The Reward for Perimenopause? Menopause!
More, October, 2008
Whatyou think you had a hard perimenopause? Trust me: it couldn't have been worse than mine. You wanna talk drenching sweats in the middle of the night, in the middle of a meeting, in the middle of can't-remember-the-last-time-I-had sex? You wanna talk pounds appearing mid-body like a busload of unwelcome relatives: parking, wrecking the place, and then refusing to leave? How about mood "swings" that make the Six Flags Stratacoaster feel like a subway ride? You want to talk hormonal horror stories? Honey, talk to me.
On second thought, don't. Just towel off your blazing body, chant your perimenopausal anger-management mantra, and listen to me instead. Because I'm here to testify, and I come bearing good news. Four years after I unpeeled 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, my very-un-merry-peri a thing of the past, exalting: Thank Goddess Almighty, I'm free at last.
I've seen the light, dear reader, and I'm here to shine it your way. Turns out Margaret Mead wasn't lying 20 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 the best part is straight through the worst partbut 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 estrogen; although your cups (not to mention your waistband) may runneth over, sometime between one and (Goddess forbid) 15 years after your last menstrual period, your hormones will settle like sediment in a calm lake. And so, then, will you. Happiness, not hypothalamus, will be your shepherd. You shall not want for a well-tempered temperament; for sleep uninterrupted by 3 a.m. costume changes and wringing-wet sheets.
You'll love menopausethis I know, for the Menopause Bible told me so. That would be The Wisdom of Menopause by Dr. Christiane Northrup, Oprah's favorite ob-gyn. Northrup's 600-page compendium was my cheerful companion through all those sleepless, sweaty nights; her blend of Western medical training, feminism, and spirituality a cool hand on my Niagara-falls foreheadand many others', apparently. Northrup's books sell by the millions in the U.S. and around the world.
So once I'd made it to the light side, and my peri-psychosis gave way to journalistic curiosity"What is this thing called menopause, and why is it such an improvement over what came before?"my first click was to drnorthrup.com. Imagine my surprise and delight: the guru of all things gynecological agreed to talk to l'il ole me. (L'il ole More Magazine, actually. But still.)
That famous voice starts our interview with a bang. "Menopause is a mind-body revolution," Dr. Northrup declares. "Aside from adolescence, it's the best time in a woman's life."
Huh? "You must have been a happier teenager than I was," I say slowly. "It wasn't a class I'd like to repeat."
"Think about it," Northrup says. "Twelve-year-old girls have a very high opinion of what they know and what they want, but without any wisdom. When we're in menopause, we have both."
I remember myself as a twelve-year-old, and realize that what she's saying is true. Issuing a silent apology to my parents for my many unwise adolescent adventures, I ask Dr. Northrup why that is.
"It's a combination of hormonal and social factors," she answers. "In post-menopause we're past the physiological instability of peri-menopause. Prolactin and oxytocin levels are high. They're the yummy bonding hormones, the ones that kick in when you're nursing a baby or making love."
"I am a lot more stable these days," I agree. "But I also find myself counting backwards, thinking about how much I want to do, and how little time I have left. The prospect of death kind of puts a damper on those yummy hormones."
"You're only 56!" Dr. Northrup retorts. "Seeing menopause as the end of your life is just a belief system. You can choose a different one. I'm 58, and I feel like I'm just getting started."
I visualize myself in the belief-systems aisle at Whole Foods, reading ingredient labels, trying to pick the best one. "In the Kung tribe in Africa, for example," Dr. Northrup interrupts my fantasy, "a woman's status in society improves as she agesand so does her self-esteem. They don't even have a word for "hot flash."
"It doesn't exactly work that way here," I comment. I remember sitting in a meeting with my boss when I was up for a promotion and also at the height of perimenopause, unable to issue a coherent sentence, sweat drenching my body, watching my raise go up in smoke along with my body temperature.
"But that's the beauty of the Boomer generation," Dr. Northrup says. "Those of us who are in menopause nowwe're the ones who changed all the rules. After five thousand years of patriarchy, we had a woman running for President." She pauses for dramatic effect. "That was us!" she exclaims. "We're the women who did that!"
Christiane Northrup's menopausal pride proves contagious. As our interview winds down, I find myself brimming with a sense of possibility, imagining the books I want to write, the places I want to see, the grandchildren I have yet to bounce on my knee. And then I realize the feeling is familiar. Oh, right: I felt like this when I was twelve.
"Menopause is harvest time," Dr. Northrup concludes. "We live the first half of our lives gathering the nutrients that come from taking care of others. We need those nutrients the way we need air and water. But in menopause, we come home to ourselves as women. We get to live our lives from the inside out."
