Managing Marriage and Motherhood on My Way to Menopause

While lying next to my daughter Aria and chatting before saying goodnight, she joked, “Mommy, is that a beard?” My ever-observant 7-year-old had noticed the tiny, dark strand of hair sprouting from my chin. I laughed. “No, it’s not a beard.” She narrowed her eyes and pointed, grinning before asking, “Is it gonna be like really long?” We laughed again, and I explained that this was just more of what Mommy’s body has been going through as she gets older, that it’s been going on for a while, and that I pluck the hairs even though it is uncomfortable to do so. As she settled down to sleep, my smile faded and I became more pensive, reflecting on these changes and how to communicate this phenomenon to her.

Entering perimenopause at age 35 is not unheard of, but I was definitely not expecting it when it hit. According to the Centers for Disease Control and Prevention, this transition usually begins between ages 45 and 55, with the average age in the United States being 52. But some begin later, and others, as in my case, start to transition earlier. I certainly began before anyone else I know and before the other women in my family had in the past.

There is often a cycle of silence around bodily changes.

At almost 37, I’ve had more than a year of symptoms, from occasional issues such as breakouts and brain fog to chronic issues like insomnia, night sweats and not wanting intimacy with my husband. At least the era of slight urinary incontinence I was experiencing earlier this year (so fun!) seems to have stopped for now.

Although this phase of life can feel isolating, I know that I am not alone. Menopause does not discriminate; it is an inevitable part of life for millions. But that doesn’t mean that the symptoms of menopause are a universal experience. Quite the contrary: Symptoms can be mild, severe or somewhere in between, with much more nuance than we might think.

Officially, menopause is determined after a menstruating woman doesn’t have a period for one year. However, there is no official diagnosis for perimenopause — the transition to menopause — merely a series of clues based on a combination of physical and emotional symptoms, such as difficulty in sleeping, changes in mood, difficulty in concentrating and hot flashes.

In general, there seem to be fewer resources and less awareness of perimenopause. Recently, I went with Aria to the drugstore, mainly to buy Estroven, an over-the-counter medication to treat menopause symptoms. I was frustrated but not surprised to discover that although the chain carried four different kinds of Estroven for menopause, the only kind of Estroven that addresses symptoms of perimenopause was not stocked. Seems I will have to keep ordering online.

There is often a cycle of silence around bodily changes. I didn’t talk much with my own mother about the changes she was going through in her late 40s. I remember her mentioning hot flashes, and I recall how she would roll down the windows even during Michigan winters. I felt annoyed that she ignored my shivering, but I realize now that I was ignoring the very real surge of heat going through her body. In retrospect, I also wonder if any of the tension between us that I dismissed as personality differences, teenage angst and normal mother-daughter quarrelling may have been connected to “the change” as well. But I also don’t want to be reductive or dismissive by blaming hormones. Society does enough of that to us.

There is very little training for this transition, and only 6.8 percent of doctors report feeling “adequately prepared” to address menopause, according to a 2019 study.

I want to be more open with Aria than my mom was with me, and my grandmother was with my mother. That seems to be the trend with each generation. Nearly 9 in 10 (88 percent) of millennial parents say their parenting style is different from how they were raised, and the top difference is engaging in open communication. As more people decide to have children later in life, the number of mothers raising school-age children while going through perimenopause or menopause continues to increase.

Parents navigating major hormonal changes may face additional challenges. “You’re already not feeling great, and then you have little children who demand a lot of time and energy from you that you may or may not have. And then also sleep; they’re waking you up and your sleep is already disrupted because you’re either having night sweats or your sleep is disrupted from hormonal changes,” says Naomi Busch, M.D., a certified menopause practitioner and board-certified family medicine physician with Seattle Menopause Medicine in Green Lake.

I understand this well. I have even less energy to play with Aria, and I sometimes worry that she will feel rejected, even as I explain I’m not feeling my best. These days, it is normally my husband who is more active with her. I selfishly wish she could remember the first few years of her life when I was the one who played with her every day, never denying her indomitable will to frolic.

In fact, these days I don’t want to do as much in general. This listlessness is exacerbated by fatigue, brought on by overall tiredness from hormone shifts and insomnia. I have been a night owl for decades, but this exhaustion goes beyond a preference for the nocturnal. Occasionally, it really does hurt to get up; achy joints and muscles are a symptom of perimenopause as well. I get migraines more often now, too.

Although I am trying to be more open with my daughter, I am also keenly aware that I need to watch what I say around her about my body as I’ve gained weight over the past year. Even though I know that weight gain is another common effect of perimenopause, along with overall shifts in body composition, this change continues to affect how I feel about myself, and the pictures I take, and the ill-fitting items in my wardrobe that I stubbornly refuse to part with just yet.

