QC: After A Hysterectomy How Can You Tell If You're Menopausal? With Vanessa Weiland

Vanessa Weiland, a certified menopause practitioner, explains when hormone replacement therapy (HRT) is warranted after hysterectomy while still having ovaries. She breaks down the progression of perimenopause symptoms and emphasizes that treatment is appropriate whenever these symptoms impact quality of life.

• Without periods as markers, focus on recognizing other menopausal symptoms
• Early perimenopause often presents with anxiety and sleep issues due to declining progesterone
• Middle perimenopause brings classic symptoms like hot flashes, night sweats, and vaginal dryness
• Less recognized symptoms include heart palpitations, itchy skin, joint pain, and brain fog
• Symptoms usually peak around what would have been the final period, then gradually improve
• HRT is reasonable to pursue whenever symptoms affect quality of life
• Treatment is generally safe and can serve as both therapy and diagnostic tool

Send your questions by using the link in the podcast description, emailing contact@endobattery.com, or visiting the endobattery.com contact page.

Chapters

• 0:00 Introduction to Quick Connect

Transcript

Speaker 1: 0:00

Life moves fast and so should the answers to your biggest questions. Welcome to EndoBattery's Quick Connect, your direct line to expert insights Short, powerful and right to the point. You send in the questions, I bring in the experts and in just five minutes you get the knowledge you need. No long episodes, no extra time needed, and just remember expert opinions shared here are for general information and not for personalized medical advice. Always consult your provider for your case-specific guidance. Got a question? Send it in and let's quickly get you the answers. I'm your host, alana, and it's time to connect. I am thrilled to welcome Vanessa Whelan. Vanessa is a primary care nurse practitioner with over a decade of experience and a menopause society certified practitioner. She created the phases framework, a course that takes a holistic approach to managing menopause symptoms, covering everything from lifestyle shifts to over the counter solutions and medical interventions. Vanessa is here to break it down for us. Let's get started. If you've had a hysterectomy but still have ovaries, what symptoms warrant hormone replacement therapy?

Speaker 2: 1:11

Yeah, so normally menopause is a clinical diagnosis and we use periods to kind of help figure out where you are in the transition. So oftentimes early perimenopause, you're still having periods, but they get longer and closer together and heavier. And then later perimenopause, you're still having periods, but they get longer and closer together and heavier, and then later perimenopause is when they start to get more spread out, and then the definition of menopause is one year without a period at all. So obviously all that is all out the window if you don't have a uterus. But all the other symptoms ought to be pretty similar.

Speaker 2: 1:41

So a lot of people in that early perimenopause phase, the reason you're having heavier and longer periods is that you have less progesterone on board, and progesterone also can make you sleepy and calmer. Our progesterone is naturally highest when we're in that week before our period. Everyone likes talking about the luteal phase now, where you just chill out and be left alone. So when you're low on that you can get anxious and have trouble sleeping. So if you start to notice that, that can be a sign of early perimenopause. And then in that middle perimenopause phase where your periods are getting spaced out, that means that you're starting to lose the estrogen, and so low estrogen symptoms are the stereotypical symptoms of menopause hot flashes and night sweats and vaginal dryness.

Speaker 2: 2:28

Some common things that are less well known are heart palpitations, itchy skin, itchy inside your ears, joint pain.

Speaker 2: 2:34

A lot of people notice brain fog and forgetfulness during this time, and those symptoms tend to basically ramp up to their most extreme, in that I would say, two years, right around the last period typically. So if things are really reaching a point where it's almost unmanageable or is unmanageable, then hopefully you're getting toward the end of it, and then you know, two to five years past the last period, things usually start to settle down because our hormones aren't going through the roller coaster anymore. They're stable, but they're low, and so for most of us the hot flashes do calm down, but some other symptoms of low estrogen stick around, like the vaginal dryness and urinary complaints and dry skin. When should you try to get treatment, which, in my opinion, is whenever you have any of those symptoms is reasonable to pursue treatment, and it might turn out that it wasn't perimenopause, but the treatment is really quite safe and you can do a little bit of an experiment and see if you do feel better with progesterone for those anxiety and sleep symptoms early on.

Speaker 1: 3:43

That's a wrap for this Quick Connect. I hope today's insights helped you move forward with more clarity and confidence. Do you have more questions? Keep them coming, send them in and I'll bring you the expert answers. You can send them in by using the link in the top of the description of this podcast episode or by emailing contact at endobatterycom or visiting the endobatterycom contact page. Until next time, keep feeling empowered through knowledge.