High on oxytocin and hope, greedy for more, I seek a second opinion from another hormone-hero of mine. In the early 90s when I had a breast cancer scare, the only thing between insanity and me was Dr. Susan Love's Breast Book. President of her own medical foundation, Clinical Professor of Surgery at the UCLA Medical School, 60-year-old Dr. Susan Love is also an Oprah-favorite, and also the author of several bestselling guidebooks to women's health, including Dr. Susan Love's Menopause and Hormone Book.
"Menopause is a great time of life," Dr. Love tells me. "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 said I should have a hysterectomy. I was so busy, I couldn't schedule it, and then the periods calmed down on their own. It taught me that we need to have patience with hormonal symptoms, which usually don't last too long."
I ask Dr. Love about the impact of cultural context on menopause, and vice versa. "If you trace women's hormonal milestones, you'll see how the process serves the evolution of the species," she says. "Girls are full of beans until they get through puberty. Then they become more submissive. On the other end of the lifespan, women experience postmenopausal zest.
"I think the purpose of our high levels of hormones in our younger years is to domesticate us enough to reproduce the species," Love says. "In menopause we're liberated from those hormones, so we can reclaim our power."
The poster crone for the power of post-menopause is my friend Julie Whitten ("Tuesdays with Julie," More, October 2006). Julie calls it "mellowpause," and she oughta know. Today Julie lives in the post-menopausal promised land of milk, honey, and hormonal balance. But she had a hell of a time getting there.
"I went into early menopause at 45, and my doctor decided to start me on Hormone Replacement Therapy," Julie tells me as we're waiting outside the U.C. Berkeley gym for our yoga class to begin, surrounded by a gaggle of giggling, gorgeous college girls. "The upside was, the HRT spared me the symptoms of perimenopause," Julie says. "But then there was the downside. Fast-forward 18 years: I'm diagnosed with breast cancer."
Julie's cancer diagnosis meant quitting HRT cold turkeywhich threw her into perimenopause at age 63, fifteen years after her last period. "One good thing about perimenopause," she says wryly, "was that it made me feel better about being single. When my hot flashes heated up one side of the bed, I still had a cool side in reserve."
She shakes her head. "Between the hot flashes, the emotional turbulence, the cancer, and the cancer treatments, I really couldn't tell what was what in my body or my mind."
Julie combs her fingers through her thick salt-and-pepper hair, as if to reassure herself that the whole ordealcancer, chemotherapy, perimenopauseis really over. "Fast-forward to now," she continues. "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 any more."
The gym doors burst open. Ponytails whipping, our fellow seekers of centeredness rush inside, jockeying for the best positions on the floor. Julie and I roll out our yoga mats in the back of the room, coax our creaky, complaining bodies into half-lotus, and sit contemplating the rows of lithe, smooth-skinned bodies in front of us.
I sigh. Julie sighs. And then she leans over and whispers in my ear. "Just think," she says, "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. Toward that end I call therapist Dr. Jerilyn Ross, director of the Ross Center for Anxiety and Related Disorders in Washington, D.C. Since Dr. 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 post-menopause. Sure enough, Dr. Ross sees the dark side of the light side in some of her midlife clients.
"Approaching menopause can be very difficult for women who haven't had kids," she tells me. "Some of my childless clients go into a total panic when their menses stop. They feel like this is it, I'm losing my chance."
I take a moment to consider thisand 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 childfree sisters, Dr. 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. "Menopause is the wave of the future. If it's bad for business, maybe you'll be needing a second career."
Dr. 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 of a sense of confidence and security. Instead of competing with other women, your friends are your support system."
"What do you recommend to perimenopausal women to help them prepare?" I ask.
Dr. Ross doesn't hesitate. "I encourage women to learn as much as they can about what's happening in their bodies, so they have a bit more control about what happens in their minds."
Living from the inside out, reclaiming our power: Drs. Northrup and Love make menopause (not to mention menopausal women) seem downright desirable. Which makes me wonder what the science says.
I call Dr. JoAnn Pinkerton, President of the North American Menopause Society (NAMS) and tell her I'm looking for the latest studies that tell women what to expect when we're expecting menopause. "Sorry," she says, "but all the recent literature is about the transition between peri-menopause and menopause, as opposed to how women feel when they're all the way through it."
A conspiracy theory springs to mind. They don't study post-menopausal women because we're useless once we stop reproducing. I stuff my pre-post-feminist anger and focus on the data that is available: three studies, each about ten years old, each confirming what the good docs, and my own experience, have said.
In a 1998 Gallup phone survey sponsored by NAMS, 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 menstrual periods stopped. Twenty-five percent reported having no particular feeling about it, and a mere two percent reported feeling "only regret."
