Dear Readers,

Please accept my apologies if this piece offends in any way. I admit there are moments when it leans toward the graphic and, perhaps to some, the gruesome, but it’s my fervent desire that by article’s end readers – male and female alike – will have a better appreciation for my utter desperation to resolve what’s been a lifetime of menstruation misery. Also, this is my personal journey and I am in no way an expert. Always consult your physician about your own health issues and needs.

With appreciation,

Whitney Joseph Shavelson

My first period was a messy affair.

It was a typically hot and sticky Florida afternoon, and I was in the middle of nowhere – or so it seemed.

I was 13, making it 1985. It was summer, and I was at cheerleading camp before eighth grade. While I’m a bit foggy about the exact location, it was either central or northern Florida.

My junior high school wasn’t known for its athletics, but the cheerleaders always competed nationally and consistently ranked among the top ten. Despite our short skirts and frilly pom poms, we trained just as fiercely as “traditional” athletes – if not more so – determined to prove that we, too, were elite competitors.

Part of that entailed intensive clinics and camps, including the summertime adventure that turned out to be rougher than I anticipated in the most unexpected of ways.

A ghastly memory

I wasn’t prepared for that first period – neither in mind nor in practice. I remember we were doing drills when I got awful stomach pains and became rather faint. I suddenly realized my shorts were a bit sticky, though I wasn’t sure why. Thankfully, I wasn’t wearing white.

I ran to my cabin and straight into the restroom. I wanted to vomit. I nearly passed out. I had none of the accoutrements a young girl should have the first time she “falls off the roof,” as the charming Southern euphemism goes. I had no painkillers, no sanitary pads, no heating pad, nothing. Thank goodness my mom was the eternal chaperone and could go get me the essentials.

The camp was in the boondocks, so it took her what seemed like an eternity to return. All the while I hid in a musty bathroom stall, my face an ashen white.

Making matters worse was the chatter from other cheerleaders bunking in our cabin. I didn’t catch every word, but I heard some. Words like “period” were muffled by running water from the sink, which nicely quieted my heavy breathing. Another wave of nausea … I was mortified and feeling oh-so-sick. I hid behind a graffiti-covered door that blessedly preserved my anonymity.

While waiting for my mom, I wondered why so many girls longed for their periods. 

With two older sisters, I knew better. I’d watched them suffer. It wasn’t pretty. What scared me most, though, was my mom telling us those painful periods ran in our family. Apples don’t fall far from the tree…

Fast forward a generation. My sisters and I proved the pattern, as we all suffered the same fate: unbearable cramps, blinding migraines, menorrhagia (heavy bleeding), mood swings, frequent vomiting, and a sundry of other equally lovely symptoms.

Possible, perhaps partial, relief?

Fast forward again, this time to college, freshman year. I excitedly walked into the health clinic for birth control. I’d read it could quell those awful periods. The pain. The long, irregular cycles. Soon, they would be a thing of the past.

I was beyond excited – this was the answer to my prayers!

But … no.

Turns out that birth control pills can exacerbate migraines. The splitting headaches I’d battled since wearing pigtails worsened. My skull exploded as if I’d swallowed a grenade instead of the pill. Stopping was a no-brainer.

My dreams of manageable, painless periods? Gone.

I wasn’t even 20. I’d have to play the long game, I realized, to rid myself of those hellish periods. I’d have to wait until menopause. It would take decades, but it would be worth it.

Three decades and waiting

Fast forward three decades and three years, and I’m still waiting (for relief, at least). Now 53, I was officially diagnosed as “menopausal” in the spring.

Some women might be hesitant to admit they’re menopausal in public or memorialize it in print. I don’t see why. We all age, and that’s worthy of celebrating. To those who grimace and grouse about growing older, getting more wrinkles, or gaining more pounds, I offer you this: Aging is far better than the alternative.

With age also comes wisdom, and ideally, a certain amount of relief.

Such was my mindset when I hit menopause.

The ‘H’ of HRT – for huzzah or help?

I was feeling optimistic, but HRT hasn’t panned out quite yet.

HRT stands for hormone replacement therapy. Before diving into HRT, let’s first discuss the basics of menopause, with some guidance from the National Menopause Foundation.

The NMF defines a woman as “menopausal” after 12 consecutive months with no period. All women experience menopause as they age and their reproductive hormone levels drop. Symptoms vary; the most common are hot flashes/flushes, night sweats, sleep disturbances, vaginal dryness, incontinence, mood swings, and weight gain (especially around the abdomen).

There are three distinct menopausal stages:

• Perimenopause, during which a woman still produces eggs and can thus still become pregnant (even if experiencing menopausal symptoms);

• Menopause, which is technically a single day marking one year since a woman’s last period; the ovaries stop releasing eggs, estrogen is no longer produced, and pregnancy is not possible; and

• Postmenopause, the phase entered after menopause; hot flashes and other menopausal symptoms stop, but the NMF notes aging women, no longer fertile, are at higher risk for other health conditions.

Women usually enter menopause between 48 and 52 years old. OB-GYN and author Dr. Heather L. Johnson explains on nationalmenopausefoundation.org that many women experience six months to up to three years of “fanfare” before their last period.

Dr. Johnson’s book, What They Don’t Tell You about Menopause: A Gynecologist’s Unofficial Guide to Premenopausal, Perimenopausal, and Postmenopausal Life, prepares women for what’s often a dreaded but inevitable part of life.

