Wishing I weren’t here--
Technically speaking, menopause is the cessation of a woman’s menstrual cycle, occurring sometime between the ages of 40 and 55. But the internal changes that culminate in this event begin many years earlier. These internal changes can produce symptoms that appear one month and may not return until many months later. The woman may be alarmed by the symptom and surprised to find out it is related to menopause.
That’s what happened to me.
was 43-years old, a bride again of four months, and feeling great. I was
looking forward to visiting my husband’s hometown in
We arrived on a Friday, a beautiful fall afternoon. The trees had just begun to change colors, and the air held a slight chill. We enjoyed a few hours of nostalgic remembrances for Steve as we visited his childhood homes, his high school, his college, and his favorite haunts. That night we joined his family for a leisurely dinner at their favorite restaurant. All indications were that we had a relaxing weekend ahead of us.
In the middle of the night, I woke up feeling bloated and slightly uncomfortable. I went to the bathroom and was surprised to find that I was bleeding heavily. My period, always uneventful and easy, should have lightened and ended soon. By morning, I had been up a few more times and continued to be perplexed by the heavy bleeding. Otherwise, I felt fine; no cramps, no other symptoms at all.
We began our day of scheduled visits to a number of Steve’s friends. I assumed I would be fine, so long as I made a restroom stop every hour or so. But by that afternoon, I couldn’t make it more than ten minutes. I was alarmed and embarrassed that, in front of strangers, I had to excuse myself to go to the bathroom continually. Finally, I told Steve that I was a little scared and thought I should go to a 24-hour emergency medical office. There was no way I could speak the next day if the bleeding continued at the same rate.
On the way to the clinic, I was afraid and confused. I had never had any trouble whatsoever with my period. All I knew about abnormal bleeding was that it could indicate cancer. I envisioned a huge tumor in my body about to explode. I had no physical pain, but emotionally, I was in agony.
We arrived at the clinic, and I felt a measure of relief in knowing help was at hand. As soon as I had filled out the registration information, the receptionist put me in a room to see the doctor. I was embarrassed at the thought of being examined by a stranger when I was such a mess. The nurse was very sympathetic. “Don’t worry, the doctor sees a number of women for similar emergencies.”
Similar to what? I asked myself. I had never heard any woman say anything about this kind of episode.
The doctor was pleasant and reassuring. He said the heavy bleeding was probably a hormonal imbalance related to my age. I remember thinking to myself, My age? What about my age? I didn’t ask him what he meant. I just wanted him to fix my problem.
He gave me a hormone shot and told me to see my own doctor as soon as I got home. I promised him that I would. I also persisted in getting him to promise me that I would not be embarrassed as I stood in front of a church full of people the next morning. He promised.
“You’ll dry up like a desert in an hour or so,” he said.
I was exhausted. Steve and I canceled our evening plans and went back to our hotel. We ate in the room and watched television. I was preoccupied with worry about making it through the next day’s speaking engagement and the plane ride home.
Fortunately the doctor was right. My body reacted to the shot in the manner of a gushing faucet having been turned off suddenly. The bleeding stopped completely. It wasn’t until we were on the plane on the way home that I wondered again about the cause. It couldn’t be related to menopause, because that only had to do with hot flashes and the cessation of bleeding. Besides, menopause happened to older women, not to me at the age of 43. I was worried that the bleeding was a sign of cancer.
I called my doctor first thing Monday morning. Tuesday morning I was in her office telling her of my harrowing experience. Since the bleeding had been so heavy, she suggested one of two things: a biopsy to rule out cancer or a D and C (dilatation and curettage--scraping of the uterus) to not only rule out cancer, but to help prevent future bleeding episodes. I tend to make quick decisions and remained in character that day.
“Let’s go for the D and C and get this over with,” I said assertively, confident that my temporary problem would be over. My doctor thought I would be fine to have the procedure done in her office with local anesthesia.
My husband and I arrived at the doctor’s office on the appointed morning. By that time, I had grown nervous about the procedure. The day before, I had talked with a friend who had had a D and C. She swore she would never again have one without general anesthesia. She wanted to be completely knocked out. I decided to keep my appointment and persevere with my plans, but her words lingered in my mind.
I was given a shot to calm me and make me feel sleepy. It worked; I was barely awake. The procedure was uncomfortable, but not painful. Time blurred completely. When it was over, I had to be led to the car by my husband, and I immediately fell asleep on the ride home.
