The Pendulum of Perimenopause: Which Symptom Will I Swing to Next?
Last week started off with me walking through Central Park, snapping pictures of the trees coming into blossom, listening to jazz, breathing in spring, and feeling pretty optimistic about life.
By Sunday I felt as though I’d barely scraped though the week and was feeling utterly overwhelmed with absolutely everything.
There was no big terrible event that derailed me. In fact, nothing specific happened at all. But by Wednesday afternoon I found myself feeling off kilter in a way I hadn’t quite experienced before.
I was restless and finding it hard to focus. I felt agitated and emotional. I had a vague sense of impending doom and I was struggling to get to sleep and stay asleep. None of my usual pick-me-ups were having much impact.
And then my throat started closing up.
Or at least, that’s how it felt. As though there was an obstacle or some kind of blockage. I was able to swallow the sensation away without too much difficulty, but it was slightly uncomfortable and very persistent. It’s still happening now as I write this.
Like most Gen Xers, I’m not averse to taking to Google to look up my symptoms. But this time I didn’t need to. I’m almost certain that this is anxiety related, brought to me by my friend of almost five years: perimenopause.
Let me back up a bit.
When I was 44, my menstrual cycle became much more erratic. I was skipping periods and experiencing mini hot flashes. I was also urinating more at night and feeling like somewhat of a stranger in my body. This prompted me to do some research around menopause and the age at which it typically began. That’s when I discovered perimenopause, the transitional stage that can take place up to 10 years prior to menopause itself. As I looked at the list of perimenopausal symptoms, it was clear to me that this was likely what I was experiencing.
I can’t say I was thrilled with the discovery. I didn’t want to accept that my body was entering this new phase. But I also felt frustrated about the scant information on offer to guide women through this lengthy transitional time. 10 years? Why had nobody warned me?
Not long after, I broached the subject with my doctor during a routine visit. When I told him I thought I was in perimenopause, his immediate reply was “Probably not. You’re still quite young to be experiencing that”. The conversation came to an abrupt halt.
I didn’t fare much better a couple of months later when I bemoaned the lack of support to a female doctor during my annual physical exam. “The information is out there, you just have to look for it” she responded.
I was left feeling puzzled as to why there is a wealth of readily available information related to pregnancy, yet guidance on perimenopause was something women were apparently expected to hunt down.
Since that time, menopause has been having a bit of a moment. In fact, as the New York Times recently declared: We’re in the middle of a menopause gold rush. It’s no longer taboo to discuss our hormonal fluctuations or the search for our who-knows-when-it-was-last-seen libido. And we’re not just having these conversations with friends, we’re sharing our experiences online, too.
Gone are the days when social media was merely a tool to share that all important “at the gym” status update, or post holiday photos for our friends and families to see. Now we’re doing livestreams to vent our frustration at how messed up it is that women didn’t get the menopause memo, because God forbid we should take our eye off the bathroom scales or the needs of everyone else around us long enough to actually nourish ourselves through the chaos of these challenging years.
Emboldening us to speak up and seek help are a slew of celebrities who are being vocal about their own menopause experiences. From Davina McCall to Oprah Winfrey, we’re discovering that we’re not the only ones struggling to find our way forward with vaginal dryness, brain fog, palpitations, or night sweats.
Davina released a documentary Sex, Myths and the Menopause. Oprah announced the launch of an entire menopause curriculum. Instagram-famous doctors, nutritionists, coaches and personal trainers are all ready willing and able to guide us through the depths of our declining estrogen and rising blood pressure.
Suddenly the silence surrounding perimenopause and menopause has been replaced by a lot of noise, a ton of marketing, and an inordinate amount of information.
The market is flooded with solutions to just about every menopausal related issue we might be experiencing. From skin to sleep, from hair to HRT, someone has a product designed to save us from our disruptive hormones.
For the most part, I’m grateful that there are solutions. We’re not having the same midlife experience as our mothers, or our grandmothers, or many of the women who came before us.
But the underwhelming amount of resources available for peri/menopause has now become an overwhelming amount of “help” to wade through.
On Saturday afternoon I found myself staring at my laptop, trying to summon up the energy to go through the 116 North American Menopause Society certified menopause practitioners located within 10 miles of my zip code and figure out which one might be a good fit for me. And of course, accept my insurance.
Meanwhile my energy levels were low and my anxiety was spiraling, so I opted to binge watch Daisy Jones and The Six instead.
Having not been able to cry for the last few years, even during the deaths of loved ones, (save a 45 second NYC transit induced meltdown) I was suddenly able to access my tears again for the latter part of last week.
From crying at a rescue pup on the internet that had to be euthanized to more tears on a walk with my husband a few days later as I tried to articulate how desperate I was feeling, suddenly everything was pouring out of me. And not in a cathartic “That feels so much better” kind of way. Rather an anxious and somewhat irrational “Is this where the rope runs out?” kind of way.
And that’s where I am.
