You Are Stripping The Bed Again At Two In The Morning
The sheet is cold and damp under your shoulder blades. You are standing in the dark with an armful of bedding, doing sums.
This started when you were 46. You are 51.
Somebody, at the beginning, said a couple of years. You built your expectations on that sentence.
You now keep a towel on your side of the bed and run a fan in February, and you have started to think there is something wrong with you specifically, because everyone else apparently got through this by now.
They did not. You were given a number that was never true.
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Seven Point Four Years
Nancy Avis and colleagues followed 1,449 women with frequent hot flashes and night sweats through SWAN, from 1996 to 2013, and published in JAMA Internal Medicine in 2015.
The median total duration of frequent vasomotor symptoms was 7.4 years.
Not two. Seven and a half, and that is the middle of the distribution, which means half of all women run longer than that.
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What I’m about to show you isn’t for the faint-hearted…But you need to see the truth.
Now The Part That Inverts Everything
Duration depended on when symptoms started.
Women whose symptoms began while they were still premenopausal or in early perimenopause had a median total duration of more than 11.8 years. That group also continued a median of 9.4 years past their final period.
Women whose symptoms only began after their final period had the shortest course.
Read the shape of that. The earlier it starts, the longer it lasts.
Which means the women who get told they are too young for this, who get sent away with a normal blood test at 44, are precisely the women facing the longest course of it. They are dismissed at the beginning of a decade, not the end of a phase.
The study also found duration varied substantially by race and ethnicity, with a median of 10.1 years among African American women and 4.8 years among Japanese women in the cohort.
Re-Price Every Decision You Made
Do this first, because it is the one that matters. Every decision you made about this was priced on two years.
Whether to treat it or wait it out. Whether to raise it at work. Whether to accept the sleep you are getting. Whether it is worth the appointment.
Two years of disrupted sleep is something to endure. Seven to twelve years of it is a health decision with consequences, and it deserves to be made on the real number.
Date It, Then Ask For A Horizon
Write down the month and year your symptoms started. That single fact is the best predictor you have of what is ahead, and no one will ever ask you for it.
Then take it to an appointment and ask a question with a timeframe in it.
My symptoms started at 46, the median duration is over seven years, and longer for early onset. What is the plan for the next five years.
That question is very hard to answer with a suggestion about layers and caffeine. It forces an actual plan, or it forces a referral to someone who will make one.
And count. Symptoms per day, once a week, on paper. A plan you cannot measure is a plan nobody has to keep.
You were not failing to get over it. You were handed somebody else's timeline.
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