It’s imminent.
Any day now, my shriveled little eggs will stop being sent down the line to “nest.” Dry, misshapen little ovum, or so I imagine, scraping their way to my womb with the ever-waning hope of decent company. These last, wheezing little gasps, I expect, are related to a twice-monthly splitting headache that feels like a metal spike has been driven into my cranium above the left eyebrow. And I know. It’s only a matter of months, weeks even, before my estrogen levels do a bona fide loop-de-doo. My bones will begin getting more brittle. Some of my hair may fall out. And I’ll begin soaking my outfits with the perspiration of an inner hellfire.
And that’s if I am lucky!!! Some women have it a whooooole lot worse. I’ve heard tales of debilitating anxiety. Chronic interruption of sleep. Terrible depression. Constant urinary tract infections. Heart disease. The fear of certain cancer risks shooting through the roof, while energy—and a libido—entirely bottoms out. All adding up to a life quality that, for many, feels like it’s completely in the sh*tter. What’s worse is that these, and myriad other symptoms, are sometimes never—depending on the individual and her doctor—properly discussed, diagnosed, or treated as symptoms of perimenopause, menopause, or postmenopause. Women everywhere are desperate for relief from these clashing, clanging bells of a body in total flux. And that sucks.
My mom had a fairly easy time of it. Other family members, not so much. I’ve decided I’d like to enter the next phase of my life with eyes wide open. Which is why when my gym buddy, my work buddy, and my sister all mentioned a book called The New Menopause within the same week—I ran out and bought a copy. Let me modify that. I bought the audiobook, because not only are my estrogen levels beginning to fail me, so is my eyesight.
The book did not disappoint. A #1 New York Times bestseller, The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts was written by Mary Claire Haver, MD, a board-certified OB/GYN who’s spent countless hours in hospital rooms, birthing centers, and operating rooms, as well as decades passionately supporting women through her own clinical practice. Many years in the making, her book is an absolute wealth of knowledge that’s long overdue. When “cougar puberty” hits, I am supremely comforted to know that I’ve got this awesome resource at hand to help me navigate the complexities of hormonal change.
Menopause is an experience 50 percent of the population has in common. You’d think we’d have made research (and help!) in this area more of a priority, but I suppose that’s what you get when you shun women away from the medical sciences for centuries. We’ve got some catching up to do, people!
Can you imagine a time when women going through “the change” were heedlessly institutionalized for a catch-all disorder dubbed “hysteria”? It’s a Greek word which, by the way, means “uterus.” Women, literally locked away for having a womb. (A “wandering” womb, no less, that was at one time believed to move around the body at will, like a wild animal! And, oh my god, if you want to go down that truly hideous but “hysterical” rabbit hole, please visit a little website I stumbled upon called UselessEtymology.com. There’s also a very entertaining chapter in Bill Bryson’s The Body: A Guide for Occupants that describes, in detail, the shocking and not-so-distant-in-the-past theories and treatments for female-specific midlife health “disorders.” But I digress!)
I was especially interested to learn from The New Menopause that women are finding profound relief from menopause symptoms—not to mention mediating their risk of osteoporosis, dementia, cardiovascular disease, diabetes, and even certain types of cancer—with properly timed menopausal hormone therapy (MHT).
Honestly, until now, the only thing I’d ever heard about hormone replacement therapy was from the movie Fried Green Tomatoes. Iggy Threadgood (Jessica Tandy) comforts her dear friend Evelyn (Kathy Bates), whose emotions have been on a rollercoaster and whose self-worth has gone doggo. “You’re going through the change!” Iggy laughs. “You get yourself some hormones!”
While the advice might be a bit pat—and the issue not quite as simple as that—I love the attitude: there is hope! The buck does not stop here. And knowledge is power.
If MHT appeals to you, chapter seven, “Everything You Wanted to Know About Hormone Therapy,” can help you make sense of the dizzying world of hormone products, covering topics like “hormones 101” (estrogens, progesterone, and androgens), types of hormone therapy (synthetic vs. bioidentical, compounded bioidentical vs. FDA-approved bioidentical, etc., etc.), available delivery systems (there are nine!), benefits vs. risks ratio, who should not use MHT, and much, much more.