Now it’s Monday, and my mood has shifted somewhat thanks to a long phone call with a much-loved friend, followed by a work out and some gentle coaxing using the mindfulness tools I have at hand. It also helps that the threat of weekend party noise in our neighborhood (my biggest anxiety trigger) is vastly reduced. For the moment, anyway.
Yet I’m under no illusions that this slice of respite is temporary. Everything is, of course. No feeling is final (thank you Rainer Maria Rilke). But this is the kind of temporary that tells me to take action now, when I’m not stuck in the trenches of despair. When I feel as though I have a fighting chance of making headway.
So I’m searching for a NAMS practitioner, considering HRT options, and doing what I can to meet myself in each moment with as much compassion as possible.
Although HRT has been on my radar for some time, I was advised by my gynecologist not to begin any course of treatment until I was a year clear of the hemangioblastoma I was diagnosed with in 2022. She didn’t want there to be any confusion as to which of my symptoms were hormonal and which of them were lingering side effects from the tumor.
In addition to that, I told myself that I’d just wait until things got “bad enough”. But I caught myself in that thought again recently and I realized that it wasn’t a particularly kind way to prioritize my health or practice true self-care.
As women, we’re conditioned to put our needs at the bottom of the list. We don’t want to cause a fuss. We’re supposed to take care of everyone else. We’re also surrounded by well-meaning motivational quotes to make us think we can just keep on going and going and going. Eleanor Roosevelt undoubtedly meant well when she said “A woman is like a tea bag - you can't tell how strong she is until you put her in hot water.” But exactly how hot is it going get, and how strong do we have to be?
I also speak with the privilege of whiteness. I have no idea how much more the “strong Black woman” is expected to endure, during menopause or at any other time.
In some ways this journey of being in an aging body has me feeling as though I know myself more intimately than ever before. But there are also moments where I whisper to my reflection “Where have you gone?”
There was a time when I wouldn’t have shared any of this. Certainly not while I’m still in it. I would have set it to one side, allowing it to marinate into a much tidier story I could tell in retrospect. Package it as a victory. Maybe even sell it as such.
The horror of “What will they think?” would have silenced me.
But I no longer care what they think. I’m not even exactly sure who they are. And if I’m worth anything as a writer, a coach, or indeed a human, it’s not noble of me to deny the messiness of being a woman in midlife. I’ve never been able to trust those glossy women who claim to glide through life’s trials and tribulations with ease. Let me not pretend to be one of them.
So that’s what my perimenopause reality is like right now. A pendulum swinging back and forth between an astonishing array of symptoms that nobody ever told me to expect. A pendulum with no particular rhythm or loyalty.
That’s what makes these peri/menopausal years so confusing and challenging. Trying to ground ourselves in a constantly moving landscape is no mean feat. We feel as though we’re in a state of flux, yet we’re not (necessarily) spending so much time on the dark side for anyone to feel undue concern. And because it’s not exactly practical for us to lay down in a cool room until it’s all over and emerge a decade later, rested and relatively unscathed, we do what we’ve always done as women. We carry on.
Only, some of us don’t.
Suicide rates among middle-aged white women in the U.S. have soared since the early 2000s, most notably for those aged between 45-54. Kate Spade, the celebrated fashion designer and entrepreneur, took her own life in 2018 at age 55.
Of course, there’s no merit to oversimplifying the complexities that may lead any one person to take their own life, but the statistics are somewhat sobering. At the very least we shouldn’t be intent on pressing the override button for the sake of keeping up appearances. Not during menopause or any other stage of life.
So, what should we be doing?
Well, for starters it’s helpful to keep track of any symptoms. Keeping a journal of what we’re experiencing, and when, can offer some clarity when things start to feel a little murky. It can also be helpful during medical appointments if we’re seeking solutions and need to give a timeline.
Nutrition is ever more important and, despite my love of all things sweet, keeping my sugar intake to a minimum has helped to improve both my blood sugar levels and my chances of getting a restful nights sleep. I’ve also completely cut out caffeine and alcohol. Surprisingly, I rarely miss either.
Other things in my menopause toolkit are hydration, movement, strength training, and boundaries. Take it from me, any people-pleasing tendencies you might have are going to need to take a back seat for the foreseeable future. Your inner Good Girl might balk at that idea, but spreading ourselves too thinly is a sure fire way to burn out our already dwindling reserves.
Above all, speak to someone. Preferably multiple people. Your doctor, your partner, trusted friends, your therapist, your Substack subscribers! Community is a crucial component of helping us approach peri/menopause as something we have a chance to bloom through, despite its difficult moments, rather than something we can barely survive.
I’m hoping that the intensity of the symptoms I’m currently experiencing will ease over the coming days. This particular part of the journey isn’t much fun at all. But this is where I find myself, so this is what I’m sharing.
If you’re also in perimenopause or menopause and you’re having a rough ride right now, then I’m sending extra love your way.
May we go gently when needed and boldly when required. May we have the courage to share our stories and the compassion to treat ourselves with tenderness. May we stop struggling in shame and isolation and come together in truth and community. And may we always look for the joy and beauty that still surround us. Even when.
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