Hold that menopause

I mentioned in a previous post one of the oncologists I saw suggested starting ovarian ablation & estrogen blocking drugs now, rather than after chemo, since my chemotherapy has been soooooo delayed by this darn wound.

Well, scratch that.

For one thing, it would really only cease one, maybe two menstrual cycles at this point -- not really worth it. Additionally, chemo will effectively put me into rapid menopause anyway, often known as "chemopause" by those who've experienced it.

So the other oncologist (a woman) thought, why torture me more now for such a small benefit? Had anyone known the skin necrosis would delay things this long, yeah, sure, it might have been a great idea. But since no one did predict this holdup, that shipped has pretty much sailed.

So we're hitting the pause button, however briefly, on menopause.

It's kind of weird knowing that right now as I type this I am PMSing for probably the last time. The last of my eggs has been released, the last time I'll bleed is approaching. While I wouldn't say I loved getting my period I did love what it represented...the cycle of life, the particular gifts of being a woman. Even if one never conceives children it is always there, a symbol of potentiality, of promise. Menstruation is a connection to Mother Earth, to the lunar cycles, to the wild side of our own natures. Monthly bleeding connects all women...as does the natural cessation of that bleeding.

But there is nothing natural about what will happen to me now, and that makes me sad. I wasn't looking forward to menopause...admittedly, since I knew HRT was out of the question due to my blood clotting issues I was even a little fearful of "the change" -- I watched my mother pretty much go deeply insane for a while at the onset of her menopause. Still, I had hoped that maybe I would be spared that...maybe somehow with some herbal supplements and such I would manage to muddle thru it with some modicum of grace.

But that was supposed to be about 10 years from now. It was supposed to be a gradual process. I was supposed to even have the option of giving birth to another child, perhaps -- or at least the illusion of that option.

I will miss getting my period...both biologically and psychologically. I will also miss it spiritually, strange as that may sound. I will miss knowing every month that my body was making a fresh start, a cyclical reminder to me that all things are possible.

New plan: menopause!

Sooooo, here's the new plan: ovarian ablation now -- as in shutting down my ovaries ASAP.

My wound, while doing very well and visibly healing even to my untrained eye, is still taking a while to fully close. Estimates are at least another month before I can even think of starting chemo.

That's just too long.

Oncologist I saw today says why not start the hormone suppression now so at least any potential cancerous cells floating around my body are starved of estrogen (ER) & progesterone (PR) while I wait to start nuking myself with chemotherapy. For those keeping track my tumors were strongly ER/PR positive (a good thing) so depriving my body of these hormones is necessary anyway, it's just usually done after chemo.

Normally a pre-menopausal woman like me would take a drug called Tamoxifen for about 5 years. But Tamoxifen causes blood clots and with my known genetic mutations it is NOT advisable. So instead they need to essentially turn me into a post-menopausal woman so I can then take the drug typically used for that stage of life. It's an aromatase inhibitor (basically an estrogen blocker) usually the drug Arimidex.

My ovarian function will be chemically stopped via injection, usually either Lupron or Zoladex -- they are what's known as GnRH agonists...they cause the pituitary gland to cease production of certain hormones and that in turn prevents ovulation. The bottom line is no more periods, no more ovulation, no more fertility.

As someone who struggled with infertility and yet was blessed to have two kids...one of which was only three short years ago, this is all disconcerting to say the least. We are lucky to have the two beautiful healthy kids we do considering all we went thru. But I suspect if I were younger I would try and have more children. Truthfully we never completely ruled it out despite my age now. According to my perinatologist I have the womb of a 30 year old (if only I had the body to match, lol!)

But by as early as next week all the choices will be gone. Boom. The end. I mean, I could freeze eggs or create embryos...but when would I have the chance to use them? The earliest would be age 52. I know women do that and I think more power to them. However for my life that would be a bit later than I think is advisable...not to mention that the hormonal changes during pregnancy would spell trouble for my chance of cancer recurrence anyway. This is it. No more babies.

I always expected menopause could be difficult on many fronts...not the least of which is the emotional issues for me regarding loss of my hard-won fertilty. But I also figured it would happen somewhat slowly...you know, sort of sneak up on me a little before I had a chance to really let it fully sink in. The natural progression of intermittant periods and various symptoms would gradually increase until I knew I was smack dab in the midst of it. I'd have time to adjust, to get used to the idea if not the physicality of change.

But this is so sudden, so quick, so...drastic. And I have to admit I'm really scared of the side effects...there's no HRT for me, no bioidenticals. We're talking cold tofurkey (remember, vegan here). Or maybe that should be steaming tofurkey considering the hot flashes I will no doubt be experiencing shortly ;)

All weak atempts at humor aside...I really do know I have to do this. In fact this is the one thing all along I have been sure of. My surgery choices were up in the air...chemo or no...axillary dissection or not, but hormone suppression was a given based on my biopsy report from way back in April. It's probably the MOST important part of preventing my death from this disease, second only to removing the actual tumors themselves.

So brace yourselves along with me, dear readers...within the next week or two I take the menopausal plunge. Hold onto your seats and get the fans and ice chips ready!