Menopausal Crazies? It's Biology.

Menopause may not be a breeze, but for most of us, it is endurable. Our thermometer is out of whack; we lie awake listening to the bathroom faucet drip; sex is iffy and sometimes laborious. But we soldier on. We get through.

For some of us, however, menopause is a descent to an unexpected and torturous realm. For some few of us the emotional swings, the moodiness, paranoia, depression, along with all the other garden-variety menopausal symptoms, can be crippling.

“I don’t know why there isn’t disability for those of us who can’t get through this,” a patient said to me recently.

Almost assuredly (unless you work for me), your colleagues won’t understand, and there is certainly no quarter given for bad-estrogen days. In fact, you could be labeled as emotionally fragile and unreliable, as Rachel describes in this article:

We may hang on by the skin of our teeth at work, but home is where the hormones rage. Is this because they have to love us anyway? Or because a pressurized vessel will burst at its weakest point? I don’t know, but tales from the home front are littered with collateral damage, as this hormonal mom describes:

I have never come so close to being mentally ill as when I experienced the roller coaster of hormone fluctuations and it scared the livin' crap out of me. I would scream at my kids and immediately be remorseful, in tears and inconsolable as my ex lovingly shepherded the kids away from me, and then I’d turn right around and do it again. Free floating anxiety was a way of life and the irrational outbursts were like an out-of-body experience that I truly could not control.

Or this from a husband:

I had a few years where patience was the central character of my personality. If she said it was too hot, I would agree and turn the air- con down. If she thought she was growing a tail (yes, this happened) I would physically examine her and afterwards suggest we go see the GP to see what could be done.

Obviously, hormones are not to be trifled with. The hormonal changes we experience during menopause can be unpredictable and powerful. And they can take years to sort themselves out. This is not to suggest that you are a complete victim to your chemical malfunction. In fact, I’d like to stress three things:

You aren’t alone. Some 1.3 women in the US reach menopause every year. About 10-20 percent of them have severe emotional responses or are considered depressed. That’s a lot of women! You can’t go around quizzing every harried woman of a certain age about her mental health, but it sure helps to find someone with whom to share the joy.

Rachel, for example, found a friend who was going through the same thing. They’d text each other at work with status updates:  “6/10 today, not too bad.” “I’m only a 4. Might jump off the balcony.”

You can find help. Granted, the path isn’t clear, and it isn’t easy. There is no magic bullet, but you may be able to cobble together a makeshift flotation device. Start with the basics: eat well and healthfully. Exercise moderately and regularly. Try to decrease bad habits, such as smoking or drinking. This may sound like a matchstick in a hurricane, but look at it as laying a foundation to build on for the rest of your life.

Create a support staff. In this case, you need a few good friends, an excellent healthcare provider, and the understanding of your family. You may have to sit your family down and explain that you’re in the midst of a transition that could take some time. That the going may be rough for a while. That you’ll try as hard as possible not to take your mood swings out on them, and they are not to take it personally if you slip up.

Your healthcare provider is a critical brick in your foundation. Many doctors aren’t well-informed about this tricky state of life, and it’s easier to pat you on the head than to work with you to sort out a solution.

Seek out an ob/gyn who specializes in menopause or an endocrinologist. Alice Chang, a Mayo Clinic endocrinologist, says in this article, “You need to find a doctor who will really talk to you and listen to your concerns. The doctor should assess your risk factors and understand the benefits and risks you face. Right now, people just don’t know enough about the data, and it is easier for doctors not to prescribe at all.”

It will end. The menopausal transition (called perimenopause) takes time—years, actually. This is a significant hormonal change from your fertile, child-bearing years to a mature female elder. No other mammal goes through this transition. It’s an important transition to mark, and even celebrate (if you weren’t too sweaty, moody, sleep-deprived, and bloated). But you might also consider the alternative—being fertile until you die!

But I digress.

The point is, menopause can be a wild, scary, and unpleasant ride, but at some point, your menses will end, and your hormones will settle down. After 12 months without a period, you are officially post-menopausal. And this could be a time of great contentment.

Here’s how one blogger describes it, “…the days of eye-bulging, vein-popping, scream-until-you’re-hoarse type of moods swings are long gone.  In fact, they are so far removed from my day to day life now, that I can hardly believe I ever went through them.”

Wait for it. Peace will come.

In the meantime, understand that the emotions driving you aren’t due to character, discipline, or genetic weakness. They’re an effect of fluctuating estrogen and progesterone. Period. While you may need help to get through, it isn’t because you’re flawed or willfully out-of-control.  

As a healthcare provider told our hysterically sobbing, menopausal blogger, “This is not a control issue. It’s about your biology.”