I spent quite a while debating whether to even write this blog post. I was raised that there are certain things one doesn’t talk about, and menstrual cycles are one of them. But the older and crankier I get (thank you, perimenopause!), the less I care about what is “polite conversation,” and here’s the thing: Perimenopause is a completely dreadful sort of purgatory before menopause, and no one ever told me that! And it occurred to me that perhaps no one has ever told other women that. Sure, we’ve all heard the jokes about hot flashes, but in my experience, they are one of the least annoying parts of the whole business. There’s so much more crap that goes along with it that the hot flashes kind of seem like little tropical vacations in comparison to everything else. Unwanted tropical vacations, mind you…but tropical vacations nonetheless.
So for my small readership, which I think is mostly female (and if you’re male, you might want to stop reading…unless you want a brief insight into what the beloved females in your life are or will be going through), welcome to my personal purgatory of the last six years or so. For one solitary blog post, we’re going to talk all about what a lousy business this perimenopause stuff is. Because, you know, it’s not enough that we get to spend decades bleeding every month and go through childbirth. We might as well enjoy perimenopause on top of that.
Note of explanation: Perimenopause means “around menopause,” and it refers to years of slow hormonal change leading up to when a woman’s periods stop (as well as the first twelve months after they stop, according to many sources). Once you go a year period-free, you’re considered to be menopausal. Until then, it’s perimenopause. And it sucks.
All right, down to business. If you know me, you’re probably thinking I’m awfully young to be going through perimenopause. And indeed, you would be right. But early menopause runs in my family, so it’s really not too surprising. It was confirmed by my fertility doctor five-and-a-half years ago, though based on my symptoms, I think it started closer to six years ago.
Symptoms is a nice segue into the down and dirty part of this post. My first symptom of perimenopause was migraines. They started when I was on vacation, because what better time, right?
Remember when car dealers used to string those lines of triangular flags all over the lot to indicate a sale? You’d drive by and see the inverted triangles fluttering in the breeze? Yeah, I get those flags in my vision, only they’re shiny and sparkly, kind of like disco lights. They flash and sparkle all over my vision so I can’t see to drive or to read or…well, pretty much anything that requires any focus. And after the pretty, sparkly flags go away, I get a crushing headache that has been known to last for up to ten days. If you know me and you know my charismatic but incredibly feisty elder son, imagine parenting him in his toddler/preschooler/kindergarten days with a crushing, never-ending headache. It was delightful.
It turns out migraines aren’t all visual auras and headaches, either. They can come with a whole host of other fun side effects! I spent well over a year frequently feeling slightly drunk, even though I hadn’t had any alcohol—feeling slightly off balance, as if I might stumble and fall, with some garden-variety dizziness thrown in there, as well as a weird trembling in my jaw that would suddenly occur for no particular reason. Add to that some brain fog, where I could no longer process information as quickly as I used to, and you can see why I felt somewhat drunk. Now, if you like the feeling of being drunk, this might be a plus for you. I was not a fan, though. If I’m going to feel drunk, I at least want to enjoy a couple of margaritas to get there.
It seems every woman over forty I know has this one. Thirty pounds seems to be a common number—thirty pounds that weren’t there suddenly are. But I like to do things up big—go big or go home!—so I piled on fifty pounds. This may have been partly due to the migraine medicine I started taking when I decided I could no longer parent young children while feeling drunk and incredibly grumpy from headaches. But whether the reason is perimenopause or meds, I’m now nice and “fluffy.”
Oh, and here’s the cruel irony of it: Once you hit about forty, it becomes much easier to gain weight, but much harder to lose it. This isn’t just me and my “I spend an hour a day, six days a week, exercising at the gym and I haven’t lost a single pound in a year” bitterness talking, either. My doctor informed me, upon seeing my revised and expanded girth, that “you know, it’s really hard to take off weight at this age.” Fabulous. Just what I wanted to hear. Hand me another celery stick to nibble while I spend another hour on the elliptical machine, will you?
Apparently I also subscribe to the “go big or go home” school of thought when it comes to bleeding. Logic would tell us that if you’re working up to your periods ending, they might get shorter and more infrequent, right? Not so, my friends! Depending on your hormone levels, they might actually get worse! Instead of bleeding every twenty-eight days, you might bleed every twenty-one days. Heck, some months I like to really go for it and have a period every two weeks! And because each one lasts about seven days, on those super-fun months I bleed for half the month. (And again, this isn’t just me saying it. The good old American Congress of Obstetricians and Gynecologists confirms this on their website.) If you’re like me and you have low iron, you can imagine that this bleeding doesn’t do you any favors.
And while we’re on a gross topic, how about the quantity? Have you ever heard of something called “flooding”? I suspect you can guess what it is, but if not, it’s when a woman bleeds so heavily that she “floods” a maxi pad or tampon. The first time it happened to me, I thought I was hemorrhaging—without warning and within seconds, I soaked through everything I was wearing below the waist. And yes, I was wearing a super maxi pad at the time—it was no match for the flood. I’ve read that super tampons are also no match for the flood. When I confided in a friend about this, she said she had a coworker who had gone through the same thing—she would have to literally run to the office bathroom, dripping blood everywhere. Ranks high on the list of nightmares for women, doesn’t it?
