Warning: If you don’t want to read about hot flashes and dry vaginas, please save us both some trouble and just click out of this right now.
You may not want to hear about it, and that’s okay, but I need to talk about it. To somebody. Anybody.
So here goes.
I, like most women, have spent most of my adult life not truly understanding what this little gem is really about—and I’m a nurse!
I know menopause means your periods stop. I hear jokes about hot flashes, and lately, I see ads for estrogen replacement cream on TV and magazine ads of products promising to improve vaginal dryness.
Until recently, that has been the complete extent of my knowledge.
We have hot flashes, dryness and periods stop. The end.
You have reached your destination. Have a lovely time.
Now that I am going through that long, poorly lit, fume-filled tunnel, wondering what it’ll be like when I come back above ground and can see the sun again, I am rather pissed that I didn’t know anything about where I was headed—not that I had a choice in going, but it would have been nice to have a brochure.
Or a map.
Maybe a Fodor’s Guide to Menopause 2016 telling me what it’s like there—where I should stay, what the locals eat, the climate, suggested activities.
I mean, seeing as I have to go there, that’d be nice, you know?
But, no. I am going on this destination vacation that I did not plan and didn’t want to take, without a book or a guide or even talking to anyone who’s ever been there. I don’t even know what the currency is.
Are there beaches? Shopping? Can I get an earlier flight home if I hate it?
Through my desperate internet searches and riffling through old nursing textbooks, I have been able to deduce that perimenopause is like a long day of traveling, while menopause itself is your destination.
During perimenopause you pack, get to the airport, park your car, and take a bus to the terminal. Then, you check in, get your boarding passes, go through security, where you provide proof that you are, indeed, you and that you are supposed to be on this flight, take everything out of your pockets and remove your shoes and belts and jewelry and jackets and dignity, hoping to God you make it through without beeping or being randomly selected for an intimate pat down or sniff of your luggage by a police dog.
If you make it through unscathed, you go to your gate, wait with an intimate crowd of too many in hard chairs (if you’re lucky) to get onto the plane, where you sit, cramped, ears hurting, turbulence bouncing, until you reach your destination, where you land, collect your belongings at baggage claim and then cleverly orchestrate your transportation out of the airport and to wherever you’re staying, finally getting to enjoy the vacation you worked so hard to reach.
Getting there is the rough part—so agonizing that you question whether or not it was worth the effort—but the reward is that you have arrived.
See the magical gates of Disney World? See Cinderella castle? You are here!
Enjoy your stay?
Not so much with menopause.
First of all, the symptoms of perimenopause are not just silly little nuisances, like the words “hot flash” and “vaginal dryness” bring to mind—it’s much bigger than that.
Much bigger than a long day of traveling.
There’s more to it—but nobody tells us a damn thing. It is like traveling to Disney World in the trunk of a car with duct tape around your wrists and ankles and a bag over your head. No one tells you anything. Mature women are lined up by the dozens to scare young pregnant women with their stories of labors that lasted for eight days and of the sensation of being ripped in two, but these same women are like Fort Knox when it comes to stories of menopause.
What gives? Because as I am now experiencing it, let me tell you, it is a lot to talk about!
Let me break it down and expand a bit on the symptoms:
1. Hot flashes.
We have heard the term “hot flash” since we were children and heard our old aunts and grandmothers carping about this one. But, our aunts and grandmothers carped a lot, so we ignored them. “So, you’re hot? Big, freaking deal. Turn on the air conditioner, for once, and take off your stupid sweater.”
But, none of us ever really understood the extreme nature of these little “hot flashes”—the intensity of the heat; the feeling of something deep in your core coming to a slow boil and then erupting, actual lava spewing up and oozing down and filling every bit of space in your body.
It leaves you standing there, florid and sweating, fanning yourself, asking everyone, “Is it hot in here??” while everyone looks back at you with exasperation, “Good Lord, no, it is not hot in here, you’re doing that crazy thing again!”
Then, turning to each other, as though you are deaf as well as insane and whispering not very quietly, “God, when is she going to stop doing that?”
2. Night sweats.
Unlike hot flashes and other perimenopausal symptoms, night sweats aren’t uncomfortable, per se, but, the sleep that is stolen from you is precious and the work you find yourself doing at midnight or two am and four am and so on leaves you exhausted and stops being amusing quickly.
It’s like waking up to care for a newborn—except that there are no adorable baby pictures to share with others and no reason to give others for your falling asleep mid-sentence the next day.