Between 1997 and 1999, therapist Dr. Gina Ogdenauthor of several books on women's sexuality, and consulting editor to Our Bodies, Ourselvesconducted a sexuality survey of 3800 men and women aged 18-86. "The 50-and 60-year-olds were having more meaningful sexual experiences than the 20- and 30-year-olds," Ogden tells me. "They reported richer relationshipspossibly because they'd matured beyond the old, "good girls don't" constraints."
Sounding positively triumphant, Ogden adds, "So much for the medical industry's assumption that sex starts going downhill when you spot your first grey hair."
You can prove it by my friend Jane Juska. Jane was born in 1933 in the Midwest, no lessand grew up in the vice-grips of those "good girls don't" constraints. Post-marriage, motherhood, and menopause, she's been enjoying a very pleasurable, and very public, sexual renaissance.
"I reached womanhood before Tampax or birth control were known to small-town girls," Jane tells me over drinks at the Berkeley hotel bar where we meet monthly, huddling under the heat lamps on the hillside patio in chilly winter and chillier summer, watching the sun set over San Francisco Bay.
"Worrying about an unwanted pregnancy ruined every single sexual encounter I had," Jane says, "until finally I got married becausewhoops!I got pregnant."
Mother of one and grandmother of two, long after her reproductive system had called it quits, Jane birthed two wildly successful books celebrating geriatric sexuality (hers). A Round-Heeled Woman (Random House, 2003) and its sequel, Unaccompanied Women (Random House, 2006) feature an impressively disparate cast of characters, all of them hotties, one of them half her age.
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 for me."
Now 75, Jane is still reading Trollope, and still having lots of sex with men she likes. She's also writing her first novela bold move for any nonfiction writer, let alone a septuagenarian. When I ask Jane about the source of her late-life sexual and literary awakeningsand whether it comes in pill formshe answers with a single world: "Menopause."
Jane waves at our size zero, twelve-year-old waitress, who's busy flirting with a table populated by handsome businessmen. Finally Jane catches her attention and gestures for another round. Our waitress nods brusquely and turns back to the men.
"The things cute girls get away with," mutters Jane, who is, by anyone's standards, a snowy-white-haired knockout.
Miraculously, our drinks arrive. Jane takes a lusty gulp of Chardonnay. "When The Curse finally stopped cursing me with cramps and mess," she says, "that's when my late-life elation kicked in. Men like me better now, too."
Jane's always good for a new twist on an old story, but this perplexes me. "I've never heard a woman say that men like her better at 75 than they did at 30," I say.
"I don't fall off the roof' anymore," Jane explains, "so I'm a danger-free zone. No fuss, no muss, no pregnancy to worry about."
She fixes her baby blues on me, grinning mischievously. "Contrary to popular opinion, menopause is a gift to women. Who knew The Change would make my sex life better than it's ever been?"
How did menopause get such a bad rep? It doesn't take a rocket scientistor even an Oprah regularto figure it out. There's our Britney-worshipping culture, which values precisely those qualities in women that mid-lifers don't possess, and scorns the qualities we do. There's the closed' sign on our uteri: whether or not we have donated to the cause, the propagation of the species is proceeding without us now.
And then there's my pet peeve: the highly unintelligent design flaw in the species itself, to wit, we're born in possession of very little, then spend decades amassing much: matching wine glasses, relationships, real estate, wisdom, Jimmy Choos. Then, just when we've got it together, what happens? The End. If only Steve Jobs had designed the human being (the "i-Me?"), we'd be born with everything we'd ever need, and slowly lose things (relationships, no; Jimmy Choos, yes) as we need them less and less.
No wonder an undeniable sign of aging like menopause fails to appear on anyone's wish list. (Try and imagine the aspirational speech of a Miss America contestant, in which she breathlessly expresses her longing for the onset of menopause.) Who wouldn't prefer to be pre- or even peri-old than post-?
Hmm. When I ask myself that question, I realize: I would. As full of myself as I was as a pre-pubescent, pre-menstrual twelve-year-old, I'd rather march forward into my post-menopausal years than have to face what Julie calls "all that hard stuff" again. Which is lucky, since even the considerable mojo of post-menopausal power can't give me a choice in the matter. Marching into the future, like it or not, means slouching toward death.
Now that menopausal zest has me thinking clearly again, I've come up with a plan. I'm going to put everything I've got (relationships, Jimmy Choos, wisdom) into enjoying the time I've got left. And every day, I'm going to thank the goddess for my good fortune. To paraphrase the ancient Chinese curse and blessing: I'm lucky to live in mellowpause in such interesting times.