Monday, April 9, 2018

The Change

This blog should come with a warning label. If you are a woman under the age of 40, you may not want to read this. It contains major spoiler alerts about your future health and well-being. If you are a man of any age, you definitely don't want to read this...

If you're still with me, I have a few things to share. Lately, I have been learning a lot about a topic that no one seems to be talking about. Well, at least no one in my circle talks about it. The topic is menopause. I am working on coming up with another word for it, like I did with the Pajama Tax, because menopause is a terrible word. It just hangs there in the air every time I say it, like a dark cloud hovering in the sky. The mere mention of it seems to make people really uncomfortable, including me.

Recently, I have started to notice changes in my body. It started with some unexpected and irregular timing of something in my life that used to be pretty regular. My monthly cycle has started to feel like I am playing a game of Russian roulette with my hormones. One month it is pretty heavy and the next month it is almost non-existent. Some months it doesn't happen at all. And of course, my emotions are all over the map as well. 

In the back of my mind, I started thinking that this could be the early stages of menopause. But I really didn't know much more than that. I told myself that it was a natural part of the aging process and I assumed that I would figure it out eventually. This month, I had a particularly rough time and I started to generally feel tired, lethargic and possibly even a little depressed, which is completely unlike me. Since my Dad passed away, I have learned to live with a baseline level of sadness in my life, but this felt different. It wasn't really coming from my mind, or even my heart. It seemed to be coming from my entire body. 

So I did what I usually do when I need to understand something better and I am not sure where to begin. I bought a book. Whenever I read a new book, I find myself referring to the author as my friend. I have made several new "friends" this past year. My friend Dr. Wayne Dyer who has taught me about personal growth and spirituality; my friend Susie Orman who has helped me to take control of my financial affairs; and of course, there is my friend Deepak Chopra, who has become a household name around our place and has taught me more than I can possibly cover here. As a side note, Mark Johnson and I are just starting his new book called The Healing Self.

Anyway, the book is called Menopause Confidential. It was written by a female doctor named Tara Allman. My friend Tara is an expert on menopause. In fact, as a 51 year old woman, she is going through it right now. That fact alone gives her credibility among the many authors, most of whom are male, who claim to be experts on the topic.

I like Tara. She is practical and authentic. She is funny and she tells it like it is. She complains about her husband and two teenage kids, mostly in a lighthearted way. I can connect with her - even though it is clear that her life is very different than mine. In fact, I would guess that my life is probably a lot different than most women my age. But the one thing we all have in common is that we are all on the same path. And that path leads to menopause.

If you want to learn more about this topic, I would encourage you to pick up a copy of Tara's book. It covers a lot of midlife women's health issues such as exercise, weight management, osteoporosis, breast and cervical cancer screenings, and other useful information. The cover art reminds me of Sex and the City. And hey, I guess the women from that show are pretty much in the same place, too. In case you don't have time to read the whole book, I am going to share a few things I learned about menopause:
  1. There are two phases to menopause. Women in their 40's and even into their early 50's are in what is called perimenopause. That means you are still having your cycle but it becomes more and more irregular.
  2. You are officially in menopause when you have not had your cycle for 12 months consistently. (i.e., an entire year). At that point, they officially declare that you are out of eggs. And you officially move from perimenopause to menopause.
  3. You are in menopause for the rest of your life. There are some people who refer to the years after menopause as "postmenopause" but that assumes you can figure out when menopause has ended. 
  4. For the average woman, the symptoms of menopause can last anywhere from four to seven years, but some women may experience them for more than 20 years. 
I always thought that menopause would last for a few months, or maybe even a year. And then it would be over. I had no idea that it would go on for so long.

It turns out that estrogen is responsible for most of the good things that happen in our bodies. As estrogen declines, we start to change. And none of those changes are positive. According to my friend Tara, I could have symptoms such as hot flashes, night sweats, brain fog, poor sleep quality, decreased sex drive, anxiety, depression and a bunch of other stuff during menopause. And I will also see permanent changes in the quality of my hair, nails, skin and many other areas of my body.

After reading this book, I was left with one burning question. Why isn't anyone talking about this? Why doesn't anyone tell you this is going to happen? When you are 12 or 13 and you have your first period, it seems like everyone is talking about it. Your Mom tells you what to expect. And the sex education teacher at school gives you a sanitary napkin in a little pouch to keep in your locker. And even your friends are talking about who has gotten their period and who hasn't.

Then in your 20's, 30's and even into your 40's you greet your monthly cycle with a sense of relief because it means you are not pregnant. Unless of course, you are trying to get pregnant. Then you probably have a different relationship with your monthly cycle that I can't really understand because I have never tried to get pregnant. 

And then somewhere in your mid to late 40's everything starts to change. And no one tells you that it is going to happen. And no one sits you down and talks about what to expect. You're pretty much left in the dark, unless you happen to stumble across an article about hormone therapy in More magazine at your doctor's office. Maybe if I had a subscription, I would have known about this sooner.

They say what you don't know can't hurt you. As someone who was always taught to be prepared for anything, I never really understood the meaning of that old saying until now. The thought behind it is that if you don't know about a problem, you will not be able to make yourself unhappy by worrying about it. When it comes to the topic of menopause, that might be true.

Usually after reading a book, I feel better. I understand more about whatever topic I am reading about and, more importantly, I have a plan for what to do about it. But reading this book made me feel unsettled. Like this huge thing is going to roll in and disrupt my life and it will last for years and afterwords I will probably never feel the same again. Worse yet, I have almost no control over it and no real choice in the matter.

The main option to treat menopause-related symptoms is hormone therapy and that is something I am not prepared to do. Not only does it seem unnatural, but as with almost all medical treatments, the side effects are almost as bad as the symptoms. The side effects of hormone therapy are similar to birth control pills, which is why I don't take those either. They include nausea, bloating, headache, bleeding and breast tenderness, as well as more serious side effects like blot clots, heart attack, stroke and cancer.

It seems like after all these years and with all of the medical expertise out there, we should be able to come up with something better. Of course, there are also a scattered number of non-hormonal treatments and remedies, but Dr. Tara doesn't seem to be very optimistic about them. Some things may only work for some women. And some things may only work for a short period of time. So basically, I am on my own.

After taking in all of this information, I am not sure where to go next. My first instinct was to find a place where I could talk it through with other women in a safe and non-judgmental setting, like my yoga studio. The owner is probably somewhere in the range of her menopause years, as are a lot of the women in my Tuesday morning class. And maybe some of those women might have a better sense of some natural remedies that I could try.

But at this point, I am not sure I would want to join my own support group. Even as I write this blog, I am not sure if menopause is something I ever want to talk about again - although I guess I will have to at some point. For now, I've decided to set the book aside and enjoy my estrogen for as long as I have it. Ignorance is bliss.

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