My prescription arrived, finally, five days ago. It’ll be a few months before it fully takes effect, but I’ve already begun to notice a difference, a fog lifting. When you’ve been living off balance for a while, it’s easy to forget what normal feels like until it is, normal, again.
A couple of years ago, I started to feel “off.” In the wake of learning about my mom’s cancer diagnosis, moving, and taking a new job, the circumstances of life finally felt like they were leveling out, and yet I wasn’t. For as optimistic and hopeful as I usually feel, I felt gloomy most days. I started to experience weird, small changes in my body that were frustrating given the attention I gave to diet that should have made me the healthiest version of myself. It didn’t seem to matter what I did, my body kept on behaving strangely. I felt anxious and depressed.
I brought up all of these minor symptoms with my doctor in January a few years back. Thankfully, he listened to my complaints and didn’t write them off as just entering mid-life, just gaining weight, just breaking out.
It turns out that my adrenal gland over-produces the hormone androgen. Symptoms of hyperandrogenism include acne, inflamed skin, male pattern balding, hair growth in places women typically don’t want hair, weight gain, and other unpleasant things a person doesn’t really want to happen to them. Not surprisingly, hyperandrogenism also comes with a side dish of anxiety and depression. My doctor referred me to an endocrinologist, who prescribed Flutamide, a drug that is typically used to treat men with prostate cancer, and other than having to take a cancer drug twice daily for the last three years, things have been pretty great.
Until I thought, maybe I’ll try to wean myself off of this drug and see if I’m better now.
It wasn’t that hasty, really. This summer, my endocrinologist moved practices. Before she relocated, she had suggested trying to drop down to one pill a day to see how my body handled it. I figured since I had to find a new doctor anyway, I’d go ahead and drop to one pill a day, and then no pills once my prescription ran out. I thought maybe the stress of the season of life I had been in previously might have caused my adrenal gland to misbehave, and maybe now, things would be normal without needing to take a medication to balance out.
This turned out to be a bad idea.
When you’re off balance, it isn’t just the physical symptoms – the hair loss, the acne, the sweating, the weight gain – that surges again; the entire lens through which you perceive the world shifts and blurs. Normal, everyday events spin into potential catastrophes. When your husband is late from a meeting you worry that maybe he got into an accident, maybe the police didn’t know to call you, maybe you’re a widow now and you don’t even know it yet. When your daughter doesn’t answer her phone after school you think maybe this is the day she’s been abducted by a sex trafficker. You imagine your son falling off his bike into oncoming traffic and your heart skips a few beats in fear. These are all processed with the cool logic of an irrational mind that needs to figure out what it will do if this highly unlikely scenario becomes your reality.
Maybe worse, the weight of every-single-thing-that-happens drags you into sadness, weariness, and loneliness. You are on edge. Your off-balanced brain and body tells your heart lies. Maybe your husband’s focused attention on his phone isn’t attention to a news article or a friend’s comments on a football game, maybe he is texting someone else, someone he loves more, even though your husband has never given you any reason to consider such a thing; he is honest and trustworthy and loyal, more loyal on the enneagram tests than you are, even.
But you think it anyway.
You might leave a women’s book club meeting realizing how everyone else has their person – everyone else has someone they trust that knows them so well and they all must feel fulfilled and loved all the time but not you, not you. You know that isn’t true, either, but in the moment it feels so true.
At the height of imbalance, a weekend your friends spend together without you might trigger absolute loneliness, which might spiral into feelings of worthlessness, which happens to spiral when everyone else is occupied, everyone else that might be able to shake you free of this spiral. It feels like you’d be an interruption, a problem, a burden with all of your burdened worthlessness.
It makes you wonder whether anyone would notice—. What if you were to just—.
This stream of wide-eyed sobbing might scare you enough to send your despairing self into the cold, winter air where the Spirit snaps you back, and you breathe, and you breathe, and you try to remember that this is probably hormones. This is probably not reality. Probably not, but you are still so sad and so broken and so hurt, and this imbalance magnifies the hurt. This off-kilter, off-balance, unhinged, raw version of Sarah can’t see beyond normal hurt and hormone-inflamed hurt.
It is exactly how I feel and so not me at the very same time.
There are people in this world who don’t feel like themselves. Something is off and it makes them acutely aware of their bodies, self-conscious and anxious and depressed. It manifests itself in a million different ways, mental health, sexual health, physical health, and more. Sometimes the right thing is medication. Sometimes there is a physical abnormality that triggers your body to be other than its best, most balanced self.
The body is so complex. We are wired for relationships – when those relationships are healthy, we glow with physical health, and when those relationships are toxic, that toxicity can manifest itself in physical symptoms. When work stresses us out, our immune system reacts. And when something is diseased, abnormal, or imbalanced in our physical bodies, our mental and spiritual and emotional health is bound to be impacted.
I am grateful for modern medicine. I am grateful for the gift of cold, crisp fall air that shocked my soul back from a ledge I never imagined myself standing on. I have never felt so low. It was frightening. I don’t want to feel so low again.
It has been five days back on Flutamide. It will take months to revert some of the symptoms of hyperandrogenism that spiked this fall and winter, but even in these first few days, I’ve noticed a significant clearing in the fog.
The sunrise is beautiful.

I am so happy to hear you are feeling better. I have known that disconnected feeling.
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