Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Is it physician burnout or perimenopause?

Beverly Joyce, MD
Conditions
September 20, 2019
Share
Tweet
Share

I am an experienced OB/GYN, well-versed in obstetrics, infertility, gynecology, surgery and — yes — menopause, or so I thought. So why was I so blindsided by my own menopause transition?

I thought I was going through burnout, with anxiety, anger, mood swings, irritability, and depression. I was at a point in my career as an OB/GYN of 20-plus years that patients flocked to me because of my reputation and expected me to deliver their babies. After all, I had delivered 99 percent of my own patients over the past 15 years — 24/7/365. Yet, I had become torn between my career obligations and my family obligations. My two adolescent children needed me to chauffeur them and assist them in all things teenager: soccer, piano, homework, dinner — all these things required my attendance and participation. I would commonly get paged out of dinners, soccer games, and personal appointments. I assumed this had all just caught up with me. I was miserable, and I let everyone know it. My office staff walked on egg-shells around me, and I was confronted by my partner about my attitude.

But why had these things become so overwhelming to me “all of a sudden” at the age of 50?

As the aforementioned experienced OB/GYN, I, of course, managed my own medical care. Not that I could do my own pap smears, but I did order my own mammograms and prescribe my own birth control pills, thyroid medication, allergy meds, etc. I had been taking OCPs continuously for many years to avoid menstrual migraines. So when I reached 50 and started having anxiety (and hot flashes, by the way), I didn’t think it was perimenopause. Because, after all, isn’t perimenopause due to estrogen fluctuations? And I was taking estrogen, so my levels should be very steady, right?

Well, what do we really know about perimenopause? Estrogen levels can actually be higher than usual; ovulation is erratic, so progesterone is low, periods are all over the place, “vasomotor” symptoms (hot flashes, night sweats) can occur. And what is the treatment for perimenopausal vasomotor symptoms? Well, isn’t it estrogen? So, I couldn’t understand why I had these symptoms. I assumed it must be new-onset anxiety, related to my career versus family mental turmoil. Who knew that vasomotor symptoms of menopause are more than just estrogen-related?

Try as I might, I could not find reliable information. But since we do treat patients with SSRIs, and SNRIs for hot flashes, how can they be effective? Hmmm, maybe there are other neurotransmitters and hormones besides estrogen involved.

So, what did I do? First, I took a week-long excursion to the Life Enhancement Center at Canyon Ranch in Tucson. I did some true soul-searching about what I wanted and needed in my career and life. After that, I sought therapy, I learned to meditate (sort-of), and I started Zoloft. Ultimately, I decided to stop doing obstetrics to alleviate the constant turmoil I felt between my (albeit self-imposed) obligations to patients and my role as mom and wife.

As I have come through the other side of this journey, now at age 56, and after doing much research on both burnout and menopause, I have come to the conclusion that my burnout symptoms had a lot to do with perimenopause. I have since transitioned to menopausal hormone therapy, and still have occasional hot flashes, although tolerable. I also still have occasional pangs of anxiety, although much less. I have learned to do deep breathing and meditation to control these feelings. And, I am sleeping great, since I am no longer taking OB call. I no longer feel the pull of patient versus personal health and family. I no longer get PTSD at the beeping of my pager because I no longer carry it.

We still have a lot to learn and to do in dealing with the physician burnout epidemic. For women physicians, and the coaches, therapists, and counselors who see them, please be aware that hormonal changes can be a strong contributor. This includes women who are postpartum or who are perimenopausal. I hope that my story will help women physicians, as well as their loved ones and colleagues, recognize the impact that hormonal changes can have on feelings and attitudes about work and career. Knowledge and empathy can go a long way to helping women cope with these issues.

Beverly Joyce is an obstetrician-gynecologist.

Image credit: Shutterstock.com

Prev

MKSAP: 52-year-old woman with chest pressure

September 20, 2019 Kevin 0
…
Next

Why pediatricians must talk to their patients about diversity

September 20, 2019 Kevin 6
…

Tagged as: OB/GYN

Post navigation

< Previous Post
MKSAP: 52-year-old woman with chest pressure
Next Post >
Why pediatricians must talk to their patients about diversity

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Beverly Joyce, MD

  • Confessions of a disruptive physician

    Beverly Joyce, MD
  • From OB/GYN to self-compassion: a physician’s tale of transformation

    Beverly Joyce, MD
  • From reluctant journaling to healing words: How writing unveiled my life’s journey

    Beverly Joyce, MD

Related Posts

  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • A physician’s addiction to social media

    Amanda Xi, MD
  • Physician burnout is as much a legal problem as it is a medical one

    Sharona Hoffman, JD
  • Despite physician burnout, medical schools are still hard to get into. Why is that?

    Suneel Dhand, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • The black physician’s burden

    Naomi Tweyo Nkinsi

More in Conditions

  • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

    Pearl Jones, MD
  • Why local cardiac CT scans could save your life

    Benjamin Cohen, MD
  • How proposed NIH budget cuts could derail Alzheimer’s research

    Tamer Hage, Tejas Sekhar, and Swapna Vaja
  • A spoonful of vinegar: Why simple glucose hacks deserve more medical attention

    Callia Georgoulis
  • Living through injury: one family’s journey to the other side

    Sarah White, APRN
  • Why congenital CMV should be on every parent and doctor’s radar

    Kathleen Muldoon, PhD
  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
  • Recent Posts

    • Why being a physician mom is harder than anyone admits

      Cynthia Chen-Joea, DO, MPH | Physician
    • 9 domains that will define the future of medical education

      Harvey Castro, MD, MBA | Tech
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • What led me from nurse practitioner to medical school

      Sarah White, APRN | Education
    • Why local cardiac CT scans could save your life

      Benjamin Cohen, MD | Conditions
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
  • Recent Posts

    • Why being a physician mom is harder than anyone admits

      Cynthia Chen-Joea, DO, MPH | Physician
    • 9 domains that will define the future of medical education

      Harvey Castro, MD, MBA | Tech
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • What led me from nurse practitioner to medical school

      Sarah White, APRN | Education
    • Why local cardiac CT scans could save your life

      Benjamin Cohen, MD | Conditions
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...