An Author on Going Through Menopause at 37
When Isabel Gillies, the New York Times bestselling author of the memoir Happens Every Day (among others), floated the idea of writing about her experience of going into menopause at a young age (thirty-seven), she was met with some push back. It’s a conversation that in many ways is still avoided, silenced, unwanted. Fortunately for us, she didn’t listen. Her personal essay on the ups and downs, the challenges—and yeah, the joys—of menopause is funny and moving, warm, and mostly, really real. As Gillies poignantly puts it, let’s keep talking to each other.
Early, Unexpected Menopause
It started with a miscarriage. In 2007, I was at the beginning of a spanking-new, second marriage and, thanks to a lot of happy hay rolling, I became pregnant. We loved that baby from the second after I peed on the stick. Loved it. We already had three fantastic kiddos between us, and this one would be ours. A million people would say you shouldn’t name a child so early, but we couldn’t help it. Billie if it was a girl, Billy if it was a boy—both for Billie Jean King. I feel a very specific tug at my heart whenever I think about him or her. I wanted to raise that baby, and I still feel like its mother.
I was more than twelve weeks along when I had the D&C miscarriage procedure. It was my third pregnancy, and I had been showing enough to make my friends squeal and give my tummy a pat. Right before they knocked me out for the procedure, my doctor leaned over and asked if I would like to know genetic information about the child. I shook my head emphatically. No. The way she said “genetic information” sounded clinical, and I hastily thought it would solely be about what had gone wrong.
We never found out the sex of the baby. I realize now not knowing anything was a mistake. I wish I knew a million things about that kid.
I would never be pregnant again.
After picking ourselves up off the floor, my husband and I started exploring fertility treatments to help get the party started. I was thirty-eight and we were still hopeful.
“Tell me about your periods,” Dr. I-Will-Get-You-Pregnant asked.
I sat up a little straighter, explaining with confidence that my periods were good and robust. Not only were my periods pretty regular (sort of), but they were VERY strong and lasted for days. Huge cramps. Terrible. Like I was a teenager. Fertile, fertile, fertile.
He looked at me. I detected a hint of sympathy. “Well, what you are experiencing tells me a lot. We will do tests, but you see, when you start menstruating as a young woman, you can have heavy flow, heavy cramping, and longer periods. Then it evens out, becomes regular, and not as strong for a long time. When your body is coming closer to the end, once again, your periods become heavier, more erratic, and lengthier. It’s a cycle.”
I didn’t like that answer, and swept it under the rug to wait to see what the results would say. The big test you take to start your fertility treatment is an FSH test. FSH is the follicle-stimulating hormone, released by the pituitary gland and located on the underside of the brain; and there is a blood test to measure those hormone levels. This is not a test given regularly to women at a routine check-up; you take it if your periods are abnormal or you’re having trouble conceiving.
A week later, I was back. “I have your results,” the doctor said as he walked through the door.
“Okay,” I said confidently. I had always done pretty well on these kinds of tests.
“Your FSH levels are in the high sixties. Sixty-seven.”
“Yeah, is that good?” (I am very dyslexic, so to me sixty-seven is a decent grade.)
“These numbers mean,” he said, “it is impossible to do I.V.F. They’re too high. What this signifies is that you are menopausal. You will probably soon stop getting your period. Women in their seventies have these numbers.”
“I didn’t like that answer, and swept it under the rug to wait to see what the results would say.”
He was so straightforward that I felt the only thing I could do was let the steady waves of shock roll over me. There was no place in that examination room for an emotional outburst. I was silenced, but roiling inside. His words—a woman in her seventies—made my guts tangle and everything in the room turn into Claymation.
“I would advise you to see your gynecologist and start taking calcium for your bones,” he said. “Without estrogen you are at risk of osteoporosis.” Estrogen and bones? The information barely registered.
“So,” I took in a short breath, trying to replace what had just been knocked out of me. “Is there any way for me to get pregnant? Can’t you give me shots of something?” I had just been pregnant, I was in my thirties, and he was a renowned expert in this field. We were sitting in one of the most highly funded fertility clinics in the world—it couldn’t be over.
“No, it would be highly unlikely for you to conceive with your eggs. There is no reversing this,” he said with calm austerity.
I had assured my husband that morning that I would be fine and he could go to the office. I could have used him not only for a hand to hold, but maybe more importantly to ask more questions (his ovaries hadn’t just been rendered useless), to dig deeper, to find out what this really meant—because I was dumbfounded.
