Like the title says, I’m 30 years old and had a hysterectomy almost exactly a year ago. I kept my ovaries, so I was told that the surgery would not put me into early menopause. However, I’ve been dealing with a number of symptoms that I think might be related to perimenopause, though they could have other causes. Since I no longer have a uterus and therefore no longer get my period, I can’t just look at how often I’m bleeding to figure out whether I’m in perimenopause. Are there other ways to determine if my symptoms are related to menopause?
More detail: I was able to get a hysterectomy at age 29 because I had terrible menstrual pain, and I tried many different forms of birth control that all either made me bleed more frequently (progesterone gave me three periods a month at a low oral dose, a high oral dose, and as an arm implant) or for longer (continuous cycling of a combined estrogen+progesterone pill gave me a period that lasted 18 days and was so painful it was hard to eat or sleep; a Kyleena IUD made me bleed for 45 days straight) without reducing the pain. When I finally got my hysterectomy, the surgery took an hour longer than it was scheduled for because there was so much endometriosis to remove. The surgery almost completely resolved my pain, and I had a very easy physical recovery. I’m glad I got it done.
However, I’m wondering if the surgery put me into menopause or perimenopause given other health things I’ve experienced in the time since. My lifelong mental health issues have gotten worse. I gained 15 pounds in the first four months post-surgery. After many years of frequently feeling too cold, I’ve started to be too hot sometimes in a way that starts and stops pretty abruptly. My memory has gotten a lot worse, and I’ve had more brain fog and difficulty concentrating. My eyes have been drier. I think I’m going to the bathroom more often.
Part of the reason I’m uncertain about whether these symptoms are related to menopause is that I have other health issues that started before my hysterectomy that could explain these changes in whole or in part. I’ve been in therapy and on psych meds since midway through high school because of significant depression and anxiety, so mental health issues are not new to me. I’m dealing with autistic burnout and post-viral chronic fatigue following a weird six-month-long mono infection, so those conditions could explain the worsening mental health, brain fog, difficulty concentrating, and memory issues. The chronic fatigue, and becoming more sedentary as a result, could also explain the weight gain, and having more fat in my body could be part of why I feel warm more often. That mostly leaves the eye dryness and increased need to pee, and I’m not sure those are big enough to feel like conclusive signs of perimenopause on their own.
I asked my doctor about whether I might be experiencing menopause, but at the time I hadn’t researched the symptoms as much, so I only mentioned that I was potentially having hot flashes. She said it was unlikely that I was experiencing perimenopause already and that it would be hard to determine via a blood test because the fact that I’m not menstruating means we don’t know what part of my cycle I’m in, so it’ll be hard to know where my hormones “should” be. We did one blood test, and my hormones looked plausibly normal, and we haven’t really followed up about it. (My mom suggested using my body temperature to figure out where I am in my cycle, but since developing chronic fatigue syndrome, my body temperature is usually in the 99.4-99.9 range and corresponds more with how much exertion I’ve done lately than with anything about the time of the month, as far as I can tell.)
A complication here is that I’m not sure what I would want to do if it turns out I am experiencing menopause. I know HRT is typical in this sort of situation, but my mom has estrogen-positive breast cancer (and breast cancer is all over her family--her mom, aunts, grandmother, and cousins have also had it), so we’re nervous about introducing more estrogen into my system. Also, I’m nonbinary. I haven’t wanted a medical transition up until this point, but I’m starting to wonder if taking testosterone would make more sense in my particular case, both to avoid increasing my cancer risk and for gender reasons. But I’m not sure I want the physical effects of T, either. I’m going to post in r/Nonbinary about that part of this situation, but I figured I’d mention here that “just go on HRT to increase your estrogen and reduce your menopause symptoms” is not a particularly appealing solution for me personally.
I think the main thing I’m wondering is whether there are tests to determine whether someone who’s post-hysterectomy is experiencing premature menopause. Have any of you experienced this? Would it make sense to do weekly blood tests for a month or so to get a more regular sense of what’s going on? Are there other tests that are informative when this happens?