High hopes for an elective chemical menopause
Why I am finally drawing a line under my debilitating autistic perimenopause
This weekend has been spent on my sofa under a weighted blanket, a knitted blanket, several cushions, my laptop, in my pyjamas, with noise cancelling earphones plugged snugly in. I have watched Seinfeld, eaten Pizza Hut garlic shrimp pizza and a loaf of garlic bread in one sitting. I am surrounded by empty mugs of tea. I have taken naps. I am absolutely exhausted.
To the unknowing eye, I could be mistaken for a woman in the final trimester of a particularly gruelling pregnancy. My sore swollen belly certainly would reinforce that impression. But I am not pregnant, I am perimenopausal. I like to think I am at the end stages of this transition, but I no longer have reliable bleeds, so there is no way of knowing.
I had Mittelschmerz (ovulation pains) on Wednesday, but no idea if this “cycle” is ovulatory or anovulatory. My body certainly seems to be in luteal phase with me packing in calories, and enforcing rest. Is it autistic burnout? Is it autistic perimenopause? Is it autistic inertia? I don’t know, but it is pretty shit. It is a moot point anyway; this is all academic.
On Wednesday, I will be having my first chemical menopause implant injection (Zoladex), and I am feeling relieved and excited. Granted, the Gonodatrophin-releasing hormone (GnRH) analogue injection will induce a temporary and reversible menopause, but I am in no frame of mind for a total hysterectomy (plus this has never been suggested nor recommended in my ongoing perimenopause treatment plan), so this is the next best thing.
Is it natural? No. Is it normal? No. Is it necessary? Yes. Because I have regressed significantly and it is unethical to not try a treatment that may be able to improve my menopausal transition.
I am no endocrine expert - a surprise to nobody! - so here are some links with more information for anyone who may be considering this treatment path. I am too tired to paraphrase, edit and fact check medical information. But I do want to share this experience with you.
The current body of research for autistic perimenopause is still extremely limited, so I shall be a guinea pig. Wheek wheek! 🐹
Links on GnRH analogue injections (they may not all be positive, but I am not claiming this is a perfect solution. It is just a potential way to reduce the fluctuations in my hormone levels that are ruining and ruling my life):
The Doctor Louise Newson Podcast. Episode 220: Hormones, HRT and Advocating for Yourself
Dr Louise Newson: “A lot of people are given antidepressants or they’re given actually drugs such as Zoladex, which absolutely floors their hormones and gives them a chemical menopause, whereas I think actually just rebalancing their hormones and keeping them smooth and flat, at a level that’s right for them can be transformational, can’t it?”
How do GnRH analogues work? Zoladex, Prostap and other GnRH analogues
“A simple explanation of how GnRH analogues like goserelin (Zoladex) and Leuprorelin (Prostap) work to induce a medical menopause or medical castration to treat conditions like endometriosis and prostate cancer. This includes a basic explanation of the hypothalamic-pituitary-gonadal axis in men and women.”
What are GnRH analogues used for? (NHS website)
“GnRH analogues are offered to patients with gynaecological conditions that are affected by the hormones of the menstrual cycle.
These include:
Endometriosis, adenomyosis and pelvic pain - to reduce pain related to the menstrual cycle and heavy periods.
Fibroids - to reduce symptoms such as heavy periods, or as a longer term treatment if surgery is not an option.
Given before surgery such as fibroid removal or endometrial ablation - to make fibroids smaller and/or the endometrial lining thinner making them easier and safer to remove or treat. It will also give an indication to how you may feel following surgery.
As a diagnostic test - to see if conditions such as severe pre-menstrual syndrome (PMS) or chronic pain are affected by hormones of the menstrual cycle, giving us a better idea how to manage the pain. If the GnRH analogues are unsuccessful, the removal of the ovaries will also be unsuccessful.”
NZ Data Sheet for Zoladex implant
Information on contraindications, risks, how to administer this injected implant and side effects (most of which are menopause symptoms!)
For obvious reasons, I am not keen to type the name of an injection + autism into Google, as it throws up results that cause my blood to boil. So I shall leave you with these basics above, and please share anything you may know or find out in the comments please 💕
I don't have any advice to offer, but just wanted to offer some loving support and witnessing. I just found your writing very recently, and I am sad on your behalf that you are going through all this, but also grateful that you are sharing your experience so eloquently. I was diagnosed Autistic only after I had already traversed the menopause rubicon, but in retrospect, it seems to me that going through all that hormonal upheaval was what made it impossible for me to mask to the level I had for all my life up to that point. What I went through was nowhere near as bad as what you are going through, but it was hell, so I can't even imagine how hard it must be for you to go through all of it. It's ridiculous that on top of what you are enduring, you have to do so much research yourself, as the medical world has been so dismissive of both Autistics and peri/menopause. I wish you the best, and send you love as you go through this. P.S., I don't know if it's true for everyone, but from my own experience, once you've crossed the rubicon, things don't go back to "normal," but they definitely become more predictable and manageable. May that be true for you, as well.
It all sounds grim and you have my sympathies. Don't forget to factor-in your recent loss, as grief - I have found - shows up in strange forms and strange places and times ❤️