By Christiane Northrup, M.D.Bantam
During menopause, a woman can feel like the only way she can continue to exist for 10 more seconds inside her crawling, burning skin is to walk screaming into the sea—grandly, epically, and terrifyingly, like a 15-foot-tall Greek tragic figure wearing a giant, pop-eyed wooden mask. Or she may remain in the kitchen and begin hurling objects at her family: telephones, coffee cups, plates. Or, as my mother did in the 1970s, she may just eerily disappear into her bedroom, like a tide washing out—curtains drawn, door locked, dead to the world, for days, weeks, months (some moms went silent for years). Oh, for a tribal cauldron to dive into, a harvest moon to howl at, or even an online service that provides—here’s an idea!—demon gypsy lovers.
But no, this is 21st-century America, so there is no ancient womyn’s magic for us but rather, as usual for female passages, a stack of medically themed self-help books. (I ask you: Where are the vampire novels for perimenopausal women? Werewolf tales? Pirate movies?) That’s right—to fully get our crone on, we’re supposed to read, even though it may feel, what with the giant Greek chthonic headpiece, that one can barely see out the eyeholes. (Who can focus on words on a page? Who can even remember where she left her giant octagonal Medea-size reading glasses?) Rest assured, though: I’m here to help. Gentle reader, if you are a female of transitional age, which can apparently be anywhere from 35 to 65 these days, let me be your Virgil to the literature of menopause. Long have I wandered through the dry riverbeds, long have I suffered; now I’ve come back to share my wisdom.
To set the stage, here is a selection of titles from my local bookstore’s women’s section: Could It Be … Perimenopause?; Before Your Time: The Early Menopause Survival Guide; The Natural Menopause Plan; Second Spring; Menopause Reset!: Reverse Weight Gain, Speed Fat Loss, and Get Your Body Back in 3 Simple Steps; and the slightly ominously titled What Nurses Know … Menopause (two words: atrophic vaginitis). On the cover of a typical menopause book, instead of the perhaps more to-the-point fanged woman with the Medusa do, one is far more likely to see a lone flower—a poppy, perhaps a daisy. Curious choice? Well, no, because as one begins to read the war stories of the M.D., Ph.D., and R.N. (atrophic vaginitis!) authors who dominate this genre, one sees narratives that are indeed Stuart Smalley–esque. Here’s a pastiche:
Mary Anne, age 48, came into my office feeling overweight and bloated. She hadn’t been sleeping, work was stressful, her husband had just gone on disability, and he required daily care. Mary Anne complained to me of lower-back problems and gastritis, and also cramping during sex, which had become more and more infrequent. She was extremely depressed about moving her 84-year-old mother to a nursing home, and upon examination I noticed vaginal inflammation.
As unappetizing as that just was to read, be glad you saw only one such passage—I must have read a hundred. Because clearly, from the medical-professional point of view, menopause, or really the run-up to it called perimenopause, is a parade of baleful, bloated middle-aged women (“Lisa, 52,” “Carolyn, 47,” “Suzanne, 61”) trudging into their doctors’ offices complaining of lower-back pain and family care-giving issues and diminished libidos and personal dryness and corns. As they sit wanly on the tables in their paper gowns, they arduously count out their irregular periods—from 35 days to 44 days to 57, going heavy to light, light to heavy, sometimes with spotting, sometimes with flooding, sometimes flood-spotting, sometimes spot-flooding. Why this variation? So easy to understand, really. The simple science: ovarian production of the estrogens and progesterone becomes erratic during perimenopause, with unpredictable fluctuations in levels, which in turn can result in many different symptoms, including major mood swings. But sometimes not. You may never feel any of this! Because here’s the key: All women are different.
And yet, even though we all are different, the list of prescriptions for us seems to be very much the same, and none of it’s fun. If one must tinker with hormone-replacement therapy, one may—briefly, in moderation. But from this point on, The Change is about healthy lifestyle. We’re all to get more exercise, drink more water, do yoga stretches before bed, cut out alcohol and caffeine, and yet (and how does this follow?) reduce stress. Even the flirty exhortations to have more sex feel like yet another job on life’s chore wheel (given that it’s supposed to be with your mate of 20 years rather than with Johnny Depp). And don’t forget all the deep sensory pleasures of a reduced-calorie diet. Menopause Reset! at least initially seemed to promise a nutritional miracle cure for that mysterious spare beach floaty that arrives after 40. I for one was excited to see that, instead of Black Swan–ing it until dinner, as apparently so many of us women do (in order to heap our measly 1,500 calories together into one meal a person might actually want to eat), you’re supposed to eat many tiny meals constantly. Hurray! But alas, after reading much dietary advice for menopausal women, I concluded that, in the horrible new metrics of midlife, each of the following constitutes a meal:
Meal No. 1 (8 a.m.):
2 tsp. nonfat yogurt
Meal No. 2 (10 a.m.):
3 almonds (unsalted)
Meal No. 3 (12 p.m.)
2 oz. low-fat barley soufflé (see Appendix D)
Meal No. 4 (2 p.m.)
small Bell pepper
1 tsp. flaxseed
Just staying awake all day to eat the food—while of course getting in those 15 reps an hour of sex with your 50-something husband—seems a challenge. No wine, though: best to pair vaginal dryness with buckwheat tempeh. Oh! Oh! Oh! Where is the plate-glass window to hurl phone through? Why is life worth living? Ouch, my corns!