My hormone journey: The appointment

So, last week I talked about My Hormone Journey postpartum and what it was like to take an at-home blood test.

I mentioned that I managed to get an appointment with my doctor with a view to get blood tests done.

I was extremely nervous leading up to it and it was a miracle that I slept as well as I did given my nerves. I was afraid that I would be fobbed off and told to “wait and see” or that it was all in my head.

At first, it seemed like my nightmare would come true. He seemed dubious and asked a series of questions that in the moment seemed to imply that he thought that I am depressed rather than having something physically wrong with me, but objectively looking back, he was probably doing his due diligence to rule it out. He also had a glimmer of annoyance that I had been told by others to “wait and see” and that I had been suffering sans investigation for as long as I have been.

Long story short, he didn’t see the point in testing my progesterone because it fluctuates so much from day to day in your cycle, and doesn’t mean a whole lot in isolation, which I was disappointed to hear, but I understand what he means. However, he instead ordered a comprehensive list of tests to be done to discover the source of my exhaustion and low energy, which are the worst symptoms I have at the moment, and certain things that he is testing for can also impact progesterone levels as well.

So today I will have blood drawn for: FSH, LH, Liver profile, Thyroid function test, Full blood count, Gamma GT, HbA1c and Renal profile.

My hormone journey: background

I’ve already mentioned in previous posts and on Instagram that I have been having issues with my hormones since January 2017, but have realized that I haven’t talked about exactly what has been going on here on the blog. Sit down with a cuppa, it’s a long one, folks!

January 2017

I was 7 months postpartum and still not sleeping a whole lot. Despite the fact that the Very Hungry Kiddo was now getting solids for a month, he was still having like, 3 milk feeds a night. I had been on the pill since September after I got my period back after having the munchkin. I was terrified of getting pregnant again because the sleep deprivation was still very real and I was still in the middle of it. I was on the same pill that I was on before getting pregnant and I was one of the very lucky few who never experienced any side effects. Sure, I was exhausted and had very little energy, but what mama with a 7 month old wouldn’t be? I had a low libido, but I assumed it was because I was so damned tired all the time.

But… the same point of my “cycle” every month, I got intense anxiety. It was typically days 13 and 15. I started tracking it using a menstrual cycle app. For 3 months straight after that, I experienced the same symptoms. My anxiety was in the form of becoming very obsessive over the idea of relactating.

In the future, I will write a dedicated post about our breastfeeding experience. But let’s just say, it was a colossal failure, a shit show, really, and we didn’t get the right support that we needed in time to make a difference. Being a first time mom, I had done a lot of research prior to giving birth, but there are some things that you just can’t know until you go through them yourself.

So, despite the fact that he was thriving on formula that I felt good about giving him and he was taking to solids like an absolute champ, I would spend roughly 2 days per month obsessively researching relactating. I knew at the time, objectively, logically, that what I was doing was batshit insane, but I simply couldn’t stop. Luckily I had the support of my husband and mom who held my hand while I dealt with the crazy.

April 2017

I decided that I didn’t have these crazy thoughts and anxiety while I was off the pill after giving birth (despite already stopping breastfeeding then), so I was going to give it a few months sans pill to see if there was a difference.

Immediately, there was. The relactation anxiety stopped. I vowed to stay off hormonal birth control and just use condoms.

May 2017

I went back to work, but despite the fact that now the kiddo was sleeping through the night (IT WAS AMAZING), I still felt exhausted. All the time. No amount of sleep would rejuvenate me. I assumed it was because of my backlog of sleep. And my libido was super low too, which was very strange for me. Prior to going back on the pill postpartum, my libido was always normal. Hell, even immediately postpartum it was there in a big way, which was a huge shock to me at the time.

I had some big changes going on my life, like adjusting from being a stay at home mama to a working one, juggling multiple childcare situations, etc. I had turned in my notice at work and was going to start a new career, which I was excited about, but I was dragging my ass at work and felt guilty about it. I couldn’t help it though, even though I was back and had had the baby, I still had that extreme tiredness that I did in my first trimester. 

