I Go to Sleep Wondering if Tonight is the Night

Let’s catch up on a few odds and ends, and then I want to talk about hormones.

Each night I go to sleep wondering if tonight is the night. Israel is facing potential retaliation from seven countries. After dinner, we debate whether to go for a walk. Is this the time they usually attack? Can we make it to a shelter in 90 seconds? After a short walk, I came back drenched in sweat. There is little variability in temperature from day to night. I took my fifth shower of the day.

I was happy to wake up this morning in my own bed, walls intact. No one knows what type of attack to expect. Mass casualities are expected. The safe room in my apartment is ready, stocked with a flashlight, a transistor radio, water and snacks. The Home Front Command is telling us not to panic, but to be vigilant. They promise to update us if extra precautions are needed. People are either scared or in denial. I belong to the former category.

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So lets get on with it. My writing has become overly focused on cancer, which does not fully represent who I am.

When I want something, I want it now. I once chased someone down the street to ask her where she got her boots. I went to the store that day. These are the boots:

In hindsight, it might have been the sight of the woman wearing them—bare-legged with a short denim skirt on a winter day—that intrigued me more than the boots themselves.

My primary doctor practices both conventional and complementary medicine. He asked if, under my current circumstances, I am enjoying my life, not tomorrow, not next week, but right now. To be honest, I hated my antidepressant because my libido tanked (unacceptable). I felt “blah” like so many that I know.

He suggested topical hormone replacement therapy (HRT). For me? I learned that this was bad medicine.

I was immediately excited that he was thinking outside the box. I wanted it now.

I am of the generation of women who missed out on hormone therapy because of the Women's Health Initiative (WHI) study that began in 1998. This large, government-funded study made headlines due to its startling findings. A press release created such panic that it led to the study’s early termination. It claimed that women using hormones faced higher risks of heart disease, breast cancer, and mortality. The message was that HRT was associated with more risks than benefits. However no distinction was made between users of different ages. The rate of HRT use dropped from 44% to under 5%, a trend that has persisted for the past 21 years.

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It has taken a long time to realize the detrimental impact of this omission on women’s health. We have been deprived of a medication that is beneficial for bones, brain, heart and sexual health. We were deprived based on faulty analysis.

Many older people are struggling with serious illness, aging parents, lack of passion, conflicts with adult children, changing dynamics in long-term relationships, and loneliness. Many complain of insomnia, weight gain, or aches and pain (not on FB of course but behind closed doors).

HRT can offer substantial benefits when used appropriately. It can mitigate hot flashes, cognitive decline, heart disease and osteoporosis. It can greatly improve sex life for all concerned. Everyone should read this abstract.

I understand the need to stop a study due to adverse effects. I have done it many times as a researcher. But it is also important to then analyze the data to see if something may have been missed.

While hormone therapy offers benefits, it is definitely not for eveyone. It may not be appropriate for women who have had hormone-related cancers. The decision to start HRT should be based on a honest discussion with a healthcare provider, preferably someone who knows about menopause. Training on menopause in medical school is pathetic, so search carefully. But no more hiding. Let’s bring HRT out of the doghouse.

Grandma Lila aged gracefully

Have an open-minded week,

Dr. Anna 🎗️