The Angry Typist

My menstrual cycle started becoming erratic in my early 40s (around 43). One cycle would come in 65 days then another twice within 45. The flow was sometime so heavy I had to change out tampons about every 90 minutes when other times were barely spotting.

I have never had an OB/GYN outside of my two child births because my Family Practitioner of over 25+ years was very thorough, never made assumptions, and most importantly she asked questions. When I spoke with her about my menstrual cycle, she said that I was probably going into perimenopause.

“Oh,” I said. “How long is that going to last? A year or two?”

She looked at me with a slight grin and replied, “It is not unheard of for perimenopause to last up to 10 years. And you seem to be starting yours a little early.”

Honestly, I didn’t hear much of anything after the ’10-years’ bit. “Ten YEARS?” I asked with my face crunched up in disbelief. She nodded and asked whether I was experiencing any other symptoms, which I said no.

The days between my menstrual cycles started to extend from 2-3 months to 6-8 months and at this point the flow was barely trickling in after the third day. I was sincerely enjoying the freedom but was always prepared with a Super+ tampon in my bag wherever I go.

When I was about 48 or 49, I started getting the dreaded hot flashes during the day, but it was still manageable. However, when I turned 50, the hot flashes and night sweats started to disrupt what little sleep I was getting so I went back to my FP to get on something to alleviate the symptoms. She suggested Gabapentin off-label.

I was familiar with Gabapentin from my first Weimaraner who was being treated with Gabapentin for his seizures. Gabapentin is in the anticonvulsant class of medicine and was approved in the U.S. by the FDA in 1993 initially with an indication as a muscle relaxant and an anti-spasmodic. Later it was discovered to alleviate mild seizures and relieve pain (Yasaei, Katta, Patel, Saadabadi). It is an analogue of gamma-aminobutyric acid (GABA) reducing the excitability of nerve cells (neurons) in the brain, which play a role in seizures and the transmission of pain signals. Gabapentin mirrors the effects of GABA calming excited neurons.

SIDE NOTE: Gabapentin is not a Federal controlled substance. Some states like Ohio have voluntarily put Gabapentin on the state’s controlled substance list based on studies which suggest that gabapentin can be misused by individuals with a history of opioid abuse or mental health conditions. When taken in combination with opioids, gabapentin can amplify the euphoric effects of opioids and increase the risk of respiratory depression, a dangerous side effect that can lead to fatal overdose (Campbell, Coomer, Jacob, Lenz).

Gabapentin was hitting my brain receptors enough to alleviate the hot flashes and night sweats for quite a few years. And then my FP semi-retired and went into concierge medicine which we couldn’t afford. Sadly, I had to find a new family doctor.

I specifically looked for a younger woman doctor. Younger so that she will be in practice long enough so that I do not have to look for another. Woman so that she will be in tune with managing my perimenopause into menopause.

April 15, 2024, I had my first full panel bloodwork after the COVID gap, and the results weren’t good. My weight had been slowly climbing since 2016 (thanks perimenopause) and I had gained a total of 11.8 lbs. My cholesterol skyrocketed to well over 200. My LDL and triglycerides were in the wrong directions. And my glucose puts me back to being prediabetic which makes me nervous and depressed because I know all the complications that accompanies diabetes.

April 22, 2024 I had my first annual wellness visit with the new FP and it was an eye opener. She thanked me for getting my bloodwork done before the visit she said “she wasn’t worried” with my numbers. Then without asking me any questions she proceeded to lecture me about proper nutrition and exercise frequency. Not once did she ask me about when my last cycle was nor did she follow up on whether the Gabapentin was effectively managing all my menopausal symptoms – which seemed almost negligent considering I was perimenopausal/menopausal. I rebuttal that I worked out 4-5 times a week and shared that the hormonal flux has been wreaking havoc on my anxiety. Both were completely dismissed without any acknowledgement that I had even spoken.

I have never been treated so poorly or felt so belittle. It was an appalling and demeaning experience, but admittedly it was partially my own sexist fault in assuming that because she was a woman that she would be well versed in perimenopausal / menopausal knowledge. If not for patient care, then at least for herself because perimenopausal / menopausal is a life stage which no woman will escape or be pardoned from.

I was so disgruntled that I immediately switched off her services and got myself a specialist in women’s health, not only OB/GYN but a DO. She listened with compassion & understanding. She asked questions. And because she is a DO, she provided a holistic approach and not only replaced Gabapentin with Progesterone, but she also recommended a bunch of supplements which made me felt better within 2-3 weeks. It was as if it was magic.

My lesson to pass on here is don’t be afraid to advocate for oneself, don’t be afraid to fire professionals who are dismissive, and ignore one’s needs. Sometimes change is not only good but necessary.

MENOPAUSE RESOURCES:

The M Factor: Shredding the Silence on Menopause

“Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond” by Stacy T. Sims PhD (Author), Selene Yeager (Author)

CITE

Rama Yasaei; Shravan Katta; Preeti Patel; Abdolreza Saadabadi. “Gabapentin” Treasure Island (FL): StatPearls Publishing; 2025 Jan-. National Library of Medicine, National Center for Biotechnology Information, https://www.ncbi.nlm.nih.gov/books/NBK493228/ July 12, 2025.

Levi S Campbell, Tiffany N Coomer, George K Jacob, Ranee J Lenz. 2021 Jul-Aug;61(4):e218-e224. doi: 10.1016/j.japh.2021.01.025. Epub 2021 Mar 2, National Library of Medicine, National Center for Biotechnology Information, https://pubmed.ncbi.nlm.nih.gov/33674205/ July 12, 2025.