Perimenopause: The Storm Before the Calm
What — you think you’re having a hard time with perimenopause? Trust me: It can’t be worse than mine. You wanna talk drenching sweats in the middle of the night, right in the middle of a meeting, or smack-dab in the middle of I-can’t-remember-the-last-time-I-had-sex? You wanna talk pounds appearing mid-body like a busload of unwelcome relatives? You wanna talk hormonal horror stories? Honey, talk to me.
On second thought, don’t. Listen to me instead. Four years after I peeled my last tampon, three years after I earned my Menopause Merit Badge, approximately one million meltdowns since Hurricane Hormone first blew me away, I stand before you on terra firma, exulting: I’m free at last.
Turns out, anthropologist Margaret Mead wasn’t lying many years ago when she said, "There is no more creative force in the world than a menopausal woman with zest." Turns out, perimenopause is to menopause what a job from hell is to a tropical vacation: The only road to the best part is straight through the worst part; but once you’re sipping margaritas on the beach, you can almost forget what drove you there.
I promise you this: However dizzying your progesterone peaks, however difficult your walk through the valley of the shadow of declining estrogen and progesterone, sometime after your final menstrual period, your hormones will settle like sediment in a calm lake. And so, then, will you. I say to you that happiness, not your hypothalamus, will be your shepherd.
Now that my peripsychosis has given way to journalistic curiosity — "What is menopause, and why is it such an improvement over what came before?" — I ask my health gurus for answers.
"Menopause is a mind-body revolution," declares Christiane Northrup, MD, author of The Wisdom of Menopause. "We go back to the way we were before adolescence. Twelve-year-old girls have a very high opinion of what they know and what they want, but they lack wisdom. After menopause, we have both."
I remember myself as a 12-year-old and realize that what Northrup is saying is true. I ask her why menopause is such a positive time. "It’s a combination of hormonal and social factors," she answers. "In postmenopause, levels of follicle stimulating hormone and leutinizing hormone remain at the high levels they reached during ovulation. This makes us feel calm and more receptive to others."
"I am a lot more stable these days," I agree. "But I also find myself thinking about how much I want to do and how little time I have left. The prospect of death puts a damper on those yummy hormones."
"You’re only 56!" Northrup retorts. "Seeing menopause as the end of your life is just a belief system. You can choose a different paradigm. I’m 58, and I feel like I’m just getting started."
Northrup’s menopausal pride proves contagious. I find myself brimming with possibility, imagining the books I want to write, the places I want to see, the grandchildren I have yet to bounce on my knee.
"Menopause is harvest time," Northrup concludes. "We live the first half of our lives gathering the nutrients that come from taking care of others. But in menopause, we come home to ourselves as women. We get to live our lives from the inside out."
High on hormones and hope, greedy for more, I seek a second opinion from another hormone-hero of mine, Susan Love, MD, president of her own medical foundation and clinical professor of surgery at the UCLA Medical School. Sixty-year-old Love tells me, "Menopause is a great time of life. I exercise more, feel better, and have more energy and drive than ever. I find that not having the cycling of hormones is very leveling."
"Compared to … ?" I prompt her.
"At one point during perimenopause, I had very heavy periods," she says. "I saw a gynecologist, who recommended a hysterectomy. I was so busy, I couldn’t schedule it, and then the periods calmed down on their own. It taught me to have patience with hormonal symptoms, which usually don’t last too long. Once in menopause, we’re liberated from those hormones, and we can reclaim our power."
Sex and Stability Post-Menopause
he poster crone for the power of postmenopause is my friend Julie Whitten, who calls it mellowpause, and she oughta know: She had one hell of a time getting there.
"I went into early menopause at 45, and my doctor decided to start me on HRT," Julie tells me as we’re waiting outside the UC Berkeley gym for our yoga class to begin, surrounded by a gaggle of college girls. "The upside was, the HRT spared me the symptoms of perimenopause," she says. "But then I was diagnosed with breast cancer." She had to quit HRT cold turkey. That threw her into perimenopause at age 63, 15 years after her final period. "Between the hot flashes, the emotional turbulence, the cancer, and the cancer treatments, I really couldn’t tell what was in my body or what was in my mind."