“Since many women have shared with me directly that they’re not even being granted the discussion of MHT,” writes Dr. Haver, “I can be 100 percent certain that they are not getting an explanation of all of the options that exist. So I’m going to offer maybe more detail here than is necessary, because I want you to know what’s available, and what questions you can ask so you can become a better advocate for yourself.”
I guarantee this is a chapter I will reread many times as I head into the next decade, especially since so many have found that, with guidance from a well-qualified doctor and with careful consideration given to their specific medical histories and their progression along the menopause timeline, the benefits of MHT far outweigh the risks.
I also appreciated Haver’s in-depth discussion of the Women’s Health Initiative Study launched in 1998 that resulted in inaccurate reporting, misinterpretation of data, and alarmist headlines to the tune of “estrogen causes breast cancer.” Haver writes, “I get questions about MHT and cancer risks every day, and this is my chance to offer a thorough take on the science that planted that link in people’s minds in the first place. To be clear, this isn’t about convincing you that hormone therapy is right for you … it’s about providing greater clarity so your decision is based on truth, not fear.”
This book was an eye opener for me—delivering not only the medical science behind what’s happening in our bodies during the three stages of menopause, but what the symptoms might look like (a much broader range than most of us realize, and no, “it’s not all in your head!”), and the daily behaviors—from nutrition to various treatment options—we might adopt to improve quality of life and mitigate risks during a time of hormonal tumult that affects so many critical aspects of our health.
Some of the most eye-opening passages in the book are the testimonials from women about their experiences—most of them expressing the desperation they felt after being unheard or misdiagnosed, sometimes for years on end.
And I think of my own sister—who mysteriously, in her 50s, began having vertigo, chest discomfort, heart palpitations, anxiety attacks, icy-hot tingling sensations on her scalp, fatigue, and itchy and ringing ears—just to name a few. It was a head scratcher; she passed her heart-health tests, brain MRI, shingles tests, and more with flying colors. It was only after reading this book—particularly Dr. Haver’s list of the 60-plus symptoms now associated with menopause—that it dawned on her a lot of what she’d been experiencing was likely related to hormonal change. “I love my doctor,” she says, “but we missed a lot of things. And I hate to say it, but of all the people I saw about these concerns—16 symptoms in all—unless I brought it up, not one of them suggested it could be related to menopause.” My sister’s anxiety levels have gone down enormously—in part, she says, “because now I know there is a reason for these things! It all makes sense. I wish I had read this book in my 40s so I knew what was coming. It would have made a huge difference.”
So what do you do if you’re spinning your wheels, specifically if your healthcare provider isn’t up to speed on the latest research or treatments for menopause care? It may be time to move on. Ask around. You may know someone who knows someone. Consider browsing Dr. Haver’s website, ThePauseLife.com, to find recommendations for excellent, qualified doctors in your area—practitioners who were specifically recommended by women who’ve “been there” and have turned their sagas into success stories with the help of a great doctor.
“A big part of the problem,” Haver writes, “is the failure to include significant ongoing education in the area of menopause in the board recertification process. Board recertification always requires a review—and proven understanding—of educational updates, but those that focus on menopause are simply not being prioritized—even in the area of ob-gyn, the medical specialty that focuses on women’s reproductive system. I have a lot to say about this, but let’s just say it’s not fit to print.”
As medical science struggles to catch up to the needs of half the earth’s population, we’re at least beginning to see some newly relevant resources in print. Books like The New Menopause are a sign of better times for women’s health.
Ladies, time to get ours. Even if it’s not hormones you’re after, there’s a wealth of knowledge in this explicitly explained, thoroughly researched book about every aspect of menopause, peri, and post. These perspectives, from a qualified practicing doctor no less, will give you a solid start as you navigate the second half of your personal century—perhaps even enabling you to redefine the scope and the meaning of the phrase, “your productive years.” You may be done having kids. It doesn’t mean you have to stop kicking ass.
