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A letter from Lorrie King, Co-Founder of Caire Beauty
Today is World Menopause Day, observed every October 18th around the world. This year's global focus is chronic pain at midlife - and if there's one thing I know how to talk about, it's what it costs a woman to be believed about her own body.
I've spent years talking publicly about estrogen decline, collagen loss, and the science behind why skin changes in midlife. What I haven't talked about publicly is the actual, unglamorous sequence of health events that got me here - three separate times in my life when something was genuinely wrong, and three separate times when I had to fight to be heard before anyone took it seriously. So today, no product pitch. Just the real story.
Uterine fibroids are noncancerous growths in or around the uterus, and they're far more common than most women realize. For me, they meant years of heavy, unpredictable bleeding and pain that reorganized my life around it.
Before any procedure, I saw a male fibroid specialist in New Jersey - a doctor who made a point in our first visit of telling me he was also the doctor for a famous singer. In that same visit, he told me, at my young age, that I needed a hysterectomy. I left that appointment and cried.
For my second visit, I brought my father. I needed someone in the room with me who would say what I already felt but couldn't yet say for myself. And he did - he told me plainly that I did not have to do anything I didn't want to do.
I kept searching instead of complying. I found a specialist in New York City who performed a myomectomy, removing 21 fibroid tumors - the largest one the size of a grapefruit. For about ten years, I had real relief.
Then it came back. I found myself using two double-large tampons an hour. When I mentioned it to my mother, she told me she'd once had to wear extra large Pampers diapers to get through a workday with the same problem. I went looking again for a non-hysterectomy option, and it was only through a friend who happens to be a GYN - not through any doctor I'd actually been seeing - that I learned about uterine fibroid embolization, a procedure that cuts off the blood supply to the fibroids. Nobody in my own care team had mentioned it as an option. The relief after the procedure was immediate.
I still think about the women who never find out embolization exists. I think about how many of them are told “hysterectomy” as if it's the only answer, the way I was told at a doctor's office in New Jersey, by a man more interested in telling me about a famous patient than in fully hearing me. I wonder how many of them don't have a father in the room to tell them they're allowed to say no. I wonder how many are still suffering in silence, still bleeding through their workdays, because no one thought to mention there was another way.
Dr. Felice Zwas has been my gastroenterologist in Greenwich for years, and the reason I've stayed with her has nothing to do with gastroenterology. She's a doctor I have deep respect for - her kindness, generosity, and thoroughness have always come from genuine curiosity, the kind more doctors should have. She's a gastroenterologist by training, but she has always operated more like a primary care physician than most primary care physicians I've had.
The first time she proved that to me, I came to her exhausted - fatigued in a way I couldn't explain, barely able to get out of bed. I gave her examples of what I was experiencing. She listened, and she said she suspected Lyme disease. She was right. If she hadn't caught it then, I think about how that could have gone on for months, chronically debilitating, the way I've watched it happen to friends of mine who weren't as lucky with who was in the room when they described their symptoms.
So when the second crisis came, I already trusted her instincts completely.
The year I celebrated a milestone reunion from Wharton, I'd already started noticing I was slightly out of breath just walking around - nothing alarming yet, just something I'd registered and moved past. My husband and I traveled to Italy and Denmark to celebrate. In Copenhagen, I couldn't get up five flights of stairs without losing my breath completely. It was bad enough that a friend's husband called his sister, a nurse, who told us to get to a doctor immediately. I was admitted to the hospital and given a blood transfusion, which brought temporary relief - but it also masked what was actually happening in my body.
When I got home, two of my doctors independently insisted I come in. My concierge doctor on the Upper East Side examined me and found nothing wrong. That same day, I saw Dr. Zwas. Mid-appointment, she paused and said, “You seem out of breath.” She took my pulse at my finger and diagnosed lupus right there, before I'd even gotten to a specialist. She called my Upper East Side doctor to see if she could get me in with a pulmonologist quickly. She couldn't. So Dr. Zwas called a friend - a pulmonologist I could walk to. By the time I arrived, I was in the middle of a full lupus flare: the telltale butterfly rash across my face, and breathing so labored I genuinely thought I was having a heart attack. That doctor sent me straight to the hospital, where I was admitted for five days. Dr. Zwas visited me every single day after her own work hours were done.
Two diagnoses. Neither one in her actual specialty. Both times, an entire category of doctor could have missed what she caught simply by listening and staying curious past the edges of her own training.
I still don't fully know why lupus showed up when it did. It doesn't run in my family, except for a great-aunt on my mother's side. What I do know is the timing: I was working long hours, sleeping very little, and under more stress than I'd ever admit to anyone at the time - and the Lyme disease had already put my body through something significant just a few years before. Whether one thing caused the other, I can't say, and neither can my doctors with certainty. Stress doesn't create autoimmune disease out of nothing, but there's real research suggesting it can be the thing that finally triggers it in someone whose body was already carrying the susceptibility. My doctors are still digging. I've stopped needing a clean answer to keep moving forward.
This year, a bone density scan gave me a number I wasn't prepared for. Declining bone density is directly connected to estrogen decline during perimenopause and menopause, and most women, myself included, don't think to ask about it until a scan forces the question.
Here's the honest part: I don't yet have a real plan. I know a wide network of experts. I hosted a panel about menopause and midlife health on October 15th, three days before I'm writing this. And I still don't have a reasonable regimen for my own bone density. I'm frustrated by that, and I think the frustration itself is worth saying out loud, because the version of this story where I've already solved it wouldn't be true, and it wouldn't be useful to you either.
Three different conditions. Three different decades of my life. And in every single one, the turning point wasn't a test or a scan - it was a person who finally listened, or a person I had to convince myself to stop listening to.
A doctor who wanted a hysterectomy before he wanted to understand me. A doctor who found nothing wrong, versus Dr. Felice Zwas, who caught both a Lyme diagnosis and a lupus flare that weren't technically hers to catch, simply because she never stopped being curious. And now, a health question I haven't fully answered, despite knowing more experts than most people ever will.
If you've ever been told your symptoms were nothing. If you've ever left an appointment and cried in your car. If you've ever had to search for the treatment your own doctor never mentioned. If you're in the middle of a health question right now with no clean answer yet - I see you, because I am you, right now, with this one.
You are allowed to keep asking. You are allowed to bring your father, or your friend, or whoever will stand in the room and remind you that you don't have to accept the first answer. That's the only reason any of my three stories have the endings they do. And if you're lucky enough to find your own Dr. Zwas - someone curious enough to notice what everyone else missed - hold onto her.
- Lorrie
This post reflects my personal health history and my own experiences with my own doctors. It isn't medical advice. If any part of this resonates, I'd encourage you to advocate for yourself the way I had to learn to - and to keep searching until someone actually listens. Feel free to email me at care@cairebeauty.com if you have any thoughts or questions.
Stress doesn't appear to cause lupus on its own - you need an underlying genetic and immune susceptibility. But research suggests significant stress can act as a trigger for onset in people who are already predisposed, and it's a well-documented trigger for flares once lupus is present.
Yes. Declining estrogen during perimenopause and menopause is directly linked to accelerated bone density loss, which is why many women don't think to get screened until a scan reveals a problem already underway.
A minimally invasive procedure that cuts off the blood supply to fibroids, offered as an alternative to hysterectomy - one that not every doctor mentions to patients as an option.
World Menopause Day is observed every October 18th to raise awareness of menopause and the support options available for women's health during this stage of life.
Yes. Lupus symptoms often overlap with other conditions and can be missed by specialists outside of rheumatology, which is why a doctor's curiosity and willingness to look beyond their own specialty can make a critical difference in diagnosis.
