QC: After A Hysterectomy How Can You Tell If You're Menopausal? With Vanessa Weiland

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Vanessa Weiland, a certified menopause practitioner, explains when hormone replacement therapy (HRT) is warranted after hysterectomy while still having ovaries. She breaks down the progression of perimenopause symptoms and emphasizes that treatment is appropriate whenever these symptoms impact quality of life.

• Without periods as markers, focus on recognizing other menopausal symptoms
• Early perimenopause often presents with anxiety and sleep issues due to declining progesterone
• Middle perimenopause brings classic symptoms like hot flashes, night sweats, and vaginal dryness
• Less recognized symptoms include heart palpitations, itchy skin, joint pain, and brain fog
• Symptoms usually peak around what would have been the final period, then gradually improve
• HRT is reasonable to pursue whenever symptoms affect quality of life
• Treatment is generally safe and can serve as both therapy and diagnostic tool

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Episode Transcript

Speaker 1 (00:00):
Life moves fast and so should the answers to your
biggest questions.
Welcome to EndoBattery's QuickConnect, your direct line to
expert insights Short, powerfuland right to the point.
You send in the questions, Ibring in the experts and in just
five minutes you get theknowledge you need.
No long episodes, no extra timeneeded, and just remember

(00:20):
expert opinions shared here arefor general information and not
for personalized medical advice.
Always consult your providerfor your case-specific guidance.
Got a question?
Send it in and let's quicklyget you the answers.
I'm your host, alana, and it'stime to connect.
I am thrilled to welcomeVanessa Whelan.

(00:43):
Vanessa is a primary care nursepractitioner with over a decade
of experience and a menopausesociety certified practitioner.
She created the phasesframework, a course that takes a
holistic approach to managingmenopause symptoms, covering
everything from lifestyle shiftsto over the counter solutions
and medical interventions.
Vanessa is here to break itdown for us.

(01:03):
Let's get started.
If you've had a hysterectomybut still have ovaries, what
symptoms warrant hormonereplacement therapy?

Speaker 2 (01:11):
Yeah, so normally menopause is a clinical
diagnosis and we use periods tokind of help figure out where
you are in the transition.
So oftentimes earlyperimenopause, you're still
having periods, but they getlonger and closer together and
heavier.
And then later perimenopause,you're still having periods, but
they get longer and closertogether and heavier, and then
later perimenopause is when theystart to get more spread out,
and then the definition ofmenopause is one year without a

(01:33):
period at all.
So obviously all that is allout the window if you don't have
a uterus.
But all the other symptomsought to be pretty similar.
So a lot of people in that earlyperimenopause phase, the reason
you're having heavier andlonger periods is that you have
less progesterone on board, andprogesterone also can make you
sleepy and calmer.

(01:54):
Our progesterone is naturallyhighest when we're in that week
before our period.
Everyone likes talking aboutthe luteal phase now, where you
just chill out and be left alone.
So when you're low on that youcan get anxious and have trouble
sleeping.
So if you start to notice that,that can be a sign of early
perimenopause.
And then in that middleperimenopause phase where your
periods are getting spaced out,that means that you're starting

(02:18):
to lose the estrogen, and so lowestrogen symptoms are the
stereotypical symptoms ofmenopause hot flashes and night
sweats and vaginal dryness.
Some common things that are lesswell known are heart
palpitations, itchy skin, itchyinside your ears, joint pain.
A lot of people notice brain fogand forgetfulness during this

(02:38):
time, and those symptoms tend tobasically ramp up to their most
extreme, in that I would say,two years, right around the last
period typically.
So if things are reallyreaching a point where it's
almost unmanageable or isunmanageable, then hopefully
you're getting toward the end ofit, and then you know, two to

(02:59):
five years past the last period,things usually start to settle
down because our hormones aren'tgoing through the roller
coaster anymore.
They're stable, but they're low, and so for most of us the hot
flashes do calm down, but someother symptoms of low estrogen
stick around, like the vaginaldryness and urinary complaints

(03:20):
and dry skin.
When should you try to gettreatment, which, in my opinion,
is whenever you have any ofthose symptoms is reasonable to
pursue treatment, and it mightturn out that it wasn't
perimenopause, but the treatmentis really quite safe and you
can do a little bit of anexperiment and see if you do
feel better with progesteronefor those anxiety and sleep

(03:41):
symptoms early on.

Speaker 1 (03:43):
That's a wrap for this Quick Connect.
I hope today's insights helpedyou move forward with more
clarity and confidence.
Do you have more questions?
Keep them coming, send them inand I'll bring you the expert
answers.
You can send them in by usingthe link in the top of the
description of this podcastepisode or by emailing contact
at endobatterycom or visitingthe endobatterycom contact page.

(04:07):
Until next time, keep feelingempowered through knowledge.