My Physician Ignored the Research…
My name is Emily. My age is 58, and my menopause age was 45. I recently retired but I was a labor lawyer for most of my career. When I was young girl I wanted to be an oncologist because my grandfather died of cancer and I found it very upsetting. I didn’t follow that path after my dad told me I shouldn’t pursue anything in the sciences because I wasn’t good at math, even though I actually was; I think if I’d stayed with that I would have been much happier in my career, but I stupidly listened to my father about a lot of things. Then, as I got older, I wanted to find something to do where I could be independent and support myself without having to rely on a man, and that sense of myself came mainly from the bad example of my parents’ marriage. I did not want to be stuck in a marriage like my mother—she didn’t have any professional skills and felt completely financially dependent upon my father, which made a strong impression on me when I was in my early teens.
While I was in college studying history and literature I didn’t give much though to what I wanted to do, I was just having lots of fun, and I’d always assumed I was going to get an advanced degree regardless. I considered joining an art restoration program in Florence, but my parents thought I’d be unable to find a job in that field and didn’t support it in any way. After college I went back home to Cleveland to look for work and take a little time off to figure out what I wanted to do. It was 1980, and the city was in the midst of a huge recession. Since Cleveland had been a major heavy-industry city since the mid-19th century, most of those jobs were transitioning over to Asia, and those that were left were increasingly mechanized; I couldn’t even get work as a waitress because the regional economy was so poor. I was kind of drifting when an old boyfriend of mine from college called and said that one of our professors was getting married in Chicago, would I like to go to his wedding with him? I said sure, and he drove from Washington DC, where he lived at the time, to Cleveland to pick me up, and we went to the wedding. Then, that Sunday night after we arrived back in Cleveland, we were all sitting around the dinner table and my father asked my friend if he had a place where I could stay in Washington for a while so I could look for a decent job. He agreed, and my dad told me to go upstairs and pack my bags, on the condition that if I couldn’t find anything after a month he’d pay for my airline ticket back home. Within a few weeks I’d gotten a couple of job offers, and then I ran into another old friend from college in downtown Washington who happened to be looking for a roommate—it was serendipitous, and within two weeks I was working and had a place to live, and I’ve stayed in this area now for almost forty years.
I began working in the securities industry and got my broker’s license, which I did for about two years even though it was awful. The market was terrible, and AAA-rated bonds were being issued at fourteen per-cent interest, so you couldn’t sell anything but bonds; many clients didn’t want to tie their money up for that long, so the whole securities industry was totally in reverse. One of my clients bought a lot of MCI stock, which was then a local company, and through a headhunter I was offered a job in their finance department. Working at MCI was fun, there were tons of young people there and everyone was making money hand over fist. I was hired to help get their monthly billing system on schedule, because they were losing revenue by not establishing their customer’s accounts fast enough to bill them on a timely basis. The work was boring, so after six months I transferred over to their anti-trust department—MCI had multiple anti-trust cases against AT&T, and also numerous filings with the Department of Justice on various monopolistic issues in practice. I was working with quite a few attorneys and thought to myself well, I can do this, all I need to do is go to law school. So I applied and got accepted, and continued working there part-time while I went to school; then I was offered a full-time position at MCI after graduating and stayed there for eighteen years. When Bernie Ebbers took over he fired all the lawyers, so I found a job at another tel-com that also went bankrupt in the early 2000s, and that’s when I started working for the Air Line Pilots Association, doing much of the same thing but on the union side around employee benefits and related issues. And then I retired in May.
I remember my mother going through menopause when she stopped getting her period at around 45 and her telling me that my grandmother went through it during her mid-forties as well. I also think she indicated to me that for her it was no big deal. She was raised in Catholic schools and was not very in touch with her body, and quite reserved about sexual subjects—for her these were private matters. My sister also went into menopause at 45, so there must be a familial genetic component for us.