October 2017

Back in October, I went to my doctor to speak about my concerns with my hormones. I decided that enough was enough. I had significantly improved the quality and quantity of my sleep for several months and my stress levels were low due to a less demanding job. At that point, I was 16 months postpartum and the kiddo had been reliably sleeping through for 5 months. But I didn’t feel right. My intuition, gut, call it what you will, told me that my hormones weren’t right. My periods were getting shorter. Libido was low. Very, very low energy. Anxiety was high. 

My doctor picked up on the anxiety and referred me to mental health services. I chose to go private because I still to this day wouldn’t have seen someone to help me, the wait list was so long. It made a massive difference, but it still wasn’t helping this unshakeable fatigue, my nearly constant brain fog. Libido was still lacking. 

I started charting my cycle using my basal body temperature using the Fertility Awareness Method and saw that my luteal phases are short. 6 days, with 23-24 day cycles in general, which indicates low progesterone at the very least.

I really prioritized sleep in a major way even more, got at least 8 hours per night, drastically reduced stress and anxiety from counseling and yet another change of job to work even fewer hours, more flexibility and similar pay.

January 2018

I read about how to support your body post-pill and how to support progesterone production. I began to supplement with a B Complex*** and Magnesium*** (with cofactors of Calcium which I need anyway because I’m lactose intolerant and Vitamin D for absorption).

I also started reading Taking Charge of Your Fertility***, which I checked out from our local library. This thing is a fascinating, amazing treasure trove and is like the women’s health bible. It’s an enormous book too, like if Stephen King wrote a book on women’s reproductive health. Great if you’re trying to get pregnant, trying to avoid pregnancy, or just want to know more about your body or a specific reproductive condition.

February 2018

I ordered a home blood test kit, which was a disaster, read more about there here, and decided to go back to the doctor, despite my worries that I wouldn’t be listened to again, that I wouldn’t get the help I needed again, that I would waste my time and fail again. That I wouldn’t be convincing enough. Menstrual cycle was at an all-time low of 22 days. I started to up the amount of healthy animal fats to support cholesterol, which in turn supports hormone production and balance.

March 2018

I am still taking a B Complex twice daily (and Magnesium/Calcium/Vitamin D in the evenings), and on the random days I have forgotten to take it I literally feel like a sleep-deprived zombie, even though I get at least 8 hours every night. For me, it’s a thousand times better than caffeine and makes a huge impact on my energy.

Appointment is made. I have an emergency appointment with my doctor tomorrow (a different one from October, for what it’s worth). I also have another appointment with a female doctor in April, so I figured it push comes to shove, I can always speak to her if it’s a disaster with my actual doctor on Friday. I’m hoping I can use the right words to convey my need, to convince him that a blood test is worthwhile and needed.

I’m excited about taking the next step and finally stop the guessing game of what I can do to help myself feel better. Because I’m ready to thrive and feel more like “me” again.

*** Amazon affiliate links. Products I’ve used and loved.

My experience with at home hormone blood testing

I went to visit my doctor in October to speak about my concerns about something being off with my hormones. She was very caring, listened to my concerns, but suggested (based on the evidence I provided) that this was all stemming from anxiety. Don’t get me wrong, I was, and she referred to mental health services and eventually went private to get the help I needed sooner rather than later. If I hadn’t I would’ve still been on the waiting list now rather than been getting the help I needed straight away.

However, my hormonal concerns seemed to be brushed to the side. Let me preface this by saying that I love doctors. I have friends who are doctors and I am pretty much the biggest cheerleader for the NHS that there is. I have seen the American system and the NHS and I would choose the NHS every. single. time.

Like I’ve mentioned before, one of my intentions for 2018 it to trust myself. I knew that the anxiety was a thing, but I can feel in my bones that there is also something going on in my body. Most likely hormones, but maybe just some deficiency that is creating a cascade of hormonal-like problems?

Taking action — getting to know my body again

I started using menstrual cycle tracking apps to see how long my periods were. They were getting shorter. My 26-28 day cycles have shrunk down to 23 day cycles. My last cycle was 22 days. I have been taking and charting my basal body temperature since that doctor’s visit in October to get more information about what’s been going on in my cycle.

What I had learned was that my ovulation day is now much later than it was pre-pregnancy. I typically day on Cycle Day 17 instead of 14ish. That isn’t such a big deal, but crucially, my luteal phase (the part of your cycle after ovulation), has been crazy short. 6 days.