“I’m in menopause? But I’m…so young.”
“This is very unusual for someone your age.”
I looked down at the new wedding ring on my finger and gently pushed it around.
“Am I going to, like, um…age faster?” My voice trembled. As old as he seemed to be saying I was, I felt like a five-year-old sitting on that table.
He told me no, that in all other ways, I would age normally, and then his voice turned into the teacher’s voice in Peanuts and my imagination took me down some scary, wrinkly, decrepit, incontinent, hip-breaking, Golden Girls road.
With no warning, and no real understanding of menopause, I was a sleepy little town about to be smacked by a hurricane.
Here’s what happened along the way to The Change. There was the pre-game show, called perimenopause, which lasted five-ish years (in hindsight, about a year of that time came before my miscarriage, which can be a sign of ensuing menopause), and blended into menopause. Some of the side effects of perimenopause and menopause were: hot flashes (of course); night sweats; irregular, fluttery heartbeat (I once almost called 911 while watching Friday Night Lights because I thought I was having a hybrid panic attack-heart attack); sudden mood swings and sudden tears (which could be unstoppable).
And that’s not all…I had trouble falling asleep, trouble sleeping through the night. Irregular periods; shorter, lighter periods; heavier periods; missed periods; ten-day periods. Loss of libido. Dry vagina. Fatigue. Anxiety (oh the anxiety). There was dread, worry, doom. Depression. Difficulty concentrating, disorientation, fogginess. Memory loss—I once decided to give the kids leftover oatmeal for breakfast and in the minutes it took to heat it in the microwave, I made them pancakes, totally spacing on the oatmeal. Incontinence (no more trampolines I’m afraid). Sore old-lady joints and muscles (yoga to the rescue, but if you f-up your neck doing it like I did, then Pilates to the rescue). Breast tenderness (although my breasts got bigger, which was a plus).
Headaches. Weight gain (no amount of spinning helped). Hair loss on head and pubic area. MORE facial hair—wheeeee! Dizziness and lightheadedness. Changes in body odor (sometimes weirdly for the better). Violent mood swings (more on those in a minute) and tingling in the extremities. Bleeding gums, harder time at dental cleanings, difference in breath odor from more plaque and decay. Change in vision. Osteopenia (it’s bone loss, which I have in my SPINE), leading to possible osteoporosis.
AND NOBODY WARNED ME ABOUT 99 PERCENT OF IT.
Even though the doctor did tell me I had the hormone levels of a septuagenarian, I was in denial about my waning fertility and what accompanied this change. Initially, the only side effect I actually attributed to menopause was the clichéd hot flashes. My first massive attack came in a restaurant when I was having lunch with a friend. It was February, two months after my miscarriage. I wanted to rip off my t-shirt in the middle of the Mercer Hotel dining room (but settled for whipping my hair into a ponytail). My friend was wearing a lavender sweater set—perfectly comfortable. A hot flash is not like when you are sweating from a jog, or because it’s 87 degrees out. It came out of nowhere, and felt like every pore on my body was instantaneously producing pencil-dot sized beads of perspiration, from my scalp to my shins. Night sweats and hot flashes began to disrupt my life—I woke up in a drenched nightgown and sheets regularly for the next year. Clearly not great, but you can live with them.
A more perplexing turn of events, and a definite bummer, was my loss of sex drive. I was madly in love and had just gotten married; there was no reason for me to have a “whatever” relationship to sex. I half-heartedly assured myself it was okay to not feel like a twenty-year-old 24/7. After all, many of my friends who were nearing a decade of marriage were telling tales of things cooling in the bedroom—I lumped myself in with them.
“I half-heartedly assured myself it was okay to not feel like a twenty-year-old 24/7.”
What tipped me off that my loss of sex drive had nothing to do with my husband: The following summer, about eighteen months after the D&C, I went to Maine with the kids while Peter stayed in New York. We didn’t see each other for three weeks—and I didn’t masturbate. What red-blooded American female does that? One in menopause. The doctor had said something about upping my calcium intake, but didn’t mention losing serious boudoir mojo. The scientific term for it is—vaginal atrophy. You can see why people don’t talk about this stuff—but please, let’s get over it.
