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SocietyNovember 29, 2020

Perimenopause is not fun, but it’s inevitable

Photo: Getty Images
Photo: Getty Images

Perimenopause and its big sister, menopause, can seem like the cruellest of jokes after a lifetime of hormone-related struggles. Ensemble‘s Rebecca Wadey felt overwhelmed and panicked, until she started talking, and listening, and realised she wasn’t the only one.‍

2020 has been a confusing mess. I pride myself on my ability to cope with stress, to break down the big picture without getting overwhelmed and to stay focused on my goals and priorities.

Seriously, I’m like a Zen master in training since a 2003 cancer diagnosis. But hot sweats, 3am panic attacks, rapidly worsening vision, heart palpitations, migraines, fatigue and brain fog have been somewhat getting in the way of my ability to cope this year. In fact, at times, it’s been outright overwhelming and depressing. Not because of Covid-19 (although that alone would do it), but because of a complete breakdown in my coping mechanisms and what seems like a rewiring of my brain pathways. Like I’m suddenly in charge of something I have no idea how to drive, let alone how the engine works.

At 44 I feel freakishly young to be navigating this minefield, as I stand at the precipice of perimenopause, looking out over the horizon of menopause, wondering exactly how I got here. And how the hell will I get out?

In 2018 I was asked to moderate a panel on “ageing with grace”, hosted by some incredible leaders in the New Zealand wellbeing community. Amid the discussion of hydration, rest, vitamin D and other interesting topics came a line from an integrative doctor that resonated so clearly with me.

“Many women go through their whole lives with little in the way of mental health problems. Then in middle age, with menopause, suddenly they’re forced to deal with emotions and issues they’ve never had to deal with before and they’re not well-equipped to do so.”

The room fell silent at this. I remember looking around at a room of women who finally felt seen. My eyes welled up.

I was 41 years old and had just started experiencing the “first flushes”, if you will, of perimenopause.

The fact I would go through menopause early surprised no one. Diagnosed with breast cancer at the age of 26, I had been told it possible chemotherapy would ‘throw’ me into menopause (most verbs to describe the process are violent, which you will understand once you experience it). That didn’t happen. As it’s a hormone-dependent cancer, I then started a medication, tamoxifen, to stop ovulating. Again, I was told to expect menopause. When it still didn’t occur I was given injections (Zoladex) to induce it once and for all.

A chemically induced menopause is especially violent and my poor little body hated it. Of everything I’d been through that year – the loss of my breast, my hair, the weight gain from the medication – I still felt that on a certain level nothing had changed the essence of me. Until menopause hit. My energy was zapped, I could no longer be in a room with groups of people. I stopped going to gigs at the Kings Arms, I stopped sleeping, and just thinking about something uncomfortable would see me break out in such a heavy sweat I would often need to change my clothes.

It was of course a means to an end, with the end being survival. I am of course forever grateful to that. And for the fact my determined little hormones pushed through the other side of it, allowing me to have two beautiful boys.

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But I’ve never stopped feeling like my poor hormones are constantly getting me into trouble. From getting my period at age 10, when my school wasn’t equipped to deal with it (if the pad burner wasn’t stuffed so full of vandalistic crap I could actually use it; the kids standing outside the cubicle would hear the creak of it being used and mock me mercilessly), through to being told my cancer was literally feeding off them, to now experiencing early menopause. I really feel like they’re trolling me.

Other examples of said trolling: when I managed to have a severe endo attack during chemically induced menopause. It was initially diagnosed as secondary cancer of the ovaries due to the supposed inability of my body to perform like this. Later, when pregnant, hormonal changes to the proteins in my blood resulted in a spike in cancer markers that led oncologists to assume I would die of secondary cancer after giving birth. And the fact that this weekend I had my first period in six months, which brought with it more debilitating endometriosis pain.

Since the “ageing with grace” talk two years ago, I’ve worked incredibly hard to balance my hormones. I practise yoga and meditation. I eat lots of leafy and cruciferous greens, freshly ground flaxseeds and healthy oils. I drink very little. I spend a fortune on supplements and CBD products.

In a pre-Covid world this kind of “self-help” was an indulgence, an active and interesting self-research project into what modalities worked for my hormonal (and mental) health. In 2020, as my oestrogen levels have plummeted, so too has my income. I no longer have $120 a week to spend on a vitamin regime. And there are frighteningly few other options.

Maybe it’s just my age or maybe there is an opening of societal barriers, but I am starting to see a lot more discussion around perimenopause and menopause; of how desperate and isolating it can be. The majority of these stories end with “and then I discovered HRT and it changed my life. I realise there’s no reason to be fearful of it!”.

Sadly for me there is a reason. As a breast cancer survivor, I am not a candidate for hormone replacement therapy nor will I ever be. For me, the only prescription answer is a low-dose SST, or antidepressant. I’m certainly not against this, it just feels odd after 44 years of no mental health problems.

It seems odder, still, that the medical profession has no answers or practical solutions to something that affects half the population, so women have to suffer through the frankly exhausting work of advocating for themselves. Of vetting through the snake oil salesmen and billion dollar “wellness” industry to find an individual fix, of running homes, families and businesses all while suffering from major physical and emotional malfunction.

And of course, most of this is done in silence. Society is repulsed by a woman who is ageing (just ask Donald Trump or Leonardo DiCaprio) and there is nothing that screams “I’m old” more than the mention of menopause. So we continue to dye our hair, inject our wrinkles, pluck our chin hairs, grit our teeth and continue to soldier on; to hold down jobs that will allow us the income to cover the illusion while never letting on that the real damage is happening internally.

If I sound vaguely hysterical it’s because I am.

Keep going!