Thankfully, I work at home. So for my one “flooding” day each cycle, where I’m having to change my protection every hour and I’m still bleeding through onto clothing, I just stay home. When I have to go pick the kids up at school, I put on black pants and get back home as soon as possible. It’s incredibly inconvenient, but at least I haven’t yet been embarrassed in front of anyone other than my own husband. Who, by the way, likes to introduce a bit of levity to the situation—when I moaned that I was worried that July 4th would be my flooding day and that I’d have an embarrassing accident at the fireworks show, he said cheerfully, “Just wear blue and white, and then the red will complete the ensemble!” Lucky for him, I laughed instead of cried at his little joke.
And again, this phenomenon isn’t just me. The topic of flooding has been covered by many; you can read about it in articles in medical journals, and numerous websites address it as well.
There’s hope, though. I’ve read that this stage of perimenopause comes when you’re nearing the end, and when you’re soon to start skipping periods. For me, it’s been going on for about 18 months, so that means the end must be near, right? If it’s not, please don’t tell me that. I prefer to live in blissful ignorance, clad in black pants that hide all secrets.
People joke about menopausal women’s moods, but I’m pretty sure there’s nothing funny about it. I have always been a calm, level-headed person. I was never one to get all “PMS-y” during periods in terms of moods. Sure, I had cramps and didn’t feel great, and I might’ve been a little less cheery than usual, but I wasn’t a raving lunatic. Unfortunately, I am now a raving lunatic. Well, maybe not that bad—you’d have to ask Chris, who was recently on the end of a tirade where I yelled, “I DON’T KNOW WHY, BUT I JUST WANT TO HIT PEOPLE TODAY!” and then went on to burst into tears and wail, “You must be sorry you married me! You only got a few years of normal me before I turned into this horrible, miserable mess!!” (The wise fellow calmly said, “I would marry you again any day in a heartbeat.” And I knew he was full of shit, but it was still nice of him to say. And probably smart, since I had just announced my desire to hit people.)
Let me be clear: I don’t find this change to my personality to be cute or funny in any way. I’m not one of those women who makes jokes about PMSing. I actually can’t even stand being around myself when I get like this. My irritability makes me irritable. It’s really a winning combination.
Did I mention that perimenopause makes many women experience significant hair loss? I recently went to unclog my shower drain and pulled a mouse-sized ball of hair out of it. I had just cleaned that drain a couple of months before, and suddenly I had a clump of hair the size of a rodent to pull out of it. And I’m the only one who uses that shower, so there is no one to blame but me. I’ve also shed so much hair into my bathroom sink that we now need to replace a piece in the drain, because it stinks as if something is dead in there. In reality, it is most likely another rodent-sized hairball that has clogged up the works.
Once again, not just me. Google “perimenopause and hair loss,” and you’ll find plenty of documentation. I have a friend whose doctor recently diagnosed her with baldness due to the amount of hair she has lost during perimenopause. No joke. If only we could somehow collect all this hair and donate it to Locks of Love. But instead, it just escapes into our drains and lingers there like a dead mouse, stinking up the works.
Never had a baby, so you think your bladder is safe? Oh no, my friend…oh no. Our good friends at the Mayo Clinic proclaim that perimenopause brings about a loss of tissue tone that can result in urinary incontinence. If you’ve been pregnant or had a baby, it’s just all the more true. I recently learned that I can no longer jump on trampolines. Ever. Even with an empty bladder. Also, if there’s so much as a drop of pee in my bladder, I can’t sneeze. Or cough. I haven’t resorted to Depends yet, but let’s just say the black pants come in handy for that, too.
This one is my most recent discovery! I’ve had significant gastrointestinal problems since I got pregnant with Sam, so naturally I thought they were the result of pregnancy and just never resolved. But guess what? Women in perimenopause are prone to GI issues! Hormone changes can result in excess gas, bloating, constipation, diarrhea, abdominal pain, and indigestion. I read an interesting article through the National Center for Biotechnology Information about the link between perimenopause and irritable bowel syndrome, which appears to be fairly significant.
Let’s just say that when you combine excess gas with urinary incontinence, it’s another winning combination.
With all of this, is it any surprise that depression is an issue for perimenopausal women? Let’s see, you’ve gotten fat and bald, you’re gassy and bloated all the time, you can’t hold your pee, and you’re prone to being overtaken by a red tide at any given moment. Hormones alone can certainly bring on emotional changes, but even aside from that, what woman wouldn’t be depressed with all that going on?
There’s more—so much more!—that I could say, but I’ve probably scared you enough. And maybe grossed you out, too. My apologies. But here’s the thing: No one told me how absolutely awful this would be. I recognize that there are far worse things—in some years (I hear eight or so is the norm), perimenopause ends and life goes on. I will certainly take this over some sort of catastrophic accident or major illness that forever impacts my life. I wake up each morning absolutely thankful for my health and my family’s health.
But do I wake up every morning thankful for perimenopause? Probably about as much as one wakes up thankful for stepping in cat vomit first thing in the morning.