Perimenopause

Another journey begins. 2015 has brought me into unexplored territory. I’ve started the currently slow and unpredictable process of perimenopause, or the transition time that takes a woman from her fertile period to “permanent infertility (menopause),” according to the Mayo Clinic. Sounds ominous, right?

I’ll admit, the whole thing seems pretty scary for me. You see, I have no frame of reference for this. No family history to rely on. Not unlike the lack of fibroid information from my Mom (thanks again, Mom!), I have nothing to go on regarding perimenopause or menopause. My grandmother never discussed it. My mom had a hysterectomy when I was a young girl. So, I have no one in my family who can shed light on their experience of this big life transition.

I’ll say this, however. I feel very fortunate that I have a terrific gynecologist (and her staff) who are helping me find information and guiding me through this craziness. They were the ones who recognized that I may be seeing the first signs of perimenopause.

It was during my annual exam almost a year ago that my gyn mentioned that if a period ever came earlier than 21 days, after the previous period that I should give her a call. I went as far as making a note of it in Contacts under her name. I didn’t realize that I would need that information so soon.

By the fall of last year, I did have a period that came 19 days after my previous period. I was a little scared. I remembered to call her, but didn’t remember why it was important. It turns out that this is general guidance for anyone older than a teen and younger than 40ish. Although I had turned 50 that year, I was still having normal periods until then. My gyn checked my blood for thyroid issues and ordered a sonogram to ensure none of my fibroids had returned (and that the one remaining fibroid had not enlarged or caused another problem).

Everything was fine, thank goodness. That’s when my gyn mentioned that I could be entering perimenopause. She suggested I Google it and get some more info. I may have looked up one thing, but that was it. After a few weeks, my cycles went back to mostly normal. It changed from an always consistently 28-day cycle to a fluctuating 23-25 days. Still, it was well within the range of not-to-worry. I forgot all about it and went on with life.

When 2015 rolled in, the cycle between January and February was a full 30 days. Hmmm. Then February to March was 24 days. Then weirdness. After that cycle ended, one week passed. Then I started spotting lightly. That lasted about 4 days and then I went into a regular bleed cycle for another 4 days. Somewhere in there, I called my gyn again. She was out on spring break and booked well beyond that, but a nurse practitioner was available in a week and a half. I took the appointment.

A quick exam and discussion about my recent history and the nurse prac confirmed that, yup, I’m perimenopausal now. Woot! Hey, knowledge is power. Unlike what I’ve read about people’s reactions to this knowledge, I’m happy to know. I am now embracing the learning process. The nurse practitioner recommended a book called The Pause, by Lonnie Barbach, PhD. Be sure to get the revised edition. A ton of updated information was incorporated since its original 1993 publication.

I bought the book. I’m reading the book. I was actually stunned to see how many women were quoted as saying, “I thought, okay, this is it. I’ll be dead soon.” WHAAAATTTTT??? Come on, now. This is not 1932. We cannot expect to be dead of old age by 63. This is just another part of being a woman.

Frankly, I think its kind of cool. I’m even sort of enjoying the adventure of the process now. Okay, so it isn’t fun to suddenly and without warning have that uncomfortable feeling and slight back ache that used to precede a cycle by a couple of days only to have the cycle start 30 minutes later. But now that I understand to expect the unexpected, I feel more prepared.

The book mentions that the general assumption is to expect what you experienced while pregnant. If you have ever been pregnant—I haven’t—and had a breeze through the process, you should expect the same through menopause. If, on the other hand, you had a nightmare pregnancy, you are likely to be just as miserable through menopause. Most women fall somewhere in the middle of that spectrum. It’s a crap shoot if you’ve never been pregnant apparently because you have no reference for the effects of wonky estrogen fluctuations and the like.

The one thing I’ve experienced a couple of times that is really bizarre is what I’m going to call Moments of Unexplained Rage (MUR). I had a couple of these MURs and THEN I got to the part in The Pause that discusses them. It has to do with the roller coaster of unpredictable estrogen flow at this stage in life. The process is complicated and technical. Read the book. But basically, it’s like having hair-trigger emotions randomly and unpredictably.

For example, your husband does something that normally would annoy you and make you shake your head, “silly man.” But in perimenopause, sometimes you get physiologically induced abnormal psychological reactions to the most inane shit. Husband forgets to wipe off counter after cutting and toasting bread. Usual reaction: “Honey, you forgot to…oh never mind.” and you wipe off the counter yourself. MUR reaction: “God dammit! WTF is wrong with you? Why can’t you ever…” And then (if you are lucky) you catch yourself. You realize this level of escalation isn’t reasonable. Even as you feel this giant ball of anger boiling up inside of you. It’s frankly the most out-of-control bizarre feeling I’ve ever felt.

The chapter in The Pause that discusses emotions emphasizes communication with your spouse or partner. I explained to my husband that I’d had a couple of weird episodes of irrational rage. I asked him to be patient as I go through this process, however long it may take. I told him that there may be times when I just want to “do my own thing” away from him and that he should try to be understanding of that. If I feel that bizarre rage thing starting to boil up, I’ll do my best to warn him and stay the hell away from him (or anyone else) until it passes.

I actually surprised myself the first two times these MUR happened. I’m normally a very expressive person with my emotions. I don’t “bottle things up” as they say. However, when I realized that what I was feeling was completely off the mark and over the top in relation to the situation at hand, I actually took a deep breath each time and kept my mouth shut. Sure, the internal conversation was fascinating, but I didn’t say any of it out loud, thank goodness. Who knows, maybe perimenopause can bring about some positive changes as well as the negatives.

For your reference:

The Pause (Revised Edition): The Landmark Guide