Although curves are more accepted in mainstream society than they were when I was child, that type of weight is distributed in a very specific, hourglass-shaped way — unlike, say, the double chin I am getting (the same chin that has the three tiny hairs growing out of it).

Speaking of hair, the hair on my head seems to be at a standstill, despite my best efforts to grow it out. Thinning and slower-growing hair also happen for many people in perimenopause. Sometimes I even get a few pimples these days. Acne is something I haven’t had to think about for 20 years, since “Friends” went off the air and the iPad mini came out.

However, the worst part of perimenopause has been the brain fog. I have never been particularly confident in my looks to begin with, so the changes to my appearance are disappointing but not devastating. My physical symptoms are perhaps annoying, but not extreme. But my intellect, my sharp wit — those were things I could always count on. But ever since the onset of perimenopause, my mental acuity has taken a hit. It is harder to focus. I am slower to recall things, even though I have always been known for having an impeccable memory. I sometimes lose my words or am slower to mentally calculate sums that used to take me only seconds.

As neuroscientist Lisa Mosconi, Ph.D., explains in her best-selling book “The Menopause Brain,” cognition is directly impacted by a decline in estrogen. “Notably,” she writes, “the menopause repertoire features at least as many brain symptoms as bodily ones.” I see now that I was more prepared for pains in my less than perky breasts than I was for neurological shifts.

As unprepared as I felt when the first perimenopause symptoms hit, many professionals are likewise not equipped with sufficient knowledge. There is very little training for this transition, and only 6.8 percent of doctors report feeling “adequately prepared” to address menopause, according to a 2019 study.

Perimenopause might seem as though something is coming to an end, but if you let it, it can also mark a beginning.

But I am learning more all the time, and I am facing it head-on with my family by my side. I have always been introverted, but these days I socialize even less, preferring to watch movies at home with my family. My emotional sensitivity has also increased, but I have chosen to lean into my feelings even more intensely. I have been reading about menopause through books and more Google searches than I can count. In addition to Estroven, I take more vitamins and supplements and try to eat healthier. Sometimes meditation helps me fall asleep (even though I cannot always stay asleep). Exercise is supposed to help, but I haven’t resorted to that yet!

I have also spoken a bit with my mother, mother-in-law, grandmother (my 94-year-old Nana, who will not even say the word “pregnant”) and an older friend who has a child at my daughter’s school. After they got over their surprise because of my relatively young age, we swapped stories and laughs. I have started thinking more about my legacy. Perimenopause might seem as though something is coming to an end, but if you let it, it can also mark a beginning.

How women can support themselves through perimenopause and menopause

• Enacting a sense of agency can be empowering. Speak to your health-care provider sooner rather than later. Fortunately, mine was supportive, knowledgeable and took my concerns seriously. Your physician may recommend medication, hormone replacement therapy or something else.
• Busch advises that we ask ourselves, “How have you been communicating about your own needs?” Instead of bottling up your feelings and trudging through it (or worrying about being a burden), as so many do, Busch suggests being open and honest with those close to you if you haven’t been feeling well or feeling like yourself.
• One piece of sage advice offered by Busch is something I hadn’t even considered: bringing awareness to the workplace. Check with the HR department to see if the thermostat can be adjusted. If you wear a uniform, ask if you can switch to cotton instead of polyester, for more breathability. Busch also recommends checking to see if employer-sponsored insurance will cover menopause medication and treatments. Some of Busch’s patients have had to pay $140 a month or more out of pocket, something she hopes will shift: “We as a society should try to support the women in our lives by advocating for those types of benefits.”
• Give families, especially partners, a chance. They are often more capable of understanding than we give them credit for.

How families can support perimenopausal and menopausal loved ones

• Be supportive, believe your loved one and be patient. Try not to make jokes at their expense or belittle them. Instead, be sensitive to what they are sharing about what they’re going through.
• It’s helpful for partners to take over some of the household responsibilities and caretaking, perhaps offering to share the load of waking up for nighttime feedings or to soothe away bad dreams.

It’s not all bad

Although much of the often limited conversation around menopause is frequently gloom and doom, I like the idea of more gray hairs (I have a few already), along with the prospect of no longer menstruating and never having to buy period products again. Although it could turn out that my daughter may be starting her period just as I’m ending mine.

While he doesn’t “get it,” my husband has been pretty supportive, allowing me more time to rest when I need to, and being more active in child care.

Despite the bouts of sadness that can strike perimenopausal and menopausal women, studies show that women are, on average, happier and more satisfied with their lives after menopause. I would hope so, since 40 percent of most women’s lives are lived after menopause. For me, I would say that I am the happiest I’ve ever been these days, and I am still in the thick of things.