) and left it at that.
It felt like I was dying, and I didn't see a way out.
After months of bleeding from my downstairs holes, I asked Dr. Nard for a blood test to see if I was perimenopausal. Dr. Nard told me that I was not, flat-out. I kept asking to get tested until finally I was prescribed the blood test to determine my hormone levels. When the results came back, Dr. Nard, with a cocky demeanour, told me that everything was great.
I felt like a stupid, dumb bitch.
Dr. Nard had done a fine job at gaslighting me throughout the duration of my illness, so finally, I gave up. Had it not been for my psychologist, who strongly suggested I seek a second opinion, I may not be here today. Dr. Nard's unprofessional and apathetic behaviour actually inspired me to file an official complaint with the College and Physicians and Surgeons in 2025, and, this year, the College determined that Dr. Nard deserved a 'caution' on his file, highlighting his unprofessionalism and dismissiveness. There was also some question as to whether or not Dr. Nard had tinkered with his notes about my case after he found out about my complaint.
After changing healthcare providers two months after I became seriously ill, everything changed. I was floored when I found out that the blood test Dr. Nard prescribed to check my hormones was not the appropriate one. What the actual fuck, right? I can't know for sure, but it appears that Dr. Nard prescribed me a blood test to shut me up. Once the appropriate test was prescribed, and my results came back, my new healthcare provider- we'll call them Ace- discovered that not only were my hormones fucked, but that I was producing a hormone that only breastfeeding women produce. The level of that hormone wasn't a little high; it was off-the-charts high. Did I have a prolactinoma?
After a brain scan determined that it was not a brain tumour, the only other explanation was stress. But I was still bleeding from my ass, so I was put on a steroid for several months. These were some of the darkest days of my life. Steroids are no joke; they are incredibly hard on the body, and I had every side effect imaginable. My neck was so swollen that it was as wide as my cheeks. I was basically an inflated, bleedy ball of human flesh. Once I stopped bleeding from my ass, we were able to move on to the next phase of my healthcare. But, by this time, a new symptom appeared... hair loss.
I wasn't just losing hair; it was coming out in clumps. The shower drain looked like TWO Chubaccas got it on for hours. If you look at the timeline, I got COVID in December 2023, was put on steroids in March 2024, and by September, I noticed that I was losing quite a bit of hair. By December 2024, I had lost almost half of my hair. To combat my hair thinning, I was prescribed thyroid medication and progesterone in January 2025, and this halted the hair loss in a short period of time. This was the first time in a year that felt like my health might actually improve.
Oh, and did I mention that Ace operates a private care clinic? That's right, I pay out of pocket for visits to this clinic. At a time when I needed care and a second opinion in double-quick time, this was the best possible option. And, at the time, I was unwilling to begin my journey again with a new doctor who was, I thought, going to rush me out the door like Dr. Nard had done. Thankfully, most of my prescriptions were still covered, and I was still able to be referred to specialists, but in a neighbouring province. There are rules, you see, when it comes to private care clinics, and debates continue to rage-on whether private clinics will hinder our healthcare system in the long-term. Nevertheless, I had to get better ASAP.
I still had bills to pay...
Now, I have revised and rewritten this particular part of the blog because I couldn't find a diplomatic way of saying that my former manager- we'll call them Beige- made my work life unnecessarily stressful because of so many insane factors that I can't even go there right now. What I can say is that I was neglected, unappreciated, and subject to abuses of power. This stress, as I came to find out, is what accelerated my hormonal imbalances from the get-go. I took my frustration out on myself by making poor lifestyle decisions, too. In fact, looking back at my younger years, every time I experienced high levels of stress, my hormones experienced high levels of imbalance. Go figure. I could write a novel about how much Beige made me question my will to live, but suffice it to say, I am still very much triggered to this day. My job was extremely taxing, and I still have symptoms of PTSD because of that experience. And, in the spring of 2025, I had to do a 'hard quit' to save myself, and that's exactly what happened; I learned self-respect because my crappy health forced my hand. FINALLY. Realistically, though, I am still very much a work in progress.
I have a lot of gratitude for my former HR manager who helped guide me through that shit-storm.
Back to HRT...
The combination of thyroid and progesterone medication helped to stop hair loss and to get my menstrual cycle back on track, but I still can't shake the weight, and I still have fatigue and brain fog. Because of these chronic issues, Ace supported me in finding a healthcare provider with more specialization in HRT. Now, in addition to thyroid and progesterone medication, I am also taking progestin. Based on my last blood tests in February 2026, my estrogen was high while my progesterone was too low. Furthermore, I have been getting my period every three weeks, and because of my heavy flow, I must now take iron supplements due to the blood loss during menstruation. It has now been one week of taking all of the medications, and after week one, I feel some of my zest coming back.
To add insult to injury, I hurt my shoulder in December 2024 and thought it would get better on its own, but it hasn't. This new, annoying injury has prevented me from doing the kinds of exercises that seemed to be helping with some of my weight gain and muscle loss. By chance, when I was looking for exercises for women my age, I happened upon information about lipedema. As it turns out, I have that, too. And, thanks to Ace's amazing team, I was immediately prescribed compression leggings to help with the fluid retention.
Am I done yet? Almost...
Throughout all of this, I have had an incredible support system around me, namely my husband, whom we'll call M. Duthier. Through the long nights, the despair, the loss of hair, the weight gain, the irritability, uncertainty, and bitchiness (though he seems to like 'some' bitchiness), he has been there propping me up (not literally because I would crush the poor guy) and reminding me every day that I'm not alone and that to him, I am still the beautiful women he met in 2022.
Also, my mom, sisters, and friends have been in my corner providing positivity, encouragement, and fun distractions. There is no way in fucking hell that I would be alive today had these people not been in my life. And, though I am part of the 14% of women who had to exit the work force because of perimenopause, I am still hopeful that one day I can rejoin the work force to do something that I love that will be appreciated.
CONCLUSION
Because of the last two years, I still have a lot of resentment and heartbreak about how my health and career were handled. I deserved better, and I'm bitter about how it had to end. This blog entry has been largely negative, so I would like to end it on a positive note.
In the end, all of this BS has led me to make some drastic, positive changes in my life. I eat better, and I'm more mindful about my stress levels. I've set up boundaries, distanced myself from those who bring me more heartbreak than joy, and I have a supportive healthcare team guiding me through these health challenges. And though I am still unable to work, I have been making use of my time by giving more attention to my amazing fuzzy family members and watching amazing lectures via The Great Courses (Prime).
I learned how to make (THE BEST) sourdough bread, and I love cooking for my husband, who has been busting his butt at work to support us both financially. In addition to his day job, he teaches online courses at night and has picked up a contract translating. I wouldn't be here today without him, and that is the truth. He and my mom have given me strength when I didn't think I had any left.
Soon, I have an appointment with a regression hypnotherapist to help shed light on some traumas my subconscious seems to be battling. My hope is that my stress levels will continue to go down, which will hopefully help my hormones balance.
MORE RESOURCES:
https://www.ccohs.ca/oshanswers/psychosocial/stress.html https://www.cbc.ca/radio/whitecoat/private-menopause-clinics-in-canada-9.7067244
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