At a friend’s 50th birthday celebration this summer, a bunch of us were standing around the campfire when I hissed at the birthday girl, “Hey, do you still have your period?”
And just like that, we were all firing questions at each other: What are your symptoms? Do you have more energy now that you’re no longer bleeding? Did your periods get heavier towards the end? And, what, exactly, is the difference between perimenopause and menopause anyway?
It was so weird, we all agreed. Here we were, a bunch of grown-ass women yet we knew next to nothing about this big physical change our bodies were beginning to go through.
It’s because no one talks about it, we decided. Everybody talks about getting your period or getting pregnant — that’s easy; it’s so obvious — but since menopause is a gradual shift, and messy and complicated to boot, it’s often not until women are on the other side looking back that we begin to comprehend what we just went through. Or at least that’s how it feels to those of us who are perimenopausal. Now, we bleed. Then, we won’t. WHAT HAPPENS IN BETWEEN???
So I sent emails to a bunch of women asking them to pretty please share what menopause was like for them. As the responses came in, I was surprised by how many of the women discredited their experiences. Oh, my menopause was medically-induced, they said. Or, It was really confusing because I was going through other stuff at the same time. It was almost as though they thought that, if their experience deviated from textbook menopause, then it didn’t count.
“But it’s the complicated and confusing experiences that we [perimenopausal women] especially need to hear,” I told one friend who felt like her experience was too much of an exception to be helpful. “The greater the variety, the better we can manage our expectations.”
Besides, textbook menopause (which, to me, is: turn fifty, periods taper off, hot flashes and mood swings, then, BAM, done) was too simplistic, too narrow. I craved the stories, the real women sharing the details of what menopause was actually like.
So here is my attempt at getting the conversation started: seven women, seven stories. Many thanks to the women for taking the time to share with us! (All names have been changed to protect privacy.)
A final note on terminology (which I had to look up, and even then I got it half wrong and had to be corrected): premenopausal women can reproduce, perimenopausal women are in the process of losing their ability to reproduce (this can last 10-15 years), menopausal women can no longer reproduce — a woman is considered menopausal when she’s not had a period for twelve months, but she’s in menopause during that year-ish — and postmenopausal women are, well, done with menopause entirely, though some symptoms do linger, I’m learning.
photo credit: my younger daughter
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Meet the Women
Rachel, 57
I have no idea when I started menopause, how long it lasted, or when it ended. I had a hysterectomy at age 42. My uterus was removed, due to fast-growing, grapefruit-sized benign tumor, but my ovaries remained — the idea was that they would still do what they do, hormone-wise, I guess. I stopped having periods immediately, obviously, so I lost that gauge on what was happening with my body.
Sarah, 77
I started perimenopause in my 40’s and it lasted for 10 years. When I was about 50, I started having very heavy periods and had several D&C’s, which would help for awhile and then the heavy bleeding would start up again. I remember having a period for six weeks before one of the D&C’s. Everything quit at age 55.
Rosanna, 65
I was about 50 when my periods started to become less predictable. This was not normal, so I knew something was changing. At 53, I had one very heavy period (while we were out of town at a wedding, of all places!), and then after that they were more irregular. Then, just before I turned 55, we had a traumatic life event and I never had another period. That was the end of that.
Nancy, 72
By age 34 or so, I could no longer reproduce like a rabbit — conceiving our youngest took a year. Then, at around age 36, pregnant again, I spontaneously aborted. This was expected, since I’d been told I had a low progesterone count and hadn’t felt inclined to interfere with nature by taking hormones. I don’t remember when I reached menopause.
Liz, 60
I was 41½ when I noticed a change in my periods. I’d just stopped nursing my youngest, but I don’t think that had anything to do with it. My periods had never been clockwork regular, but I noticed they became increasingly irregular over the next couple years. It’s hard to remember exactly when I stopped; I just continued to go longer and longer between periods. In the end, I hadn’t had a period for six months, and then I had the mother-of-all-heavy-periods. That was the last one! I remember telling my sister about it; she’d experienced the very same thing, with the very same timing.
