I recently read a book review recounting one woman’s harrowing passage through perimenopause. The Madwoman in the Volvo is a graphic and humorous account of emotional upheaval, distress, seismic life changes, and finally, the author is cast gently upon the slightly less fraught shores of menopause. Perhaps sadder (or more thoughtful), probably wiser, and definitely optimistic about the future.
So, in honor of this season, which is guaranteed to nudge all but the most stoic among us off the ledge, I have two messages for all of us hot-flashing, sleep-deprived, hormonal gals.
If you feel as though you’re losing your mind, you aren’t alone. Hear that? You are not alone. In fact, you are legion—there are many of us.
There are, in fact, a silent (or, more likely, howling) army of women who feel just like you. I recall the patient who was referred to me by her new therapist, who had refused to treat her until she got her hormones straightened out. (Previously, she had been told to see a therapist by the police.)
I recall a close friend, the very picture of motherly benevolence, who hissed in my ear, “If that kid doesn’t stop yammering at me, I’m going to tape her mouth shut.” She was referring to her sweet but talkative adolescent daughter. I was shocked. A few years later, I was feeling like that myself.
You can assess your lifestyle and experiment with healthy change. You can eat kale and take vitamin B12 and black cohosh. You can meditate and do yoga. You can stop smoking and reduce your alcohol and caffeine intake. You will feel healthier, and your symptoms might become more tolerable. In case you haven’t noticed, I’m a big advocate of healthy lifestyle choices.
But, if you, like many other women, continue to feel like you’re hanging on to sanity with bloodied fingernails, and those you love are suffering right along with you, by all means see your doctor and find out what pharmaceutical options might help you.
Read this article, written by a woman with access to all the current research on hormone replacement therapy (HRT) and an enviable journalistic pedigree. Here’s what she has to say about her decision to go back on HRT:
I would like to be able to tell you that I weighed these matters thoughtfully, comparing my risks and benefits and bearing in mind the daunting influence of a drug industry that stands to profit handsomely from the medicalizing of normal female aging. But that would be nonsense, of course. I was too crazy. I went straight to the pharmacy and took everything they gave me.
Perimenopause—the hormonal roller-coaster years preceding menopause—can be a long and bumpy ride. It usually begins somewhere between 45 and 55, but can start much earlier. These are the years of unpredictably cresting and crashing hormones, when the crazies come out in all their glory. This stage can last from 2 to 10 years.
Menopause officially beings in the thirteenth month (one year) after your last period.
Which doesn’t mean you’re out of the woods. Many women still have hot flashes and emotional turbulence. But life should slowly settle down as your body adjusts to its new, post-hormonal self.
So, that’s my second holiday message: You aren’t crazy, and eventually you’ll be okay. Wiser, maybe more self-actualized, and really, really okay.
With that, a very happy holiday from MiddlesexMD to you. And as the Madwoman in the Volvo said, “Have some cake, for God’s sake.”
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.