The D and C revealed no evidence of cancer. The diagnosis was “hormonal changes.” It may be hard to believe that I didn’t ask any questions. But at that time, I accepted it to mean my hormones were fluctuating and no other symptoms would occur. Just in case another incident did occur, however, my doctor prescribed birth control pills, which contain hormones, to have on hand. Taking one or two of them would stop any unexpected bleeding. Always consult carefully with your doctor. If there is a possibility that you are pregnant when bleeding occurs, taking medications with hormones is dangerous.
Life went back to normal, and I almost forgot the whole incident. The bleeding, which I now know was hemorrhaging, happened again about a year later. This time I had the birth control pills with me. Once again, I was out of town for a speaking engagement, so when I returned home I called my doctor. This time she did a biopsy instead of a D and C. (A biopsy examines the tissue to rule out cancer. It does nothing to prevent further bleeding.) Again, thankfully, no cancer. The diagnosis: hormonal.
Unlike my experience with the D and C, the biopsy actually caused more bleeding. This, too, is normal, but it was nonetheless disconcerting. I became apprehensive about future episodes of unexpected hemorrhaging and carried tampons with me all the time, along with the magic pills that would shut off the spigot. There were three more incidents in four years, and all three occurred when I was traveling. I learned that this is a normal, early symptom of menopause.
In the years following that first sign, I lived with a general sense of watchfulness. Other symptoms kicked in, including anxiety attacks, dizziness, and forgetfulness. There was no pattern or consistency with any of these interruptions. Anytime, anywhere, I could start bleeding, sweating, feeling dizzy, or emoting dramatically.
This probably doesn’t sound like good news. But by being informed and preparing for what is to come, much of the fear and uncertainty of the beginning phases of menopause can be alleviated.
The first symptoms of menopause signal the beginning of a process that can last for several years.
In the book Managing Your Menopause Dr. Wulf Utian and Ruth S. Jacobowitz define the word that is used to describe this entire process.
The word “climacteric” comes from the Greek and means “critical time.” Sometime during this so-called critical time (generally a ten-year span between the ages of forty-five and fifty-five) your last period will occur--usually when you’re around the age of 50. But changes are happening long before that time, and beginning in your thirties, you may not only notice them but you can do something about them.
The process unfolds this way:
Often the word menopause is used to refer to the entire process of the climacteric. That is how the process is defined in this book.
Understanding menopause and how to respond to it can help a woman move through the process more smoothly than a woman who begins with little warning or knowledge. But why don’t women know more about this process?
My mother was from the old school. You know, the one that touted the doctrine: You should never talk about religion, politics, or sex. I never questioned her. I accepted that these subjects were off-limits. While religion and politics filtered into our dinner-time conversations occasionally, s-e-x never did.
My parents’ involvement in my sex education consisted of my mother slipping me a book when I was 12 and telling me to read it. I remember it being excessively technical and boring, with no pictures or sketches, which was disappointing. Of course, the other kids at school had long ago told me about the “birds and the bees.” So, after a week, I handed it back to my mother without a word. She took it, and that was that.
When I was growing up, my mother never mentioned menopause. It might be assumed that as one’s own mother entered this life passage, a daughter would hear (or overhear) what was happening. I did not. My mother was rushed to the hospital one morning when I was ten years old. She was 46 and had some sudden, secret something happen in the middle of the night. My father took her to the hospital, and I stayed home with my grandmother, who helped keep the secret. When my father came home later that day, he told me she had undergone a hysterectomy and would be home soon. I didn’t know what a hysterectomy was, nor did I ask. I was simply glad when she came home and all was well again.
Both my mother and father treated any sexual subjects as shameful. The fact that menopause involves a woman’s sex organs would have been enough to keep them silent.
Many women now over the age of forty or fifty grew up in households similar to mine. I know because I interviewed over 100 of them for this book. Their parents did not talk about sex, and their mothers did not talk about their menopause when it occurred. Some of these women have since asked their mothers about this taboo topic. The ones whose mothers talked freely after the fact described symptoms like those their daughters experienced. The main difference was that those women suffered in silence.
Now we live in a different time, where s-e-x and m-e-n-o-p-a-u-s-e are discussed a little more openly. Well, sex is, anyway--menopause, less so. To help you bridge this conversation with your daughter, I’ve included a set of Postcards From Menopause in the back of this book. To use them, answer the questions or journal about the suggested topics on each card, then send the cards to your daughter or a younger woman who has yet to experience these changes. (If you need more sets of cards for daughters two and three, call 1-800-FL-TODAY or log on to www.familylife.com.)