By an order of magnitude, the worst part of menopause was my erratic temper. For two years, I was as easy to set off as a mousetrap—and it could come down as hard. Typically, when women go through menopause, their children are college-aged and on their own. Mine were in elementary school and living in my house during all of this upheaval. Without warning, I could experience melancholy so deep I would cry until I looked like Rocky Balboa after a run in with Apollo Creed’s right hook. I tried to keep the emotional hurricane away from my family, but I was at its mercy, didn’t know when it would sweep through me, and sometimes they were directly in its path. I once got so upset with my husband (for something unmemorable and trivial), I tore our up our wedding album. I knew in the back of my mind that I’d made it on iPhoto and could print another one in the morning, which I did, but it was all so dark. I was out of control. (Just ask my kids.) Sometimes I would look out onto the Hudson River from my bedroom, and feel like sinking to the bottom.
I also wasn’t sleeping. Up until that time in my life a solid eight or even ten hours a night was absolutely no problem, but when I was in menopause, getting to sleep was unachievable.
“I once got so upset with my husband (for something unmemorable and trivial), I tore our up our wedding album.”
With all the anger, sadness and insomnia, I thought I was having a breakdown, I felt helpless. I remember looking into Peter’s face after a particularly bad crying fit and he said, kindly, “It’s like you’re unhinged.” A little less than two years had passed since the D&C. I was not associating my behavior with anything physical. I went to a psychiatrist, but I never told him I was in menopause, or made mention of a miscarriage—as clear as it is now, it didn’t click that my behavior was all the result of hormonal changes to my body. I’m the kind of girl who went to the gym when I had cramps and rolled my eyes at friends kvetching about their PMS. If I was acting bonkers, I thought it wasn’t because of “women’s issues,” it was because I was becoming insane. My therapist gave me tools to help me with the depression and temper, but without the physical piece of the puzzle, he was at a disadvantage.
You’re considered in menopause when you haven’t had a period for twelve months. I stopped getting my period altogether about three to four years after my miscarriage. Just after that time, I went back to the same psychiatrist after a particularly steady and happy summer—I was feeling…normal…and trying to figure out why. He asked me what had changed and it was only then I told him that a doctor years ago had given me the diagnosis of early ovarian failure when I had a miscarriage. His face dropped: If only he had known. It was then, after the storm had cleared, that the dots were more, neatly, connected, that I linked all my physical symptoms and mental behavior to menopause, and figured out how to feel like my (new) self.
Today, I have three teens in the house and it ain’t nothing but a thing. I never cry uncontrollably in the bathroom, my husband and I once again make love not war (with the help of understanding and coconut oil), and I feel peaceful, much more like a dove than a grenade. I take estrogen, and that’s because I have no history of ovarian, uterine, or breast cancer in my family. But the estrogen prescription might change as soon as my next doctor appointment. What I learned about mitigating menopausal symptoms is that you have to be flexible, investigative, and preferably prepared for some explorations to go askew.
Soon after the fertility doctor told me I was barren, I had sought out an Ayurvedic doctor in New York. I thought even if the white coats are singing one tune, there is a whole lot of music out there. The Ayurvedic doctor only had to lift up the skin on my hand and let it go to tell that my FSH hormone levels were skyrocketing (menopause causes loss of plasticity in the skin). Just as the other doctor had said, this doctor didn’t think she could help me conceive or reverse Mother Nature’s plans, but she could give me herbs to take that “may help.” In my desperation and urgency to find the miracle, I rushed home and swallowed all the herbs she prescribed while standing at my kitchen counter. I’m not sure I even read the directions. (Yes, I wonder now if I took more than what was necessary.) I looked like Lucy in the factory trying to eat the chocolates.
And, as if I were in a Nora Ephron movie, that night I had a twentieth high school reunion dinner—you know, the gathering where you really want to have your shit together and look “better than you did in high school!” Even if a twentieth reunion sounds old to some, it wouldn’t be unheard of for a classmate to be pregnant at one—I wanted so badly to be one of those women.
Sometime between gobbling down pill after pill (I couldn’t tell you now what the herbs were) and standing-around-talking-about-jobs-and-spouses-with-a-glass-of-chardonnay, I had an outlandish allergic reaction. By the time I had gone through the buffet line, my face resembled a pink, cream-filled snowball, and my ear lobes were grapes. I was itchy even under my armpits. I sat down on a sofa, plate on lap, searching for words to explain to my classmates—most of whom I hadn’t seen since high school—what was happening.
