Perimenopause at 51

What to Expect

One woman's odyssey through the Trump presidency. My focus is centered on the many issues affecting women--but what doesn't? There's a new post every week.

Cathy still has not entered menopause. She talks about her sense that you can “choose” life outcomes. She is choosing not to have any dramatic symptoms going forward.

Although she is not a medical professional, she is the executive director of a holistic health center, so she sees women dealing with menopause in different ways on a regular basis.

My name is Cathy and I’m 51. I would say I’m perimenopausal.

I definitely still have my periods, even though I wish that wasn’t the case. I was born in New York in 1963 and lived there until I turned five, and then we moved to Long Island. I spent a great deal of time with my grandparents, who lived in the City, and with my extended family out on Long Island as well. And even though I didn’t really care to live on Long Island, we had a swimming pool and great trees and tons of space, and because my aunt and uncle lived next-door it seemed like our property was huge. There were always lots of outdoor activities—hide-and-seek, baseball, picking berries off the mulberry tree and having our feet and fingers turn black because we ate so many of them.

At some point as a teenager I realized, or somehow became aware, that my grandmother had had a hysterectomy; but when I was that age, my mother and her sister were both still pretty young—my mother was only 18 when she had me– and so neither of them were dealing with menopause, or even having to encounter the thought of it at that point in their own lives. But I think by the time my mother reached 50 her period had stopped, and her sister basically stopped having hers when she was in her early- to mid-40s, which was was pretty early on. I always thought I’d probably be lucky if I went into menopause that early too but that’s not yet been the case. As a child I never heard horror stories about menopause, and I don’t remember my mother or grandmother saying they were having hot flashes, or anything else like that. I just don’t recollect those pieces being an issue for them, even though it doesn’t necessarily mean they weren’t.

When I was still living on Long Island and approaching about 40-ish, my friend Linda and I got together and she was talking about perimenopause and referencing Christiane Northrup– and of course I didn’t know then that I would have a professional connection with Dr Northrup up in Maine later in my life—and I remember it was interesting but still a little too early to be thinking about it, and why would I need to have any issues or concerns with that now? That’s clearly the first conversation I had about menopause, though Linda was my age and she wasn’t going through menopause—she was perimenopausal, just like I still am.

I work in a place called True North, a non-profit integrative healthcare center. We have a variety of practitioners– clinical practitioners– i.e. doctors, and a variety complimentary care practitioners—massage therapists, acupuncturists—it’s a compendium of different types of modalities. One of the people we’ve had from the very beginning is Bethany Hays, a gynecologist specializing in functional medicine– she’s one of the few certified functional medicine physicians in the country to focus on women’s hormones. In working at True North I’ve learned a great deal about health, hormones and nutrition—not just from a menopausal perspective, but overall and in terms of general healthcare and the alleviation of disease and, in certain cases, managing or reversing some relatively bad health situations.

The first time I ever heard about menopause was from a neighbor who had a daughter significantly younger than all of her other children, and I recall hearing her referred to as a menopause baby, because clearly at the time of her pregnancy the mother was acting under the erroneous assumption that she was in menopause. But I hadn’t heard anything particularly negative, other than you may think you’re in menopause when you actually might not be, and if you’re concerned about contraception then you might need to consider using it over a longer period of time. My friend Linda was more in tune with those issues and concerns, and maybe it was from her perspective of wishing to be healthier, or knowing what to expect because her situation may have been similar. She also lived with her mother and two grandmothers growing up, so I assume there may have been more of an ongoing conversation there as well. I’m not convinced that the reason I didn’t really have any negative connotations or hear that much about menopause derived from modesty or reticence, or it being a taboo situation—it just didn’t seem to present that much of a challenge for anyone in my immediate family.

When I had PMS it certainly came with a lot of cramping, and I felt really tired and just kind of sick, and uncomfortable in my own body. And then when I got in to my 20s, after I had lost a fair amount of weight, the situation worsened as my period increased; later on, as I started to gain the weight back, all of that sort of dissipated, and since I’ve been in my 30s and 40s I’ve not had any more of those terrible periods. I very rarely have cramps, but I feel bloated every month and get some of the classic PMS symptoms of wanting to eat things that are salty and chocolaty, and suddenly I’ll be sitting there with a big bag of potato chips and think, oh, yes—no wonder—I’m probably getting my period! I’m not one of those people who tracks every month, in part because I don’t have to be concerned by that. I had a tubal ligation when I was in my 30s, but still I usually get my period every month and it’s actually become more regular, and in the course of five days all-told it’s done and over with. It comes on very quickly, and the first day is pretty light, and then the second and third days are really heavy, and the fourth day is pretty light again. When I lived with a partner he would always feel compelled to say something about it, and so clearly I must have been a little bit of a challenge—not that I thought I was. But certainly I can become annoyed much more readily, and I’ve noticed in the last two or three years that I’m prone to being more emotional in terms of crying. I’ll suddenly be in tears over something that really doesn’t warrant it, but not to the extent that I think that I’m crazy— there’s something behind it for sure, and I’m more likely to let the emotion overcome me and actually cry the tears than just hold it in. I do have a physiological indication of the fluctuation of my hormones, which is that usually on the first day or the day before my period I’ll become nauseous, and that can last for the better part of a day– just feeling a little queasy and not-so hungry. And the other thing I’ve noticed over the years is that on the first day or leading up to it—usually the day before—my lips will get very pale. I don’t know what that has to do with anything but it’s just something I’ve noticed about myself, and it’s pretty subtle– I don’t think anybody else would notice it, but I do. Maybe I should track when I’m going to get my period, because then I could manage those times when I’m really short-tempered and feel like I want to kill someone. I don’t usually really know I’m due for my period until I’ve already eaten that bag of cookies or potato chips and then it dawns on me; but how could I forget– one month to the next– how could I forget?