"Fast-forward to now," she continues. "At 66, I’m healthier and more energetic than I’ve ever been. My kids are on their own and doing great. I can do what I want, when I want, and I’m making the most of it. Not much scares me anymore."
The gym doors burst open. Ponytails whipping, our fellow seekers of centeredness rush inside. Julie and I roll out our yoga mats in the back and sit contemplating the rows of lithe, smooth-skinned bodies in front of us. "Just think," Julie whispers, "we’ve already been through the hard stuff. They still have it all ahead of them."
Since my friends’ and heroes’ responses to menopause so closely mirror my own, in the interests of journalistic objectivity, I decide to solicit a minority opinion. To that end, I call psychotherapist Jerilynn Ross, of the Ross Center for Anxiety and Related Disorders, in Washington, D.C. Since Ross’s clients are self-selected as the less, um, sanguine among us, I figure she might have treated a few women who fail to see the magic in postmenopause. Sure enough, Ross sees the dark side of the light side in some of her clients.
"Approaching menopause can be very difficult for women who haven’t had kids," she tells me. "Some go into a total panic when their menses stop. They feel like this is it, I’m losing my chance to reproduce."
I take a moment to consider this — and realize that feminism notwithstanding, being the last apple on my family tree might make menopause feel less quieting, and more like a door slamming shut. Just as I’m sinking into sorrow for my child-free sisters, Ross strikes a happier note.
"But then, once they’re fully in menopause," she continues, "many of those women feel a sense of relief. Their bodies have made the decision for them. They tell themselves that they have to accept it. And most of them do." She pauses. "It’s not unusual for a woman I’ve been treating for years to quit therapy after her hormones stabilize."
"Uh-oh," I say. "If menopause is bad for business, maybe you’ll be needing a second career."
Ross chuckles. "We all hear such awful things about that phase of life," she says, "and then you get there, and realize that you’re still the person you were, only more so. You still feel sexual. You have more confidence and security. Instead of competing with other women, your friends are your support system."
That insight is borne out by facts: In a 1998 survey by the North American Menopause Society, 51 percent of postmenopausal women reported being happiest and most fulfilled between the ages of 50 and 65. In a MacArthur Foundation study conducted between 1989 and 1999, 62 percent of postmenopausal women said they experienced "only relief" when their periods stopped.
From 1997 to 1999, therapist Gina Ogden, PhD, author of The Return of Desire, conducted a sexuality survey of 4,000 men and women ages 18 to 86. "The 50-, 60-, and 70-year-olds were having more meaningful sex than the 20- and 30-year-olds," Ogden tells me. "They reported richer relationships — so much for the assumption that sex goes downhill when you spot your first gray hair."
You can prove that by my friend Jane Juska. Born in 1933, this mother of one and grandmother of two birthed two wildly successful books celebrating geriatric sexuality (hers) — A Round-Heeled Woman and its sequel, Unaccompanied Women — long after her reproductive system had called it quits.
The books sprang from the personal ad Jane placed in the New York Review of Books in 1999 when she was single, 66, and sexually deprived. "Before I turn 67," the ad read, "I would like to have a lot of sex with a man I like. If you want to talk first, Trollope works."
Now 75, Jane is still reading Trollope and still having lots of sex with men she likes. She’s also writing her first novel. When I ask Jane about the source of her late-life sexual and literary awakenings, she answers: "Menopause."
She goes on, "When the Curse stopped, my late-life elation kicked in. Men like me better now too."
"I never heard a woman say that men liked her better at 75 than 30," I say.
"I’m a danger-free zone," she says. "No fuss, no muss, no pregnancy to worry about." She grins mischievously: "Contrary to popular opinion, menopause is a gift to women."
Originally published in MORE magazine, October 2008.
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