If you’re approaching menopause, it may be that your daughter is busy chasing toddlers; she may not feel that an in-depth discussion on menopause is relevant right now. If she doesn’t seem interested, suggest that she tuck these cards away. In ten or twenty years she’ll wonder, What did Mom go through? Is this normal? At that time, she’ll be grateful for your in-the-moment writings on your experiences. Hopefully, you’ll be there to answer any questions she may have, but if you’re not, she’ll appreciate your forethought in preparing her for this life stage. She’ll be relieved to know that you did not suffer in silence, and neither should she.
To better understand why our mothers and grandmothers endured this change without a word, let’s look at the way menopausal women were portrayed in recent history.
At the beginning of the twentieth century, many people (men and women) thought that menopause equaled insanity. Menopausal women were described as hysterical females who were over-sexed, self-indulgent, and subject to madness.
One of the popular books of the day, The Dangerous Age, a novel by Karin Michaelis, was published in 1911. The central character, Elsie Lindtner divorces her husband and runs away with a younger man. This behavior is attributed to her mad state as a result of her age.
Lois Banner, describes Elsie and her friends in Banner’s book, In Full Flower.
As the novel progresses, most of Lindtner’s middle-aged women friends suffer emotional breakdowns. Some alternate between mania and depression; some leave their husbands. Some become obsessive; one woman cleans her house over and over again. Another is institutionalized and treated surgically.
This view was so prevalent in the early 1900s that it was reflected in the name chosen for the surgery common to women between the ages of 40 and 50—hysterectomy. Lois Banner explains how this word came into existence.
Michaelis’s presentation of menopause as producing insanity resonated in the views of many gynecologists. Drawing on misperceptions standard for centuries, many gynecologists posited a direct linkage between the uterus and the brain. (Such a belief would result in the term “hysterectomy” for the removal of the uterus and ovaries, referencing the mental condition of hysteria and its presumed connection to female reproductive organs.) And such beliefs were extended to aging women.
Not everyone agreed with this negative picture of menopausal women. In 1912, the opposite image was popularized in the book Woman’s Share in Social Culture by Anna Garlin Spencer. Lois Banner describes this view: “Spencer drew from contemporary evidence that women lived longer than men and were more vital in older years to assert that menopause afforded women a ‘second youth.’”
These conflicting views of menopausal women continued to cause confusion. Banner continues, “The first opinion has been that menopause is an illness bringing a breakdown of body and mind. The second has been that menopause initiates a time of strength for women.…”
By the 1930s and 1940s, it seemed that the first opinion was winning the popularity poll. Growing numbers of women were being diagnosed as insane due to menopause. Hospitals had whole sections for mentally disturbed, menopausal women.
I can understand why my mother and other women her age decided to keep quiet about any menopausal symptoms they were experiencing. They could have found themselves institutionalized as a result of speaking out.
Menopause is not mentioned directly in the Bible, but there are two examples of women who bore children after they were no longer of childbearing age: Sarah in the Old Testament and Elizabeth in the New Testament.
In the Old Testament we read, “Now Abraham and Sarah were old, well advanced in age; and Sarah had passed the age of childbearing” (Genesis ). God intervened, and Sarah gave birth to Isaac.
the New Testament,
These passages are silent with regard to menopause except to show that God chose to intervene in the lives of both these women and give them children even after they were old. But, while the Bible is silent about menopause, it has much to say about age.
When my daughter, Lara, was in the sixth grade, she had to find a Bible verse that described her mother. At the end of the school day, she proudly brought her paper home to me with her verse describing me. “The silver-haired head is a crown of glory, if it is found in the way of the righteousness” (Proverbs ).
I was 38 years old at the time, but my hair was very gray. (I have always preferred to call it white.) Lara beamed up at me as I read her paper. I smiled, hugged her, and thanked her for thinking of me as righteous, evidenced, in part, by my silver crown.
It was a mixed blessing: My daughter admired me but described me as aged. The incident made me realize that the Bible does have some positive things to say about aging. Older people are presented as possessing wisdom worthy of respect:
Wisdom is with aged men, and with length of days, understanding. --Job
You shall rise before the gray headed and honor the presence of an old man, and fear your God: I am the Lord. --Leviticus 19:32
But, it also acknowledges declining health in old age.
the eyes of
Do not cast me off in the time of old age; do not forsake me when my strength fails. --Psalm 71:9
Perhaps the most well-known biblical text that describes a godly woman is Proverbs 31. This passage focuses on the character of a wise woman, not her physical condition. It lifts up the qualities of virtue, industriousness, wisdom, kindness, and fear of the Lord.
The Bible paints a picture that defines women without reference to menopause and uplifts both men and women who attain an old age. But current society has not pursued the same ideals.
few years ago I ordered a body lotion from a store in
There were creams for the eyes, nose, mouth, elbows, hands, feet, thighs, legs, and “special” creams to boot. Evidently each cream knew how to work on its designated body part--but not on any other. Heaven forbid that you mix up your eye cream with your thigh cream. No telling what would happen.
