TW: This post contains references to suicide.
This past weekend the movie version of the classic coming-of-age novel “Are You There, God? It’s Me, Margaret” by Judy Blume opened to much acclaim. Gen X friend groups, many of whom had passed the novel among themselves 40-plus years ago as they were navigating their ascent into adolescence, went out to see the movie together, while others took their own teen or tween daughters to see the movie.
The almost reverential reaction to this movie’s release has shone a spotlight on what a seminal work Blume’s novel was for women of my generation. Growing up in a time when bodily functions, especially anything related to the reproductive system or sex, were deemed shameful and proper ladies didn’t discuss such things, AYTGIMM was the first (and sometimes only) open and vaguely honest talk we got about our changing bodies.
In the anticipation leading up to this past weekend’s opening, one comment kept popping up in every conversation I had with my friends or saw online: “When is Judy Blume going to write a book about menopause?” Gen X women are yearning for a new book on the topic. If there’s one topic left for our mothers and aunts to shy away from and our doctors to overlook and underserve, it’s this phase of life and all the physical symptoms that come with it. With few resources available and many medical professionals woefully uneducated about perimenopause, many women are left feeling like they’re alone in what can be a rocky transition toward menopause.
But fear not, my friends! Resources do exist.
I’ve even written about this before, but as my symptoms have changed and I’ve gone down the winding, sometimes obscured path toward feeling healthy and keeping my sanity in check, I realized there’s so much more to discuss and so many more women who need to know that the changes they are experiencing are real, especially if they feel like their families, friends, or doctors aren’t listening or understanding what they’re going through.
So, keep reading to find out how you can navigate this stage of life with more confidence and to find a little support and a reminder that you’re not alone.
What began as a few hot flashes here and there, and some fatigue and body aches in the week before periods over the last several years, has gradually evolved into multiple daily hot flashes, night sweats, irregular periods, and bouts of alternating rage and depression. Those I could live with mostly. And the herbal supplements recommended by my PCP seemed to help, especially with the hot flashes.
But when my body began aching as if I had the flu around the clock, and when my moodiness turned even darker and I began having crippling anxiety attacks multiple times per week, that’s when I began to think I might not survive this period of my life. In fact, when I began researching about perimenopausal anxiety and depression, I was shocked to learn an increasing number of women do not come out the other side of this transitional period.
(TW: Suicide mentioned ahead.)
Researchers from the Menopause Experts Group have found that over the last 20 years, the suicide rate for women ages 45-54 increased by six percent. Women in this age range experience the highest suicide rate of all women, with 7.1 deaths by suicide per 100,000 for women ages 45-49 and 6.1 deaths per 100,000 for women ages 50-54. These deaths can largely be attributed to misdiagnosis and dismissal of symptoms by physicians who have not been educated on the depth and breadth of perimenopausal and menopausal symptoms.
Women who have breezed through life with few or no bouts of depression or self-doubt can suddenly find themselves plagued with a loss of confidence, a sense of not knowing who they are anymore or what their purpose is. Anxiety, rage, and deep sorrow can come on out of nowhere. More than a few friends have told me lately they don’t know who the woman looking at them from the mirror is anymore. Favorite activities have lost their allure. Brain fog clouds their ability to get things done or make decisions. And some days, a sense of worthlessness, that no matter how irrational it may be, threatens to swallow them. And all of this emotional (and physical) may be exacerbated by life circumstances like balancing career and home life; navigating parenting teens or young adults while also caring for aging parents; and having little or no time to meet your own needs.
Meanwhile, well-meaning doctors who lack education on this topic put women on antidepressants and tell them to change their diets and get more exercise or to meditate and find ways to relax instead of addressing the real cause of their symptoms: a decline in the reproductive hormones estrogen and progesterone. And while menopausal hormone therapy (MHT) or hormone replacement therapy (HRT) as it was previously known, isn’t considered appropriate for all women depending on other health conditions, it can be a godsend for most women going through perimenopause.
Now, you might be thinking, “Isn’t HRT associated with an increased risk of breast cancer?”
Maybe not, according to Robert Langer, one of the principle researchers on the 2002 Women’s Health Initiative study that is often quoted when discussions about the pros and cons of HRT/MHT are discussed. According to Langer, the WHI study which looked at the use of estrogen and progestin in combination, and which was terminated early, did not account for the use of other medications or previous health history or pre-existing conditions of the women in the study. Moreover, he says, “the study results were not statistically significant for breast cancer harm,” and the only significant results of the study showed an increase in venous blood clots and a reduction in hip fractures.
So, while I am not a medical professional, I do believe women should have access to tools and resources that can help ease the physical and emotional symptoms caused by the decline in hormones. And I believe they should be taken seriously by their doctors. If you’re experiencing hot flashes, mood swings, anxiety or any of the other numerous symptoms associated with perimenopause, it’s worth having a discussion with your doctor. And if they dismiss you by telling you this that what you’re going through is normal and just part of aging, resist the urge to tell that doctor where they can stick that opinion. You are not alone and there is no need to white-knuckle through what can feel like agony. Arm yourself with research and find a new doctor.
I’ve previously recommended Dr. Jennifer Gunter’s book “The Menopause Manifesto.” She also has a Substack blog called The Vajenda, where you can find answers to many of your questions about perimenopause, menopause, and HRT/MHT. (It’s also a great resource for women in their reproductive years, as well.)
Another outstanding resource for researching your symptoms and possible treatments is at the North American Menopause Society (NAMS) website. They also offer a listing of NAMS certified practitioners who have demonstrated subject-matter expertise.
Again, remember that you’re not alone.
While your mother or aunts may say they don’t remember going through this, weren’t they also the ones who told you that they don’t remember sleepless nights with babies or tantruming two-year-olds? The same ones who glossed over “the talk” and avoided telling you about periods and reproductive health and just said “the pads are under the bathroom sink” if you need them?
You’re not crazy. Your symptoms are real. And if the discussions I’ve seen in women-only online groups is any indication, you have thousands upon thousands of sisters going through this with you. Many of whom thought they were losing their minds until they found each other. Don’t suffer alone. Talk to your friends. And if they won’t admit to what they’re going through because they’re shy or embarrassed, remind them of Margaret and her friend Janie when they have to buy pads from a male cashier…
Be the brave one and initiate the hard conversations. It’s not always easy and but by being real about what you’re going through you can let your friends know they don’t have to be embarrassed or suffer alone in silence about something that needs to be normalized.