I have a couple of friends who are older than I am, and I’ve see them having hot flashes during the daytime and pulling off their sweaters and getting totally flushed and perspiring, and I thought that was just awful. And my instinct was that there really wasn’t any reason for me to have to go through that, and I’d convinced myself that I wasn’t going to have hot flashes long before I knew anything about how to modulate hormones. When I was around 45 I decided to have a test called a woman’s hormonal panel—referred to in my office by the acronym WHAP—that basically measures your hormones during one particular time of the month– say for example on the twenty-first day of your cycle– to provide a kind of roadmap for where you are in time. It’s a benchmark—if you have a practitioner who can properly clinically interpret that data —for recommending supplements and other things to help bring those levels of the many different hormones in your body into a state of balance. When I did my WHAP I was not too surprised to learn that my testosterone level was a little on the high side, and I thought, well, I guess that fits. But whether it’s estrogen or estradiol or other remedies, there are many supplements that can be used to regulate your hormonal balance. And of course I think food is even more important– I can’t say that I take the best care of my own health, but I have information that can be helpful and useful to me. I used to take EstroFactor, among other things, but it’s complex, so if you’re doing this you need to make sure you don’t throw something else out of balance, and that you’re not eradicating some element or combination of elements that your body requires. You still need testosterone, you still need estrogen– and I mention those two because those are the big ones that everyone knows about—and regulating those has been very helpful. It’s empowering when you have real information that can be measured—it’s not just subjective. It’s great when people can talk about their experiences, but to know there are ways that you can look at this more clinically informs the pieces that you can’t actually measure. When you have a degree of control– for someone who’s feeling really out of sorts with managing any of the times around menopause—it’s more meaningful to understand what’s going on with your body. My mother and grandmother certainly didn’t have any of this information, and that’s something that’s changing. So many really well known healthcare professionals are getting out there and practicing and writing books and doing lectures, and all of that is very helpful to women encountering these challenges.

Of course, even though I say I’m not going to have hot flashes, and I’m assuming I’m not going to have issues with mourning the choice not to have children I consciously made in a permanent way a long time ago, I realize there will be some changes in my body. It’s definitely harder to lose weight—certainly when I was younger that was easier, and if I had listened to what people were saying then I would have made a more concerted effort around that when I was in my late-30s. I think there might be some changes from an emotional perspective, but that could be good—perhaps I won’t have those PMS pieces where I’m feeling particularly perturbed at someone, or have some of the same bad food habits at certain times during the month. And my sister just underwent a total hysterectomy– but she’s had six children and five pregnancies, so very different effects on someone’s body than even having one child—and her physician advised her that if she was going experience any menopausal symptoms she was going to feel them immediately. I don’t know if that’s true or not—so far she hasn’t had night sweats or anything else like that, and hopefully she won’t, but if she does I have good resources for her, and I feel lucky about that.

Where the word ‘change’ comes in may not just be about the physical aspect. I’ve never thought about it in that way because, again, it wasn’t something I saw in my own family—those kinds of external life changes. No one got divorced or relocated after they raised their kids, and I’ve never even had anyone in my family move out of state. But I can certainly see a relation in that things do change for women as well as for men. There is research that shows men have similar experiences as women—everyone tends to forget that men also have hormones, and not just testosterone, and so there’s a whole other set of circumstances that they’re dealing with. But men typically don’t take very good care of their health and are probably generally less aware of those kinds of things. It makes me wonder, if they were managing their hormones better, might they be less likely to feel discontented and divorce their wives to seek out younger women. I would like to think that for myself, as well as for any woman, that by the time you’re approaching the 50-ish mark– whether it’s late-40s or early-50s—that you feel more self-assured as an individual. And if there are things that you haven’t done in your life perhaps that kind of restlessness is a catalyst for people to empower themselves and finish that master’s or do the PhD or start a new business. I don’t think it all has to be perceived as negative—like leaving your husband because the kids are all grown up and out of the house—but even that, too, is empowering. So maybe that’s what it’s all about—an opportunity for people to really fulfill themselves. It may also be true for some women during menopause that getting healthier, or going back to school, or starting a business, or relocating, is a way of replacing what is often perceived as a loss. Because there’s a power to every aspect of fertility, and certainly many women do feel like their real power and wisdom comes to bear when they’re in menopause, and they become the Queen or the Crone. I know a lot more about myself now than I did when I was 20, or even 30 or 40—I sense that over the decades my wisdom deepens and intensifies, and I’d like to think that that is something universal.

Comments are closed.