“Even if a twentieth reunion sounds old to some, it wouldn’t be unheard of for a classmate to be pregnant at one—I wanted so badly to be one of those women.”
I threw in the towel: “I’m having an allergic reaction to a field-full of Ayurvedic herbs I ate today because I’m in”—I don’t think I’d ever uttered the words in public—“early menopause.”
Someone hilariously and instantly said, “God that sucks.”
And it does! It does suck.
But you can also kind of get into it. Remember this all happened extremely early for me, so it took years to figure out, but once I had embraced and gotten woke to the irreversible changes in my body, I stopped fighting and started honoring the truth. Not only did I start to get behind myself as a maturing woman, but I figured out fun stuff to do. I could slather oil all over my skin three times a day and not break out. I had a ball researching every essential oil under the sun. I even wrote an article about essential oils for Cosmo—a job that felt sexier than any job I had when I was menstruating.
Not long ago, a younger friend was a little discouraging when I told her I was writing about menopause. “But it will feel like this huge nightmare coming at you,” she said, her hands shooting up in the air like she was about to block a Frisbee careening toward her head. “Who will want to read it?” Her barely-thirty-year-old forehead wrinkled with concern.
“Not only did I start to get behind myself as a maturing woman, but I figured out fun stuff to do. I could slather oil all over my skin three times a day and not break out.”
I guess she is right—it isn’t the same as cracking open Are You There God? It’s Me Margaret. before you got your period. Nor is it putting a pillow under your shirt to see what you will look like pregnant. But I believe that knowing what it could be like is better than not knowing. And starting to wrap your head around what our bodies will do is as important as tucking a tampon in your evening purse. It’s better to be prepared.
It’s been ten years since my miscarriage. When I look back, I see a young woman, scrambling, rollercoastering, and ignorant. Today, clarity and knowledge feel necessary to me, so I listen carefully and try to own what is real. Just last week my Chinese medicine doctor, Jane Seymour Page, M.Sc., L.Ac., said this:
“In Chinese Medicine the seasons of life are respected and celebrated for what they are; varied interpretations of, capacities for, and choices about the use of energy. Each season has its own limitations and opportunities. For most women, once fertility has waned, then ceased, the libido ultimately decreases and the tissues change. There is an option to shift focus inward and plumb the depths of wisdom earned; to experience and participate in life with authority. This does not imply that sexual activity disappears, it simply calls for a slower, richer, less frequent participation. We then have energy to expend on as yet unexplored aspects of life. Forcing youthful demands on an evolving elder is foolish and absurd because it runs counter to their purpose. Whether we have raised children or not, whether we have partnered with another or not, this is a time to give the self primacy and to interface with our communities with warmth and discretion.”
I wish someone had laid that on me back when.
“But you can’t do anything about perimenopause or menopause if you don’t know what it is, and why it’s happening. So, let’s talk—to mothers, doctors of all kinds, older pals, husbands, wives, partners, each other.”
Menopause is hard, there is no question, but there is no reason to think all is lost. There is a ton you can do for the sad, shadowy feelings (shrinks, walks, community engagement, friends, music, sex), dryness (argan oil, coconut oil, hormone replacement therapy, longer-more-deeply-engaged-sex), insomnia (magnesium, exercise, reading, meditation, sex) mind fog (word retrieval problems, humor). I’ve tried a lot, some of it works, some doesn’t. But you can’t do anything about perimenopause or menopause if you don’t know what it is, and why it’s happening. So, let’s talk—to mothers, doctors of all kinds, older pals, husbands, wives, partners, each other.
The big feelings I was getting through perimenopause and menopause, however scary and disruptive, were like the unknown side of the universe. There were frightening moments of darkness, but also bright, unexpected comets (I wrote three books in the last ten years), towering and then plummeting climates, and different speeds of light. I learned how deep we can go, how much we can feel, and how mysterious it all is. I also learned, once again, how grateful I am for people sticking by me when humanity roars.
The scientist Carl Sagan said my favorite quote of all time, “In the cosmos, there is no refuge from change.” Is that true or what? Goodness, all I have to do is look at the teenagers in my apartment to see Carl knew of what he spoke. For me, now that my hormones have balanced, I recognize myself once again—I feel normal, and it’s a mighty relief. But I’m staying alert, I’m on my toes, I’m open to what might, or what certainly will change in the great, wide future.