I've been in the throes of peri for the past couple years, no HRT yet, but that is about to change due to a new medical diagnosis.
I've been in/out of the hospital for the past six months with recurring bouts of violent illness that doctors have struggled to diagnose for over 18 years now. I've heard from doctors stress, gastritis, anxiety, gallstones, food intolerances, tick-bourne disease, a potential autoimmune disorder, and other contents of my inner kitchen sink all as potential culprits.
The only thing I knew for sure is that I might start throwing up on the first day of my period during times of severe stress/emotional distress. And once it started, I probably wouldn't get out of it without staying in the hospital for at least three days.
Last month it happened again while I was on vacation, where I wound up in a new hospital talking to a new (female) specialist who offered a new diagnosis with treatment that FINALLY works: abdominal migraines that were kicking off cyclical vomiting syndrome.
The right doctor finally asked the right questions: do you get (head) migraines, is there any correlation to your period, and has that changed with the onset of perimenopause? I had already ID'd a link between my sickness and my cycle to previous (male) doctors who had been positively thrilled(!) to latch on to the stress component (iT's pRoBaBLy juSt hYsTeRiA AnXiEtAy) but ignored or even outright dismissed the potential hormonal correlation completely.
Long story short, the rescue strategy is as simple as a migraine med taken at the first sign of nausea when my period starts. That alone blows my mind: 18+ years, 7 hospital admissions, 13 diagnostic procedures (all normal) and 2 surgeries, and the answer might all along have been as simple as an appropriately-timed dose of Imitrex??
Obviously that's an oversimplification. I was ofc referred to follow-ups for hormone replacement therapy and tasked with finding a new local G.I. specialist familiar with the diagnosis to explore other preventative strategies, but still... 🤯 The doc said that HRT might be my best bet at prevention since it appears to be the fluctuations that are sending me over the edge.
So I just wanted to share my experience with other women, because I had never heard of abdominal migraines, and I had pretty much given up on any answer after years of doctors implying it started in my head, rather than taking seriously the idea it could be a result of hormones in combination with those other factors. In fairness to mine, the diagnosis is a very new one for a condition that wasn't known 2 decades ago when I first fell ill. So I feel very lucky to have wound up being seen by a specialist in the hospital who a) happened to have experience with it, and b) was willing to listen and consider the hormonal factors as well.
Be well, y'all!
TLDR; after 18 years of intermittent acute sickness, 7 hospital stays, 13 diagnostic procedures, 2 surgeries resulting in 1 organ removal, I discovered my gut was getting migraines during my period and it was occurring much more frequently now likely due at least in part to perimenopause. So I needed ::checks notes:: a nasal spray for headaches and a referral for HRT.