Birthday Reflections: 44

As I celebrated another waltz around the sun this week (yeah 44!), I’m keeping to my annual “birthday reflections” post. Being an external processor means I pretty much verbalize whatever is in my head, so this year’s reflection has to do with women’s health. Specifically, perimenopause (fair warning! long post! TMI!)

The average age of menopause in America is 51. It’s not your typical polite dinner conversation, but the reality is perimenopause—the 4-6 years before your last period (which signifies menopause)—are pretty awful. And it can last 10+ years!

When we were going into puberty as preteens and teens, most moms sat us down to talk about how our bodies were changing. No one does that for perimenopause. Now that I am going through it, I talk about it with anyone who will listen! (Signal eye-rolling from Justin and my sister …) 

My menopocalypse started around age 35. Here’s the thing though. I didn’t connect the dots that all of these things I was experiencing could be related to perimenopause until more recently. And that’s mainly why I want to share the TMI, because I think there may be other women out there wondering what’s up with their body and these unexpected myriad of symptoms that no one tells you about. Please take everything I am saying with caution: I am certainly not a doctor, and only speaking to my experience and conclusions based on my personal research. 

So let’s rewind to 2013/age 35 when I believe my hormonal roller coaster started. Many people know I ended up in a hospital with blood clots in both lungs. While the cause couldn’t be pinpointed, being on birth control for ~20 years was certainly partially to blame. Doctors recommended I go off the pill, never get pregnant, and never take hormones again. 

I believe losing that extra dose of hormones (estrogen and progesterone) I was receiving through birth control had an impact, because shortly after going off the pill, I started experiencing headaches, insomnia, anxiety and major mood swings. 

I’ve always been susceptible to headaches, but the ones I started having in my late 30s were migraine-ish. 

Insomnia has been my male mistress most of my life. Although my 20s were probably my golden age of sleep, I resigned to the torment of tossing and turning between 2am-4am in my 30s and 40s. I just could not turn off my hamster-wheel-spinning brain during those vampire hours. 

The anxiety, on the other hand, was new thing for me. I would drown in a sea of panic, ruminating over menial things that happened in the past that I couldn’t change nor feel better about. Even though the cyclone of thoughts would often be illogical and irrational, I couldn’t control my obsessing. And sometimes, I spit that anxiety out as anger. Since puberty, hormones have been fluctuating, so mood swings were common. But a spectrum of emotions—happiness, sadness, worry, satisfaction, restlessness, relief—started pouring out of me like spilled milk, and sometimes all at once. It was almost like an out-of-body experience … I didn’t recognize myself and I felt very unhinged. 

This went on for a few years. We were still blowing around the country with the wind, so I wrote the heightened insomnia and anxiety off as byproducts of the lifestyle wearing on me. 

Around 2017 (age 38), I started having more frequent periods. My doctor at the time said I was too young for menopause, even though I told her my mom hit it at 37. She was concerned that the irregular periods were a sign of endometriosis, so sent me for an ultrasound and biopsy (normal results – phew!). 

That doctor retired, so I switched to another. Meanwhile, my cycles became regular again, but I was still having the anxiety and crazy-bad insomnia. I mentioned all this to my new doctor, and even mentioned the menopause thing, but she again said I was too young for menopause. She did suggest starting a low-dose anxiety med (Lexapro for the win!) and talked me through some over-the-counter options for my insomnia. 

I strolled into my 40s, feeling more balanced on Lexapro and finally being able to sleep through the night thanks to diphenhydramine (Benadryl) every night. 

Then right around 42, I was inundated with a few more unexplained and unexpected “issues” popping up.

I started having terrible brain fog. My type A organization trait seemed broken because I often felt scattered and had to really stop, concentrate and think through what I’m doing step by step. I was never all that sharp and snappy, but still, this felt like my thoughts were moving through honey. And the word finding was getting more frequent with that tip of my tongue syndrome. Forgetfulness too. If I don’t write it down the minute I think of it, it’s gone forever. My paper planner definitely helped me reduce stress and increase focus to triage my priorities. But sometimes I wonder if this is all just early-onset Alzheimer’s????

On top of my sluggish thinking, I’ve also felt less energy and motivation. I get overwhelmed easily by decision making, and suffer from planning fatigue. As such, I’ve started being more intuitive of preserving my energy. I say “no” more often and have dialed back socially. I wholeheartedly think I’ve turned into an introverted homebody who will come out of her shell on her terms! 

Physically, I’m definitely getting a little thick and flabby around the middle … And with that unexpected weight gain, I started noticing some joint pain. The axles on this engine are definitely starting to rust! 

Some other odd issues I’ve noticed: adult acne (didn’t I suffer enough as a teenager???), dry, itchy skin, particularly on my palms and face, and circulation deficits. For example, my right thigh goes numb, my right wrist and elbow ache, and my left calf feels so tight at night that only wearing a compression sock seems to help. 

If you’ve ever heard about menopause, you probably heard about the hot flashes and low libido. Both of those are part of my life as well. This year, I went 6 months without my period and the hot flashes were awful during that time. My “aunt flow” returned, then disappeared for another 2 months, causing more hot flashes.  

This year I started going to another new doctor since I had established my residency in Alaska and switched insurance plans. She also agreed I was a little young for menopause, but suggested taking bloodwork in April to check the levels of my thyroid and follicle-stimulating hormone. Normal ranges for FSH typically fall under 21, but mine was 55.5. Mystery solved! That is an indicator of perimenopause (until I don’t have my period for a year, then it is officially menopause). I felt so grateful for the validation!! And now I just blame every little symptom on hormonal decline and succumb to my body being the boss now …

Ladies, please reach out to me and tell me I’m not alone! I’ve already checked in with most of my older girlfriends, and the consensus is “I remember a few hot flashes and headaches, but overall it wasn’t that bad.” Am I the only one who feels like perimenopause is holding a malicious grip over me??? I’ve been doing more reading and listening to podcasts about fluctuating hormones in perimenopause because knowledge is power. I feel seen when I listen! I have a few girlfriends my age who do nod their head in agreement, and as one said: “It’s like everyone is having their own nightmare, but all at the same time.” I guess you’re truly a grownup when you really start wishing your friends “good health” on their birthdays, ask about their ailments and give advice on caretaking for parents. 

(For the record, my favorite podcasts include: Hit Play Not Pause, Thriving in Menopause, Menopause Management and I am not broken.)