Menopause: Give me Hormones or Give me Death!

It's always a bad sign when a husband accompanies his wife to her doctor's appointment. Fears of cancer, a broken foot, hearing voices, fainting, chest pain---something serious. Thus, when I noted Patrick Morrison sitting in the chair of my exam room next to his wife, I braced myself.

Imagine my shock when the first words out of his mouth were, "Doctor Burbank, you HAVE to give my wife hormones. It's that or I'm calling a divorce attorney and the kids are calling the Department of Children's Services."

"I'm not that bad," she hissed, in a tone that could curdle honey. Since I knew Patrick and his wife, Sandra, had been happily married for nearly two decades, I asked them to fill me in on what was happening to their family.

Arms folded defiantly across her chest, Sandra snapped, "Menopause should be outlawed."

For starters, Sandra kept the air conditioning cranked so high, the rest of the family had resorted to wearing winter coats. "You can pile on more clothes, but I can't walk around the house naked," she retorted, when one of them had dared to complain about how cold the house was.

Sandra bit her husband's head off for the slightest infraction, (i.e leaving his socks on the bathroom floor, not loading the dishwasher to her liking, and my favorite, forgetting to dust the clock radio in their bedroom.) Sandra would then burst into tears and sob and lament what a terrible wife she was for screaming at him like that, and why didn't he just leave her because she was a h-horrible p-person, sob, sob, sob, and w-why did he p-put up with her, and he could have done so much b-better, and she was so f-fat and irritable, sob, sob, sob, and he had every r-right to w-w-walk out on her. All over a clock radio that hadn't been dusted!

Patrick, also a patient of mine, had played the role of long-suffering husband for four months now.  He knew she was menopausal, and with the 2006 study showing a slight increase in breast cancer and heart attack risk among women who took Hormonal Replacement Therapy, he had discouraged her from taking estrogen.

"So what's changed you mind?" I inquired. "Why are you now willing to incur the increased risks?"

The two looked at each other. Dead silence. Then Sandra looked away, picking at a hangnail. "You tell her."

Patrick filled me in: One night, at the dinner table, Sandra suddenly got one of her horrific hot flashes. "The hot flash from Hell," she added.

Her two sons, aged sixteen and thirteen, were sitting at the dinner table munching on fried chicken, when suddenly they saw their mother flushed and perspiring. Next thing they knew, she had flung off her blouse and was sitting at the dinner table clad only in her bra from the waist up. She then grabbed the bread plate and began fanning herself.

Her two teenaged boys, eyes now the size of moon pies said, "Mom! What are you doing?"

Sandra, fanning herself frantically with the bread plate, glared at them. "You don't know what it's like to have a hot flash!"

The younger snapped, "Nor do I want to, if this is how they make you behave!"

The two boys glanced across the table at their father, hoping he'd do something about her troubling behavior. Instead, his eyebrow crinkled with the unspoken message, "Just ignore her." He gestured with his head toward their dinner plates and he began munching on his biscuit, as though a fifty-year old woman sitting at the dinner table clad only in a bra from the waist up, with two teen-aged sons looking on, were perfectly normal. Patrick, trying not to trigger one of her verbal tirades and crying jags in front of the boys, kept his mouth shut and focused on buttering his biscuit.

Following their father's lead, the boys completed their dinner meal as though nothing were amiss. But after the meal, the oldest took his father aside. "Dad, you've got to do something about Mom. She's completely out of control. Yesterday, she screamed at my girlfriend for leaving a Coke can on the end table instead of putting it in the recycling dumpster. Then she started bawling her eyes out and she ran out of the room saying she was a terrible mother. I was so embarrassed, and now Danielle refuses to come to the house anymore."

That's where I came in. Patrick beseeched me to prescribe his wife hormones. In high doses.

After a long discussion with them both about the risks and benefits, we opted for a one or two-year course of HRT. We'd hope to taper off after several years.

"It's that or the looney bin," Sandra said with a hint of a smile. "Besides, with two sons to fund through college, divorce is out of the question, right?"

He smiled. "I only said that to make you realize how bad things had gotten. I wasn't serious." He squeezed her hand. "We'll get through this menopause thing together, just like every other crisis in our marriage."

Thankfully, with the addition of hormones, Sandra was soon back to the loving, patient, and non-sobbing woman she used to be.

Menopause is definitely not for sissies!