Puberty Part Deux - Part One

Welcome to the Menopause...

Menopause for me was like going through a second puberty. My girls were in their tween and teen years while I wandered, alone and unaware, into the wilderness of perimenopause. Confused, and frankly horrified, about the changes happening to my body as my kids were going through their own transformations into womanhood - easy for me to explain their budding breasts, breakouts and menstrual cycles. Been there. Done that. Not to mention puberty you’ve got a text book for it.

Menopause on the other hand, well, there’s no textbook for that … not when I needed it. Ten years ago menopause was a slightly dirty little tea party secret totally withheld or only whispered confessionally between the closest of friends.

Then the hot flashes hit, brain fog rolled in, chronic sleeplessness, weakness in my grip, accompanied by stinging burning sensations like pins and needles on the back of my hands… and then… the cherry on top - debilitating valvular dryness. Periods. Ovulation. Libido. AKA my mojo suddenly seemed a no-go.

Fear and embarrassment of not being what I considered “a woman in full” was enough to make me want to not even admit the truth to myself. I needed help. But where to turn?

OB-GYN’s tend to concentrate on the front end of the business: birth control, childbirth, not so much on the backend peri and menopausal women. Three years of searching and I landed on the book and podcast ‘Menopause Confidential’ penned by NYC Gynecologist Dr. Tara Allman.

Allaman offers deeply researched science backed counsel and treatment modalities to, as she says, “Make your vagina juicy again” involving oral hormone replacement, topical creams, and intervaginal estrogen rings. Women often endure symptoms, brought on and aggravated by low estrogen levels, as minor as adult on-set acne to life changing conditions like painful intercourse, vulvar atrophy which can make even walking excruciating, as though the vajayjay is covered in hundreds of tiny paper cuts, hot flashes, to sleeplessness, frozen shoulders and tightness in the femur sockets. Forgoing HRT was a given for a lot of Gen Xers, due to concerns based on the 2001 UK funded Million Women study findings stated that HRT can trigger breast cancer even in women who have no family history of the disease.

In 2019, the Women’s Health Initiative published a further study, now widely accepted as the standard in prescribing HRT, debunking the Million Women Study.

While Dr. Allman goes by the book - no off-label drug treatments in her practice - there are Docs out there who push the menopausal health envelope. The Wiley protocol, where topical hormones cycling through estrogen progesterone and topical testosterone and weekly injections are all self-administered leaving dosage somewhat up to the patient’s discretion, is also an option for women who want to have more control over their cycles. The Wiley protocol offers options that can induce a menstrual cycle, without the presence of ovaries, by using progesterone to thicken the lining of the uterus enough to cause shedding. There’s an opinion that this controversial treatment could be a more effective way to reduce the risk of uterine cancer.

Point being, there’s more help and more info out there than ever.

Menopause affects all women differently - mothers and daughters and sisters can have wildly varying start times and symptoms.

Perimenopause came calling for me mid 40's, my mother in her late 50’s and one of my sisters somewhere in her 60’s. I had every imaginable symptom - my mother and my sister ZERO symptoms.

The important thing is to talk about it.

My best friend had early onset menopause due to thyroid triggered infertility issues. It was a secret she held for nearly fifteen years, because our sense of self is often bound up in feeling sexy and fertile.

Women have never been given any other message.

But then, you look at the very few species on the planet who share the menopausal phase of life with us - Rhesus monkeys, chimpanzees, killer whales, narwhals, and pilot whales. Highly intelligent evolved matriarchal hunting societies formed and enduring since the earliest stages of Earth’s existence. Scientific theories suppose that menopause is to avoid the dangers of childbirth, in order to preserve the female caregiver and repository of knowledge of the species into old age. Counter theories are older females, if they were to continue to reproduce, would compete for resources with younger females possibly thinning out the herd. Orcas seem to be ruling the oceans for millions of years and having a fine time out there riding the waves…