I began menopause unceremoniously at the tender young age of 33, thanks to a total hysterectomy. (Sorry for the rhyme, there; I tend to get all poetic when we chat about my uterus.) After having spent the majority of my lifetime at the mercy of everything that can possibly go wrong with those stupid organs (endometriosis! adenomyosis! infertility! ruptured ovarian cysts! hypermenorrhea, and I hope you’re not eating if you click on that link!), I was not one of those women who approached the surgical suite weeping for the loss of my womanhood, or anything like that. I believe the last words I said to my doctor before the anesthesiologist put me under were “Take it all out and don’t look back.”
I was ready, is my point. (I’ll take menopause for $200, please, Alex! What is The Lesser of Two Evils? YESSSSSSSSSS!)
And I’ve dealt with the fact that my internal thermostat is now permanently broken and I am always too hot, and I’ve dealt with the reality that unless I go on an all-calcium diet I’m a very likely candidate for osteoporosis, I’ve been through a breast cancer scare and the associated suggestion that I might have to stop taking hormones. But the thing that continues to drive me absolutely bananas is the insanity surrounding BUYING my estrogen.
I like estrogen. It makes me feel pretty. And, you know, less neutered. It helps keep my bones strong and prevents me from growing a beard and also keeps me from going completely insane, because—like most people who enjoy a double-X chromosome pair—I need some estrogen to stifle any murderous urges that may occur. (Those with an XY chromosome pair generally subvert this urge by watching football.)
My medical team prepared me for the endless carnival of excitement that is Finding The Right Hormone Dose And Delivery. I started off my journey on a combination estrogen-progesterone patch, and with that came relentless nausea until I was switched to an estrogen-only patch. Then I switched from that patch to a different one, and used it happily for a long time. I was super duper lucky (as I nearly always am!) and developed an allergy to the adhesive used on the patch, and so went on the hunt for a new hormone method. Later, I briefly switched to a hormone ring that caused me to have panic attacks, and finally, I switched to a topical estrogen gel, which is what I use now.
Is it a royal pain in the butt? Yes, yes it is. But I knew that it would be.
What I was NOT prepared for is the utter joy of going through all of this while trying to get said hormone treatments covered by my HMO.
Oh, they’ve been with me every step of the way. In the beginning, there were the problems with math. Later, when I switched to the gel, my insurance stopped covering it at all, and for years I used a Canadian mail-order pharmacy to keep myself well estrogenated. The good news is that my current insurance does cover the gel, but the bad news is that my local pharmacy screws up every single time I refill it.
For the last three months, every time I’ve gone to refill my hormones, they’ve only had one container instead of two. Now, it used to come in a larger size, so the prescription is written for one pump of 100 (100 what? I have no idea—grams? molecules? follicles?). Now that the only way you can get it is in a pump of 50, it stands to reason that I should be given TWO pumps to equal the original amount, which is a 1-month supply.
Apparently I am the ONLY PERSON IN TOWN who uses EstroGel. (I AM SPECIAL!) The pharmacy only ever keeps one container in stock, and then when I call for a refill they put it in a bag for me and then get completely confused when I come to pick it up and point out that this is only half my refill. They NEVER call to tell me they need to order more, don’t come pick it up yet. They NEVER seem to remember me, even though clearly I must, by this time, have CRAZY ESTROGEN LADY tattooed across the top of my file.
For months, I have gone to pick it up, been given just the one package, have patiently explained that this is only half my prescription, have then been told they’ll order the other one and I should come back in a couple of days.
I have been patient. I have tried to be understanding.
Yesterday I went to pick up my refill and was greeted at the pharmacy by a sweet young thing. I greeted her and gave her my name. She went and retrieved my prescription bag and pulled out—you guessed it!—a single container of EstroGel.
“Okay, here’s the EstroGel,” she said. “Anything else for you today, Ma’am?”
I sighed. “Um, yes, actually. That’s only one container. There should be two.”
“Oh, I’m sorry, Ma’am,” she chirped, all apologies, “Did you have a second prescription?”
“No, just the one,” I said. “But it’s for two pumps. One is only a two-week supply. There should be a second one. Let me guess: You only have one?”
This was where her face changed, slightly. She looked down at the bag, then over at the computer, then back at me again to say, “Ma’am, we can only give you what the prescription is written for. I can’t give you a second one. It’s written for one container.”
[There is a way that young people in the south say “Ma’am” that says, “I was raised to call you ma’am and I will do it because I’m a good kid, but each usage will drip with just a little disdain to make it clear that—while I am addressing you politely—I am actually picturing running you over with my car.”]
“The prescription is written for one container of a size which no longer exists,” I corrected her. “Now it comes in that half-size, and so in order to fill the prescription properly, you need to give me TWO of those. Look at the order history, please. I always get two.”
Her gaze went back to the computer. When she looked up again, her face made it clear that the gloves were about to come off. “MA’AM,” she said, very firmly, clearly using all of her What To Do When An Addict Tries To Bully You pharmacy training, “PLEASE. You only get one container. You have only EVER gotten one container. I can’t just give you another one, Ma’am. This is all you get.”
I couldn’t help it; I started to laugh. It was that or punch her in the face, really, and the former seemed slightly less rude and much less likely to get me arrested. “Okay,” I said. “You’re right, I just IMAGINED getting two of those containers every month for the last YEAR. I made it up! Because I’m ABUSING ESTROGEN!” She, by the way, was not laughing. And the more horrified she looked, the harder I laughed. “May I please speak with the pharmacist?” I finally managed, wiping my eyes.
She fetched the pharmacist, and I explained the problem. The two of them retreated and I managed to ascertain through a combination of lip-reading and the young tech’s wild gesticulations that she was telling the pharmacist what a CRAZY, DELUSIONAL BULLY I am.
“It’s written for ONE HUNDRED!” the tech huffed in conclusion, ready to be congratulated for her staunch ability to Just Say No to hormone-addled estrogen-seekers.
The pharmacist removed the container from the prescription bag, looked at it, and then showed it to the tech. Then she pointed at where it clearly says CONTAINS: 50 down at the bottom.
The tech turned crimson. The pharmacist sent her away (she slunk off quite willingly) and the pharmacist went back into the supply area and then emerged.
“I’m so sorry about that,” she said, sounding like she might actually be sorry. “Unfortunately, we only have the one container. I’m going to need you to come back for the other one after I order it.”
I took a deep breath and explained that since switching to this pharmacy they have never been able to fill my prescription without incident. That I have had to make a minimum of two trips (and sometimes three!) for every refill. That they often call and tell me to pick up when it’s not ready, that they NEVER call to tell me it’s NOT ready. That I have to argue with a tech nearly every time I come. And that I never found it particularly embarrassing to be on hormone replacement before I started using this store, my neighborhood pharmacy, where now I am made to feel like a complete freak every. single. time. I go in.
The pharmacist pushed the bag across the counter to me. “Just take this one,” she said. “No charge. I should have the other one here tomorrow and I’ll call you myself. I’m really sorry.”
I could tell you that it was too little, too late, and that I’m changing pharmacies again (the one I used across town never had this problem). But I’m a little too busy huffing the (FREE!) gel directly out of the pump to think about that right now. Who wants a hit?