I sadly confess that I have tried a number of these panaceas for aging. I have now faced the stark reality that, of course, they don’t work. Why have I wasted money on such foolishness? Because I have bought into the American dream that says youth is the only form of acceptable beauty. I swallowed the cosmetic companies’ claims of regaining a youthful appearance with their wonder creams.
Intellectually and spiritually I know that this is not true, but it is difficult to dash the hope of looking forever young.
Fortunately, I am changing my mind, and I am beginning to give up my quest for the fountain of youth in a bottle. While writing this book, I met the most engaging women who unashamedly accept the physical results of aging, and they do it with style. They don’t worry about wrinkles or a little weight gain. They take care of themselves physically but operate on the truth that beauty is more than skin deep. Advertising may be targeting older women with the promise of looking younger, but many older women are focusing on far more fulfilling arenas. They are trying to improve in areas of life where they can learn and grow instead of trying to be something they are not.
For many menopausal women, aging and beauty began to take a back seat in July of 2002 when the medical community announced that using hormone replacement therapy (HRT) increased their risk of breast cancer, heart attack, stroke, and blood clots. With that discovery, treating menopausal symptoms safely became far more important than minimizing laugh lines or crows’ feet.
On a list of priorities, effective and safe treatment for menopause certainly outranks disguising age. And that, I’ve found, is just not possible, as my next story tells.
on in my menopause journey, I had been visiting my daughters in
One jewelry store displayed enticing signs that announced discounts of 40 percent to 60 percent off each purchase. I picked out some earrings for my daughters and myself and went up to the counter. The clerk, a woman about my age at the time, smiled and rang up my items with the discounts. Then she said brightly, “And, you get an additional 10 percent off!”
“Oh, great!” I smiled back. “How come?”
She turned and pointed to a little sign on the wall behind her.
TUESDAY IS SENIOR DISCOUNT DAY--ADDITIONAL 10% OFF
I was shocked. My heart started to race, and I had to stifle the urge to punch this friendly lady right in the mouth. Senior Discount! Is she kidding? I wasn’t even 49. How dare she!
I was screaming at her in my mind, I smiled weakly and thanked her. I could
feel the redness of embarrassment creep up my neck, over my face, and even into
my scalp, which was concealed by my white hair. That did it for shopping that
day. I took my old, exercised body and slinked into my rental car. The four-door
The clerk in the store didn’t mean to insult me. She was giving me an added discount on merchandise. But, I felt both wounded and outraged.
After that experience, I realized how sensitive I would need to be to the women I approached for interviews for a book on menopause. As I made those approaches, I was pleasantly surprised. The first women I talked to were so enthusiastic that I decided to try another idea. I asked women if they would be willing to be interviewed in focus groups of approximately the same age range.
The first group met during lunchtime. (They all worked.) I was amazed at the openness. Nobody wanted to stop at the end of the hour. I found myself greatly encouraged and less anxious about some of my own symptoms and feelings. Other women had experienced the same things. They were able to laugh, talk, and offer suggestions. The atmosphere was warm and relaxing, exactly the opposite of what I had anticipated.
After that first one, all the groups met in women’s homes. When the research was completed, a few of the groups decided to continue to meet as support groups. The setting was safe, and the stories from other women were comforting.
The silence seemed to be over, and women were ready to talk. That openness continues today; in fact, it is growing. Every October 18, World Menopause Day is celebrated by women who intend to raise awareness of the issues connected with menopause. The World Health Organization says that 1.1 billion women will be age 50 or over by 2005. Many of these women will benefit from this growing awareness.
Menopause happens to each woman blessed to reach this age. Our generation and those following are further blessed with newfound information. This, and a touch of wisdom, enhances the way we move through this life passage.
Remember that God designed our bodies to make this change; it’s a natural part of aging. While it necessitates adjustment, it also brings new insights, freedom, and fresh perspectives. Even thought there were times when I wished I were elsewhere, this life stage isn’t all bad.
Nothing is permanent but change. --Heraclitus
Every age has its pleasures, its style of wit, and its own ways. --Nicolas Boileau
There is a time for everything, and a season for every activity under heaven. --Ecclesiastes 3:1 (NIV)
Internal changes can produce symptoms that appear one month and may not return until many months later.
Menopausal women were described as hysterical females who were over-sexed, self-indulgent, and subject to madness.
I met the most engaging women who unashamedly accept the physical results of aging, and they do it with style.