Why is a short luteal phase a big deal?

In short, it means it’s likely that your progesterone is low. Progesterone is a hormone and is beneficial because it helps create a good old lining of your uterus for any fetuses to implant to, if you’re into that kind of thing. A luteal phase of less than 10 days is considered short, with some recommending 12 days minimum to avoid miscarriage.

Even if you’re not into making babies any time soon or are done making babies, it can cause other nasty things like low libido, fatigue, brain fog, depression/anxiety and vaginal dryness among a host of lots of things (check out the link. There’s a lot!). In other words, totally not things you need in your life if you want to be thriving!

So didn’t you say something about a test? 

Ah yes, the test. So I was feeling a bit dismayed that my hormonal issues were dismissed by the doctor I saw and the possibility of going through all the trouble to make a doctor’s appointment and taking time out of my day just to be dismissed again just made me feel frustrated. I decided next time I went to the doctor, I wanted to be armed with information. So I looked up a few, and choose one using the finger prick method rather than having blood taken by a professional (which cost an extra £25), saved up the cash (£59) and ordered it.

What is it like? 

It came in a fancy box, with everything you needed (except which days of your cycle you had to take the sample, with was in a separate e-mail that kept hiding in my inbox, annoying!).

I have given blood countless times since I turned 18. I’m an old pro. Finger pricks don’t scare me, I’ve had it done umpteen times and The Brit is Type 1 diabetic. And well, we’ve tested my own blood sugar from time to time using his tester kit for shits and giggles. I’ve always been a good donator and had no reason to believe I would have any issues.

Taking the sample

I treated it a bit like I would before going in to donate blood. I had a big, iron-filled breakfast. I drank a ton of water. I followed the guidance and took a warm shower and did some light exercise to get the blood flowing. I was standing up and massaging my finger from palm to tip. I did all the things.

The time came and I was really excited. I pricked my finger, opened up the little vial that I had to fill. Annnd. Blood was coming out, yay! …Until it stopped. I re-read all of the documentation. Washed my hands with warm water again, did more jumping jacks and push-ups. Then I prepped to use my other finger. Blood was flowing nicely until it wasn’t after about 5 minutes. There was a miniscule amount of blood that I managed to get into the vial. Nowhere near the amount needed to run the tests.

Now, let me just paint a picture of how messy this was. Don’t read this if you’re faint of heart. Just skip over it. I don’t know if it was just me, but blood was kind of leaking/oozing out of the pad of my finger rather than dripping out in nice drops like what normally happened when I was donating blood and they check to see you have enough iron floating around in your veins. I would put my finger up near the vial and it just looked like I had been finger painting in blood, it was smearing EVERYWHERE. I might have got just as much around the little test tube/vial thing than I did in it. It was like I had cut myself shaving or while chopping something. Both times. With both fingers. It wasn’t fun. It was supremely frustrating.

Calling customer service

After this fiasco, I remembered that our local hospital would actually take the blood intravenously for you. For a fee. I had discounted this before because why pay when I’ve never had any issues before? But now? I just wanted to get it done and get results. So I called and spoke to a very nice lady. She told me that many people just simply can’t for one reason or another get enough blood for finger prick tests and some of the people in their office had the same thing going on as me.

Then she dropped the bomb. Unfortunately, since purchasing my blood test kit, our local hospital had stopped being a “partner” with this home blood test kit company. The next local one was 200 miles away. Or I could pay another £39 to have a nurse come out to my home and take blood for me.

After this, I felt dejected and extremely disappointed. I had already sunk £59 into this thing and it hadn’t gone well. Should I sink another £39 and wait another month (I had to wait for a certain point in my cycle) just so I can say that I’ve done this?

In the end…

I trusted myself and what my gut told me to do in that moment.

I chose not to add another £39 to the fire to get some nurse to come out and take my blood at home. I decided to consider it an expensive mistake and discarded the crime scene blood test kit.

Take a hint from fate, the universe, whatever. Do it properly, take the time, and work through the normal channels where I can get more local support before and after the fact. The doctors will probably respect the results that their own phlebotomists take more anyway.

These are the things I have told myself. Hopefully I made the right decision.