I knew absolutely zilch about menopause going into it. Nobody ever talked to me about what would happen, including my gynecologist and regular physician. I’d heard about hot flashes, but in the beginning I didn’t even know I was going through it. When I was 43, I started having these anxiety attacks where I’d get really nervous and anxious and sweaty and couldn’t sleep—I’d worry all night long about very mundane things, and I’d never been like that before and thought I was going crazy. I was always a good sleeper, one of those people who could put their head down on a pillow and sleep for eight hours and wake right up. I didn’t realize that this was part of menopause until later, but I finally ended up getting a prescription for Ambien. I also mentioned to the doctor who prescribed it that my periods were getting irregular, and she gave me a test for menopause and then told me in fact that it had begun happening. She said that I may or may not get more periods, but she didn’t say that my sleeping issues were connected to menopause, nor did she make any effort to initiate a conversation about other physical changes I could expect then or in the future, which I found to be not particularly helpful. She was a bit younger than me and just may not have been trained to have that discussion. And when I went to my gynecologist that same year, she told me I should be taking the birth control pill and stay on it for fifteen years, and I said well, isn’t that hormone therapy? And she said yes, and when it happens to me I’m going to do the same thing. So I said, what about all the recent research showing that the pill increases your risk of cancer and heart disease, and she said I don’t care, I’m just going to take that pill, and she opened her mouth and made the gesture of dropping it onto her tongue. I said okay, but I’m not doing that—I took birth control for almost twenty years and I’m not going there, I’m done with hormones. She completely dismissed any and all of the research, and I though that was outrageous, but again she was maybe not even 40 at the time. Basically, I was incredibly annoyed that none of my physicians ever discussed with me what could possibly happen, like all my tissues thinning out and vaginal dryness. Anyway, in the meantime I’d moved away from where I’d been living and changed doctors. I went to a new gynecologist and told her that I was having dryness and painful intercourse and loss of sex drive, and she told me all I had to do was use a small amount of Premarin and I’d be fine. I did that for a while but I found it disgusting and stopped. Nevertheless, it was huge for me, and I wasn’t expecting all these changes that were bringing me back to a place of when I was 12 or 13 years old. It was a complete reversal of how I felt in terms of my sexuality, especially in the way my body felt, the way my tissues were, and the loss of muscle mass and tone. It was very discouraging that I was going to have to deal with menopause without any real preparation. Gradually, as my menopause progressed, I’d get flashes of being hot for two minutes and then cold for two minutes, and it would go on that way for hours, which was extremely distracting and annoying. I remember breaking out in a sweat in my office and it was embarrassing when I’d have to get up and adjust the air conditioning or fan myself with work papers; it breaks your concentration when all of a sudden, for no apparent reason, you’ve got sweat dripping down your forehead while everybody else in the room is comfortable. And then gradually it dissipated, but I still get hot flashes periodically, and I don’t know what triggers them.
I think going through menopause changed my personality a little; my husband always tells me I’m not the happy-go-lucky person I used to be, and I guess that’s right because I have no estrogen in my body. Literally, it’s gone—I recently had a test, and it’s at such a low level that my doctor suggested I start replacing some of it. I don’t know why these physicians keep trying to push hormone therapy—it seems like a whole lot of work in terms of risk monitoring for a benefit that’s nebulous at best. I still have no libido, and my husband had a horrible prostate infection a while ago and he’s had to make that transition to a new kind of sexual identity as well, so we just don’t have sex anymore and that’s fine with me. But if anything happened to him I would not be interested in going with another man ever again. If I knew in my last year of having sex that this was going to happen to me maybe I would have had more sex! There’s a sense of loss there, and if I’d understood what was ahead I might have acted differently, or at the very least I’d have been better prepared for the eventuality.
I find women to be more interesting, and the things I do are predominantly with and among women in the same ways they were when I was a pre-teen and everything revolved around my girlfriends. There were girls who I thought were simply the most amazing people in the whole world, and I don’t know if part of that was having crushes on them or not. And if I have sexual dreams now they involve other women, so menopause may have changed my sexuality to some degree. I do remember this period when I was 14, 15 and 16 where I went boy crazy. My hormones kicked in and it was all I could think about, but that eventually settled down. I went to a women’s college that had gone coed, so again it was a situation where there were mostly women around, and I was happy with that.
I never had a strong drive to have children—I was happy and contented with the way my life was, and it didn’t seem as if I were missing out. And again, I didn’t have a great example from my parents’ marriage; even though my husband is nothing like my father and we’ve been married for thirty years, I always wondered what if he ever did become like my father, so I kept taking the pill.
My advice would be to talk to as many women who are going through or have gone through menopause as possible, and to get engaged with other women on the subject when you hit your late thirties. Learn about it, because if you know what’s happening you’re less likely to think you’re crazy. And perhaps the loss of sex drive wouldn’t be as harsh an experience if you knew about it beforehand. Maybe parts or none of it will happen to you, but no matter what being prepared is key. I remember reading Our Bodies, Ourselves by Judy Norsigian when I was going through puberty, because my mother wasn’t communicative about those topics, and I thought okay, so this is what’s going on. There’s a real need for the dissemination of information, and physicians have to know more about this so they can educate and have conversations with their patients.
Eventually, every woman who lives through it will come out on the other side and be okay.