(Live) Perimenopause, Medical Gaslighting and Estrogen Patch Inefficacy

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I’m Sam Galloway (she/her) and I am an AuDHD woman four months into surgical menopause (hysterectomy and oopherectomy).If you are interested about why I needed the surgery, you can read more here.Thanks for joining me on this wild midlife ride! 🎢Thank you to everyone who tuned into my live video with Sonia Voldseth, the creator of Menopause & Misogyny! TL;DR * This advocacy-focused conversation documents real harm caused by estrogen patch failures and loss of choice in Aotearoa New Zealand. * When menopausal and neurodivergent women aren’t believed, symptoms escalate into cognitive, emotional, and physical crises. * Menopause care is essential healthcare. It is not optional, not cosmetic, and not something women should have to fight this hard to access.Sonia and I are both fortunate enough to live in Aotearoa New Zealand. Sonia, originally from the United States, lives surrounded by mountains in Queenstown on the South Island, and I, London Irish in origin, enjoy beachside life on the Kāpiti Coast near the bottom of the North Island.Unfortunately Sonia and I have both been affected by the ongoing oestrogen patch debacle. In 2024, we saw a global shortage of oestrogen patches, which I wrote about here. Currently there is laboratory testing underway in response to many people reporting that their menopause symptoms have returned despite staying on the same dose and brand. This has coincided with a new formulation of this vital hormone therapy treatment. My fellow pedants may notice that today I can’t decide whether to spell it “oestrogen” (UK and NZ) or “estrogen” (US), but please know that I am referring to the same hormone, regardless of the spelling used.Remarkably, the sedatives and general anaesthetic still have lasting effects on my capacity to write articulately, now four months after my total hysterectomy with bilateral salpingo oopherectomy (cervix, uterus, ovaries and Fallopian tubes removed). Surgical menopause has been life saving to my mental health, energy capacity and general functioning, so I am not complaining. But, rather than feeling able to summarise our discussion myself, instead I include ChatGPT’s offering below.As ever, for accessibility, you have the options to watch the video (with or without closed captions), listen to the audio and/or read the transcript. AI-Generated Timestamped Summary00:00 — Why this conversation matters02:31 — Progress made… then undone05:31 — Estrogen patch shortages & loss of choice (NZ)09:01 — Symptoms returning on the same dose12:01 — Collective patterns, individual gaslighting15:31 — Neurodivergent risk & mental health impacts18:31 — Estrogen as a brain hormone22:01 — Why “just switch to gel” isn’t simple25:31 — Sleep collapse as the red flag28:31 — Admin, advocacy & exhaustion32:57 — Suspected formulation change (mid-2025)34:31 — Medsafe reporting & deflection36:05 — User-error narratives & systemic gaslighting37:42 — Absorption differences & dosing reality39:58 — Brain fog, language loss & regression41:25 — Estrogen receptor saturation explained44:19 — Menopause is serious, not “just hot flushes”45:37 — Generational harm & WHI fallout47:03 — Surgical menopause & compounded harm48:37 — Aging with quality of life49:30 — Vaginal estrogen, bladder health & prolapse prevention52:35 — Prolapse, gatekeeping & specialist care54:38 — Medical training gaps (global)55:10 — Vaginal estrogen & cancer-risk reassurance56:07 — Solidarity over infighting56:56 — Closing reflections, access & hopeThank you to fellow AuDHDer and PMDD survivor Kim Pitts for chatting with us in the comments about her personal experience of menopause and medical misogyny. Kim and I have previously chatted live (link below) and here is Kim’s Auti Peri Q&A.Cheers,SamThis work exists through collective care. A paid subscription is a meaningful way to support Divergent Menopause in 2026. Thank you! 💕 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe