Menopause: The Magical Mystery Tour

By Dr. Gretchen KubackyMenopause/Peri-Menopause

I received a phone call from a well-meaning nurse practitioner in my gynecologist’s office a few months ago. She pertly announced “your labs are in and you have no estrogen…that means….(gobbldey-gook-blur-mind-spinning-not-listening-blah-blah-as-I-try-to-absorb-this-very-blah-blah-unexpected-information).” Say what?! While she was trying to give me the 30-second version of why I should really consider Hormone Replacement Therapy (“HRT,” a very imposing topic that really does deserve to be considered in ALL CAPS), I had not yet absorbed the fact that I had no estrogen. What WAS running through my mind at the same time was this whole other set of pertinent facts: I am 47 years old, the average of menopause in this country is 52, I haven’t really been having any symptoms, and, by the way, my mother went through menopause at age 55, which is the best predictor we have of when a woman will enter her own menopause. This was seriously NOT FAIR!

Once I had absorbed the facts, they still didn’t make sense to me. I had assumed, based on previous lab work, and my age, that I was peri-menopausal. But peri-menopause can start in your thirties and run for up to 15 years. (Now that explains a lot, doesn’t it?!) Peri-menopause sounded like this nice, safe, fluffy place – a pillow between full fertility and the rock-hard crash of menopause and all that comes with it. It was a given that bearing children wasn’t an option for me for many years already, so I didn’t have much to get over there. But my mind was racing with every possible negative stereotype and assumption about worst-case menopause:

• I’m OLD!
• I won’t be sexy anymore.
• My (insert your favorite vaginal euphemism here) will dry up and be utterly useless.
• My body’s entire collagen supply will magically recede in one fell swoop, most likely on the day I most need it, leaving my face a collapsed and hideously wrinkly facsimile of what it had once been. I will look like a crone, an apple-head doll, one of those wizened old women from the mountains of Peru (never mind that I am a fair-skinned Caucasian of northern European descent).
• I am decrepit.
• Strange hairs will start growing from me, just like the old men I see who have 2” long bushy ear hair. I will be as oblivious to it as they are, thereby solidifying my descent into decrepitude.
• One in five women over the age of 75 dies following a bone fracture. It’s time for heavily padded garments and sensible shoes, so I can protect myself as my bones weaken and decay. Internally, I will become a pile of dust, concrete powder without a binder, completing lacking internal structure or support.
• My heart is weakening and developing cardiovascular disease right now, and it’s getting worse every second that I don’t have estrogen.
• I will become deep-voiced and aggressive, like a pit-bull mama whose puppies have been stolen.
• If I take HRT, I’ll be a junkie begging her doctor for the stuff when it’s long past the point of efficacy or safety. I’ll seek out black market estrogen patches and pay anything for them. I will stand on the median strips and freeway exits, holding a sign that says “will work for estrogen.” I’ll live in fear of a shortage of Vivelle dots. I’ll plot the hours until I can apply the next patch and get my estrogen fix.
• I’ll develop a very unflattering meno-pot (that characteristic abdominal pooch that women of a certain age have) on top of my existing abdominal fat, which pretty much already looks like a meno-pot or a four-month pregnancy anyway, and then everyone will know I’m POST-MENOPAUSAL (because most people are SOOOOO adept at assessing the outward physical signs of menopause, right?!).
• My hair will start thinning and then I’ll have to dye it blue/lavender/pink to…wait…why do elderly women dye their white hair those weird psychedelic colors anyway?

In sum, I had a mini panic attack about the losses associated with aging, crossing that once-fuzzy boundary from peri-menopause to menopause, and all that entailed. I slammed right up against my pride, vanity, cultural assumptions, and a little too much knowledge about women, hormones, and the reproductive and medical systems. I took my bag lady fantasies a step further than usual, and contemplated deprivation of any and all aspects of life as I know it. I saw menopause as equivalent to death. I tried to focus on role models and images of hot 60-somethings who are undoubtedly post-menopausal (Raquel Welch, Sophia Loren, Jane Fonda, etc.) – I swear, I tried – but I just could not make the positives erase all of that other stuff that was bubbling through my brain.

As it turns out, my late 40s/50-something girlfriends and my 72-year old aunt were the most amazing, wonderful, and knowledgeable resources who offered condolences, congratulations, and containment. They welcomed me into a new phase of life that features many advantages. They told me how to manage the disadvantages so that I could still have beautiful skin, a healthy sex life, and strong bones. My medical team – naturopath and gynecologist – jumped in with educated advice and a complete lack of judgment about the state of menopause. They offered easy, low-risk, reliable solutions that were backed-up by decades of empirically validated studies. Maybe this menopause thing wouldn’t be so bad after all.

Menopause is, of course, inevitable for all women who make it that far in life. But even though we as a culture now discuss everything on TV, up to and including menopause, nothing and no one ever really prepares you for the slam of it. This is likely my half-way point in life. Menopause is a powerful marker of a distinctive phase in life, and a reminder to make the most of what remains. It is also, as I’m now quite capable of reminding myself, a time of post-menopausal zest. Here’s the secret…freed of reproductive system challenges and wild hormonal mood swings, many women are more productive, more creative, and more satisfied with life once they reach this place. Who knew?!