Hi, I'm Dr. Gunter.
I'm an OBGYN and
author of The Menopause Manifesto, and
I'm here to answer some questions.
So, unfortunately, we don't
have enough data on
what to sort of expect or
for people who are
taking testosterone and who also
have ovaries and so
there could be really a wide range of
symptoms. For some people, the
testosterone will
prevent a lot of the symptoms.
And for some people it may not.
And so this is really
an area where we need a lot more
research so we can we can help
people understand what to expect.
And also understand what
kind of health screenings, if
they should change from
a timing perspective, like screening
for osteoporosis, does being on
testosterone affect that?
We just, sadly, don't have that data
yet. I think that people who
are getting
their gender-affirming care from
physicians who are prescribing their
hormones, that that's
just going to be sort of a case-by-case
discussion about kind of how to manage
things kind of long-term.
So that's a great question.
So if you're talking about a
hysterectomy, meaning just
removing the uterus, so we're not
talking about the ovaries, what
that could do is that can lower the age
of menopause a little bit.
And we think that's related to sort of
the information and trauma from surgery
and how that might actually affect the
ovaries.
And so just taking the uterus out could
slightly lower the age of menopause.
And the reason that matters
also, you know, symptoms might start
earlier, but the lower your age
of menopause kind of from that average
of fifty one, the greater
your risk of having complications
related to menopause.
So heart disease, osteoporosis,
dementia, those are increased with
early menopause.
Now, that's not a reason not to
have a procedure, but those are things
to all consider sort of in,
sort of your overall health care.
So, for example, if you're going to
have a hysterectomy early, for whatever
reason that may be, then you want to
make sure that you're
on top of cholesterol screening
and screening for diabetes and making
sure that you're getting enough calcium
in your diet and doing weight-bearing
exercises because the three
healthiest things for your menopause
are to not smoke, to be
doing the recommended amount of
physical activity and also a healthy
diet.
The one thing that always surprises a
lot of people is that hormone levels
are not valuable at all
in managing menopause, and
I think it's hard for people to believe
that because we kind of all equate
testing with caring: if my doctor
cared about me, they would just do this
test. I think that's how
medicine has been sold to many
people, right?
And the truth is, is
we are able to diagnose puberty just
fine without doing blood tests, right?
We're able to tell when someone has
transitioned from puberty to adulthood,
right?
Just fine with...
Just by looking back when you're twenty
one or twenty two, you might say, 'Hey,
I guess I stopped growing and
I guess this is how I'm going
to look and I feel like I
guess I'm finally done and must be
through puberty now.' But you don't
know that until you're done,
right? And so I
think that people are
shocked when we say, well there aren't
you don't need a blood test for
menopause just like you didn't need a
blood test for puberty.
As long as it's happening at the time
when it's supposed to happen.
You know, if you think it's happening
to you when you're 32, totally
different story! Just like if someone
was going through puberty at age four,
totally different story!
That's not when it should be happening,
right?
But if something's happening to your
body, exactly when it should
be happening, then that's good.
That means your body is actually
working as it should be.
Yeah, that's a huge failing.
So a lot of the
data we have is really centered
around heterosexual women
or there's just
there's no questions asked at all.
So you just, like, you don't know.
But since a lot
of the questions like, for example,
about sex are clearly sort of,
you know, sound more geared towards
a heterosexual coupleship, that
how do these things apply to
people in same-sex relationships?
And we don't have enough
data there to say and that's a real
failing.
It's a huge problem.
We've made a lot of strides, I would
say, in the last 10 to 15 years
about having far more,
sort of, cultural and racial diversity
in studies, which is super important.
But I still think we're really
lacking,
you know, with data outside of
the heterosexual lens, if you will.
And that's something that, you know,
that we need to push for.
You can find me on Twitter
@DrJenGunter, on Instagram
@ DrJenGunter.
I have a substack called The Vajenda
(with a J...
play on words!) And I have
a new podcast with the TED audio
collective called Body Stuff with Dr.
Jenn Gunter. The book is The Menopause
Manifesto, and it was
published on May 25th and
you can get it everywhere that you can
buy books.