CSG: You have lichen sclerosis, which can make your outsides fuse together. We think it’s caused by low estrogen.
CSG: You also probably have endometriosis, which can make your insides stick together. We think it’s caused by high estrogen.
Me: Crap. Wait—so my estrogen is both too low and too high?
CSG: it is counterintuitive, yes
Me: That’s not what counterintuitive means
CSG: No? Oh well
Me: So they’re related
CSG: Not at all. One has nothing to do with the other
CSG: So there is no cure for either
CSG: You could try pregnancy
CSG: Sometimes it helps
Me: But I thought you said infertility was a common side effect of both these things
CSG: It is, yes
Me: so then…
CSG: but it’s worth a shot, right? Plus: sex!
Me: But I came to you because it hurts to move. Like, at all. So sex doesn’t sound fun
CSG: I see
CSG: We could try menopause!
Me: How would that work?
CSG: We can make it happen chemically. It’s pretty awesome, actually. It’s a drug called–
Me: No, I mean why would that help?
CSG: fewer hormones!
Me: But you said lichen sclerosis was caused by a hormone deficiency
CSG: I’m talking about the endometriosis
Me: But what about the lichen sclerosis?
CSG: They’re unrelated
Me: They’re not that unrelated. They’re both on me
CSG: What is your point
Me: Won’t the hormone deficiency driving the lichen sclerosis get worse if we try this for the endometriosis?
CSG: Well, you’ll of course have to take some hormones to counteract the side effects of the menopause
Me: But then—so—wait, what?
CSG: You know, hot flashes, that sort of thing
Me: No, I know what menopause is, but you’re saying I have to take hormones to replace the hormones we’re deliberately stopping to see if stopping hormones works?
CSG: It’s your choice, of course
CSG: Maybe after three months of menopause you’ll be able to have babies!
Me: Why would that be?
CSG: … hormones?
Me: Do you think I’m one of those TV sets you fix by banging them really hard on one side
CSG: Look, we just don’t know, sometimes it works
Me: Okay. So if we do the temporary menopause, that means no ovulation and no pregnancy
CSG: No ovulation, that’s right, but you can get pregnant during it
CSG: But you shouldn’t
Me: I thought you said pregnancy might help?
CSG: Not during menopause, though. Afterwards
Me: So pregnancy after menopause but not during menopause might help with the pain caused by my insides and outsides which are in some danger of “fusing” because I have way too much estrogen and also not nearly enough. That’s what you’re saying
CSG: Exactly! Well, maybe
Me: Even though I am possibly already infertile
CSG: You got it
Me: This is the best treatment plan you can give me in this, the most scientifically advanced nation in the world, where we can turn vulvas into functional penises and transplant hearts
CSG: Remember, you’ll have to use condoms when you have sex
Me: I am not having—nevermind. Okay
CSG: And remember, it might not be endometriosis at all
CSG: If the menopause helps, it probably is
CSG: it also might not help and it could still be endometriosis
Me: So the diagnostic value of this is–
CSG: We just want you to make an informed decision
CSG: So you wanna give the menopause a shot?
CSG: That was a joke. It is a shot!