Grasping at straws

Where does menopause fit in? Because of the controversy over the risks of hormone replacement therapy, or HRT, for menopausal or perimenopausal women. A large 2002 study found that women treated with estrogen and progesterone had higher risks of heart attack, stroke, blood clots, and breast cancer.

Many doctors hit the breaks on HRT after that study and their patients “white-knuckled” their way through menopausal side effects like worsened mood, increased anxiety, sleep problems, incontinence, and decreased sex drive. Some women may have sought out alcohol, anxiety meds, and painkillers to cope.

Beyond the dangers of mixing these substances, the cruel irony here is that long-term opioid use makes women’s hormone situations worse, says Beth Darnall, a Stanford University professor who specializes in pain-psychology research.

“When women go through menopause, there are big changes with pain, anxiety and depression. There is a hard body of research on this,” Darnall said. “Opioids, taken long term, reduce the level of hormones in the body. This can lead to a greater sensitivity to pain. And it can feed into this dose-escalation cycle.” …

As a woman — and intractable pain patient — who’s gone through menopause, I don’t know what the hell this professor is talking about. Opioids, taken long term, reduce the level of hormones in the body? Um, isn’t that what happens during the aging process, for both men and women? How can you put the blame for aging on opioids? And wait, I thought there wasn’t any research on the long-term effects of opioids?

In fact, the opposite of what she says may be true. I’ve heard plenty of stories from women who’ve suffered migraines for decades and then, after menopause, the headaches go away.

I know everyone is different, but menopause didn’t affect my intractable pain in any way, except to end my very painful periods every month. So, whatever these “big” changes with pain, anxiety and depression that women are supposed to experience during menopause, I guess they just passed me by. Or else this professor is full of shit.