Leslie, 72
My hysterectomy was so sudden and so completely unexpected that it was as detrimental to my mental health as any of the other extreme medical procedures that I’ve had, and there have been a few. Part of this is due to the fact that I had no time to even consider the procedure. I was at the hospital, prepped for a hysteroscopy — a procedure where, as I understood, they’d simply look at the uterus — when the doctor casually suggested that he might do a hysterectomy if he saw lots of endometrial tissue adhered to the uterus. If so, what did I want him to do with my ovaries? I paused a bit, and then replied, “Oh, just take them out. They won’t be functioning much longer anyway. I don’t want to wake up and find that I need another surgery!” So, you see. I have my own ignorance for some of the blame. When I came out of surgery, I learned that the doctor had cleaned me out. One ovary was adhered to my uterus. The other he just took because it was easy to do.
Karla, 53
I don’t recall a specific start time to all the changes. It was so gradual, the slow drip of the water. No day to pinpoint, but maybe I’m just not remembering it…. maybe it started four years ago? I think my first realization was a spotty menstrual cycle, but since my cycle wasn’t ever really bad, I didn’t pay attention until I had my annual midwife visit and she started asking questions. She commented that I could be in perimenopause, which I’d never heard of. So there’s that! After that, I paid attention a little more.
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Symptoms
Rachel: Four to five years after my hysterectomy, I had a “breakdown” of sorts: a very difficult period of insomnia, depression, anxiety, unexplained weight loss, zero libido, frequent crying. One night I ended up in the ER with chest pain that ultimately was called anxiety. In hindsight, I can see I was doing more than was healthy in terms of a stressful job (and there were unusual stresses at work). I felt like, and maybe was, a horrible mother.
Sarah: Perimenopause hit me as extreme anxiety and insomnia. I would go night after night with no sleep at all while teaching full time. I also started having night sweats (but not very many hot flashes during the day). Because of the lack of sleep, I started having depression, weight loss, and, because I was always tired, I didn’t want to go anywhere, except for my job. I was also parenting a teenager who was into partying and drinking, which contributed to my anxiety.
Rosanna: I must not have had many symptoms because I really don’t remember drastic changes. I started having hot flashes in my early 50’s — they were almost welcome because I have always been cold. (When I was younger, I couldn’t wait for menopause so I could maybe be warm; alas, it’s a different kind of heat and has not solved my problem of being cold. I hate winter!) I remember going through a phase where I could not wait for the hot flashes to be done, but I don’t think that lasted much longer than a year.
Nancy: No problems. Nothing like many other women’s crazy-making experiences.
Liz: I had hot flashes off and on, but I wouldn’t say they were very severe. Through the whole experience, I kind of felt like I was someone else. I can’t quite explain the feeling — kind of jumpy inside, and I found it hard to focus. That went on for quite a few years until I felt more calm and focused.
Leslie: Right away I had terrible night sweats and panic attacks. Another very definite consequence: drying up. I noticed my hair changed texture, my skin lost some of its elasticity, and I started using drops in my eyes for “dry eye.” On the plus side, there were no more odd pains in various parts of my body — migraine and leg aches — that, in retrospect probably were connected to endometriosis, the disease I probably had and that no one ever mentioned.
Karla: The absolute most frustrating thing for me (besides a decrease in libido) has been memory loss and forgetfulness. It feels like it snuck up on me, which made me feel like I was losing it. I’ve had moments of crazy thoughts of thinking I had Alzheimer’s. I don’t remember some “obvious” events from just the year before— it’s become a family joke. And really, is this just aging or is it all connected to perimenopause? I say that because, around the same time, my eyesight started to go, I felt like I only had to look at food to gain weight, and I developed the ability to predict weather through my aging knee. Also, I started having hot flashes at night, I began constantly asking my kids to repeat things, my hair began greying, there was more hair on my chin, I started having hot flashes during the day and times I had higher-than-normal levels of anxiety.
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Coping Mechanisms
Rachel: I tried everything: exercise, eating right, supplements, prayer, mediation, massage, consultation with a natural healer, cognitive behavioral counseling, medication. Somewhere in there, a nurse practitioner suggested HRT (hormonal replacement therapy), which I did. I lost track of how long I was on Estradiol — I just took it to help with everything: insomnia, moods, libido. In recent years, a nurse practitioner suggested it might be time to stop since I’d been on it for ten years.
Sarah: My doctor put me on a hormone replacement regimen, which wasn’t very helpful, so then he put me on a depression medicine. I put on a happy mask when I was out with people, and very few friends knew what I was dealing with.
Rosanna: When I realized that regular coffee made my hot flashes worse, I started making either full or half decaf and that seemed to help.