The more you know…

Knowledge is power when it comes to menopause, stresses Dr. Johnson, who emphasizes that estrogen plays a vital role in women’s reproductive health as they age. That brings us back to HRT.

“Prior to menopause, estrogen is mainly your friend. Its decrease and subsequent absence after menopause can lead to a number of medical issues such as vaginal dryness, pain with intercourse, and frequent urinary tract infections. More importantly, with the loss of estrogen’s protection at menopause, women rapidly catch up to men in numbers when it comes to high cholesterol and heart disease,” explains Johnson.

According to The Mayo Clinic, HRT is now called menopause hormone therapy. Its website, mayoclinic.org, defines MHT as “medicine with female hormones … taken to replace the estrogen the body stops making after menopause … to treat common menopause symptoms.”

The world-class clinic cites studies showing MHT “prevent[s] bone loss and reduce[s] broken bones after menopause … but [warns] MHT [has] risks,” depending on the type of therapy, whether the medicine is taken orally or topically, the dosage, the length of consumption, the patient’s age, and personal health risks.

Yet the US Food and Drug Administration and the US Department of Health and Human Services have been spreading the word that HRT is safe and blame an early 2000s study by the Women’s Health Initiative linking HRT to increased cases of breast cancer of fear-mongering.

Esteemed periodicals like the Journal of the American Medical Association largely agree. “MHT is broadly considered the most effective treatment for common symptoms of menopause, but its estimated use among postmenopausal women declined from about 27% to about 5% from 1999 to March 2020.” 

The drop in hormone usage pointed to the WHI study, with the FDA and HHS indicating it did a disservice to women who feared getting breast cancer, leading the agencies to announce on November 10, 2025 that they would drop the “black box” warnings on HRT products for menopause.

“[The study] found a statistically non-significant increase in the risk of breast cancer diagnosis. The average age of women in the study was 63 years – over a decade past the average age of a woman experiencing menopause – and study participants were given a hormone formulation no longer in common use,” according to the FDA.

“Tragically, tens of millions of women have been denied the life-changing and long-term health benefits of HRT because of a medical dogma rooted in a distortion of risk,” said FDA Commissioner Marty Makary, MD, MPH, who made the announcement with HHS Secretary Robert F. Kennedy Jr. “For too long, issues of women’s health have been underrecognized. Women and their physicians should make decisions based on data, not fear.”

HRT details

HRT is available as whole-body or systemic hormone therapy in a pill, skin patch, ring, gel, cream, or spray. Systemic HRT provides more estrogen than other HRTs, and when absorbed by the whole body it can treat multiple symptoms. Low-dose vaginal estrogen is available as a cream, tablet, or ring. It offers less estrogen for the body to absorb and therefore usually treats only vaginal and urinary symptoms of menopause.

In addition to relieving the traditional menopausal symptoms (hot flashes, night sweats, sleep disturbances, bone loss, and low libido), HRT with estrogen and progesterone can lower the risk of other ailments for women, including cardiovascular disease, by as much as 50%; Alzheimer’s disease, by 35%; and bone fractures, by 50 to 60%.

It’s great to see HRT now being considered by women once too scared to even consider taking hormones, myself included. And while my menopause journey has been rocky, I’m hopeful I’ll round the corner soon and thrilled others have reaped and are continuing to reap the benefits of HRT with fewer negative effects than formerly believed.

Not quite the silver bullet … yet

My past periods considered, the fact I’ve struggled with HRT isn’t a huge surprise, especially when considering my maternal family hormone history. That said, I’m holding onto hope.

My regular OB-GYN was on maternity leave when I was prescribed HRT, so it’s been a bumpy road from the start. Her substitute said I “might have some bleeding” in the beginning but didn’t warn me I could get my period again with the same disabling cramps I’ve battled my whole life.

It’s been nearly five months and the intense pain remains. So do the periods. This isn’t what I bargained for and certainly not what I expected. I’m writing this because I don’t think many women know this could happen, nor do I think the men in their lives know, either.

My new normal seems to be crampy and cranky, and I feel as if I’m in a permanent state of PMS. I thought menopause was going to end my periods. Period. What the heck happened?

According to my OB-GYN (who’s since returned as a new mom!), it can take three to five months for my hormones to regulate. Since we’ve tweaked my dosage twice, I may have to extend my wait twofold.

Anticipation…

By now it should be evident that I’d been eagerly awaiting menopause.

Look, did I relish the thought of gaining weight, of losing hair, of swinging moods, or of any of the other horror stories I’d heard through the years from women who dreaded the idea of aging? Heck, no!

But every month for nearly 40 years, in between being doubled over in pain and downing extra strength Ibuprofen every six hours, I continued to cling to my dream of no more nasty little periods once I hit menopause. I believed after I put in my time I would enjoy the reward. And now that I’m in what I’m hoping is the final stretch, I’m willing to face whatever challenges are necessary knowing that at the end of the day I still have a chance of finding calm – and no more period pain.

So, I’m keeping the faith that at some point I’ll join millions of women who have found relief with HRT and are enjoying their menopause journey in a peaceful and powerful way as a result.

That’s an end goal that I can definitely embrace – even if the journey thus far is proving to be incredibly and excruciatingly painful. I’m a woman; I can take it. What else is new? •

*Disclaimer: All medical claims made in this article are information researched and provided by the author. The information is general in nature and not specifically meant for any particular individual. You should always seek out medical assistance from a medical professional based on your individual needs and circumstances.