I had a hysterectomy at age 28, with one ovary left intact. At age 43, my thyroid was removed, related to a diagnosis of cancer. Now, I have hot flashes, insomnia, mood swings, irritability, intolerance to cold and heat (including tingling in the hands from cold), heart palpitations and occasional anxiety. Most of the time, I feel like I am someone I don't know. My doctors tell me that it is "all in my head." I wonder if there is a connection between the loss of my thyroid, the hysterectomy and early onset of menopause. Am I off-base in feeling that all this is related? How do I find a physician who will take a comprehensive approach rather than treating the individual symptoms?

--Cassandra

Well, to me it sounds as if one of two things is going on: (1) your thyroid hormone levels are out of whack and your medication needs to be adjusted, or (2) you are entering menopause and may need some estrogen. Women who have had a hysterectomy may go into menopause a few months to a year earlier than they would have otherwise. The thyroid gland and its hormones are involved in ovarian hormone production, and menstrual irregularity is common in women with either an overactive or underactive thyroid. So, no, you are not at all off-base in thinking that these things are related.

I don't know what kind of doctors you have seen regarding these problems. You should certainly see a gynecologist. If you already have, and you are not satisfied with the answers you have received, I suggest seeing an endocrinologist -- either a medical endocrinologist or a reproductive endocrinologist. The latter may be a better choice if indeed your symptoms are mainly related to menopause.