Leslie: The doctor immediately offered a prescription for fake estrogen, but I refused since I was already phobic about blood clots.
Karla: Talking to women friends: the most valuable resource to be found. Exercise is now more for mental health than physical health. Also, I lasered my facial hair, I began to move to the couch when my husband started snoring (sleep is not overrated), and I bit the bullet and joined a weight loss program.
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Relationships and Sex
Rachel: During menopause, my marriage was extremely strained. Was my marriage strained because I was depressed/menopausal? Or was I depressed and desperate because my marriage was crap? Chicken and egg. Who knows.
Sarah: I didn’t share my problems with my female work colleagues, since many of them were younger than me. My husband was kind, but not a great support, as men just don’t understand.
Rosanna: Funny you should mention sex! Again, it is one of those things that nobody talks about but I am really curious, too. I have very little to no sex drive and it has been that way ever since that traumatic life event. I’m not sure if the trauma brought that on, or if it was menopause. I think the changes in our relationship may be been partially on account of menopause, but I also think that it is much more complex than that. So much in our everyday lives has also changed as we are getting older, and that factors in big time!
Nancy: My husband still thinks I’m the cat’s meow. But sex takes a lot of patience and kindness. It just doesn’t seem important. It’s not something I think much about. Those hormones aren’t driving me. No libido.
Liz: I don’t feel the desire for sex that I had in my younger years. That was the only downside to the whole process.
Leslie: As well as all the other drying up, my vaginal area dried up as well. All you women who are about to have your uterus removed, take note: Sex will never yield quite the same degree of pleasure, as you will no longer have a contracting organ in there to “move mountains” for you (so to speak).
Karla: There’s definitely a decrease in libido. It is hard to be the instigator when it’s lost its fun. I feel guilty for making him be the initiator so I am trying to be more intentional, which totally takes the fun out of it. I’m still learning to communicate better about this and be truthful and honest. I’m also still happily married and feel grateful for my main squeeze. I do put up with a lot — but he probably puts up with more.
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Looking back, any insights? How do you feel now?
Rachel: I didn’t ask women much about this when it was going on. Looking back, I think it was pretty much survival time. Maybe more conversations with women who were 10 or 15 years older would have helped. Also, I notice when I am hating myself and try to reframe my thinking. For example, I hate my feet. They are ugly— not cute in sandals. But I try to switch those thoughts to appreciation that I can walk and run and hike and bike. I like the concept of referring to my body as “she” rather than “it.”
Sarah: I was so thankful when I was in my 50’s and felt normal again!
Rosanna: I can’t say that menopause has made me feel different physically, but it has affected my metabolism. I try to walk 1-2 miles several days a week since my work is pretty sedentary, but I still struggle with weight gain.
Nancy: I don’t mourn the changes. I still feel womanly.
Liz: Now that it’s all over I feel really good. No more emotional ups and downs. No more of that monthly bloated feeling. No more worries about when the next period would come. And I have lots of energy.
Leslie: I realize I’ve focused more on the cataclysmic nature of my menopausal experience, and I often feel bitter about the perhaps ten more years I might have had at least one functioning ovary (I have no idea if there are other treatments for endometriosis now, or even at the time), but my advice is: Hang onto all your female organs as long as possible!! And TALK, TALK, TALK to your doctor — nowadays perhaps a woman. Wow, unheard of in the day! — about each and every detail of every aspect of what they suggest. Also, ask about prescriptions and other solutions to deal with whatever it is you’re experiencing.
Karla: I finally paid the money and joined Noom. I was so tired of doing all the right things and not losing weight, but, like a good Mennonite, I hated to pay for it. So I vowed to do exactly what they said so for the first 3 months so I could quit and not pay more. And it worked! I lost what I hoped to and have kept it off for six months. This has made me feel more confident and feel better about myself. I’m so glad I did it and I feel like my weight is back to where it was before having kids. Additionally, other things that I have noticed and am grappling with are more facial wrinkles and hair, loose skin, and wiry white hair. I’d like to say that I’m slowly accepting these things, but I’ll probably be working on this for the rest of my life. I’m such a work in progress.
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This same time, years previous: curbing the technology addiction, where the furry things are, the quotidian (10.19.15), rich, would you come?, how to have a doughnut party: part 1, Italian cream cake.