Here’s how it goes: you’re having a lovely sleep, and all of a sudden you find yourself awake because you are cold. Not just a little bit cold—icy cold, complete with goosebumps.
On further inspection, you discover that you and your pajamas and your hair and your sheets and your pillow case are soaking wet. It’s literally as though you made your bed with wet sheets straight out of the washing machine, then crawled into bed after taking a shower in your pajamas.
Only you didn’t take a shower or wash your sheets, you are lying in a cold swampy soup of your own sweat, and you are soaked through.
This requires immediate action: strip your side of the bed of clammy sheets, including the mattress protector if it’s wet; remove damp pajamas; shower, including washing your greasy sweaty hair; redress in dry (for now) pajamas; attempt to remake your side of the bed using several beach towels or a comforter folded in two, all without waking your partner who is enjoying the best sleep of their lives; try to fall asleep again.
Pray there’s not a recurrence during the night. Which there might be.
3. Vaginal Dryness.
There are simply no words available to adequately describe this seemingly trivial condition. Dryness, in all honesty, doesn’t sound like a terrible thing, and in many situations it isn’t. Dry weather feels better than humid; dry skin is better than sweaty and can be solved with lotion; dry turkey is why cranberry sauce was invented; dry plants just need to be watered.
Most dry things are reversible. Easily fixed with water, lotion, cranberry sauce, or the likes.
Not a vagina.
And the term “vaginal dryness” doesn’t begin to convey what is actually happening down there. I mean, what does that really look like, anyway?
It looks like sloughing skin (think post-sunburn flaking and peeling); cracking (think chapped lips, literally); scabbing (post-cracking…again think chapped lips); one dry, atrophied mucous membrane chafing against the other as you walk, causing the aforementioned sloughing/cracking/scabbing.
Underwear hurts. Peeing hurts. Bathing hurts. Walking hurts.
This body part is screaming at you every second of every day and can not be ignored. Personally I have no desire to be that consciously aware of any of my body parts at all times—especially not that one.
Doctors and magazines may refer to “painful intercourse.” Just today I read several medical articles that are insensitive enough to call it “discomfort during intercourse.” You assholes, I thought. That doesn’t even begin to cover it. From the words “discomfort” or “painful,” one could infer that intercourse is actually happening. But, with the “vaginal dryness” of perimenopause, it is “impossible intercourse” or more plainly “intercourse that isn’t happening.”
Like trying to coax a large sweaty foot into a stiff and unyielding shoe. No hosiery nor amount of lube is allowing entrance. Just, no. Not today, possibly never again.
Women, as much as men, are sexual beings, but when the key body part responsible for pleasurable interaction is broken, ain’t no sex happening. What a travesty to potentially lose this part of one’s identity. One that loves and is intimate and can give and receive such pleasure. Who can ever be ready for that little surprise nobody told you about?
4. Mood swings/Fatigue/Depression
I don’t pretend to know exactly how much of a perimenopausal woman’s mood swings are hormonal (I know it’s a lot) and how much is because the body she has known intimately for her entire life has become a foreign territory…probably also, a lot.
I mean, is it really possible to separate the two?
Can we actually quantify how much fatigue is due to plummeting hormones and how much is from being up all night with night sweats? Can anyone know how much moodiness and depression come from low estrogen levels and how much is because the part of you that has made you “a woman” since you were an adolescent is now leaving you? Is it the itching and burning between your legs, the lack of sex and the desire to feel sexually attractive to your mate or is it strictly low testosterone?
Is there a difference? Does it really matter?
So what do women need to prepare for this trip?
They need information. They need the trivializing and downplaying to stop. They need menopause to stop being something embarrassing to talk about. They need other women to have the brass ovaries to stand up and tell them what is happening or going to happen to them. Share your stories of night sweats and low libido. Admit that your vagina is drying up but this is what you did about it.
They need not to feel ashamed of their bodies and its changes.
They need not to fear aging. Women are tough creatures but they don’t appreciate surprises and secrets and shame.
Awareness has been brought to male-only conditions such as erectile dysfunction or “Low-T” (which, by the way, is just as pertinent to women but only advertised as a problem for men), normalizing it and encouraging sufferers to educate themselves and join the club.
Can’t get it up? It’s okay, we couldn’t either, but now our mates love us and we have hot dates and baths in separate bathtubs (?) and lots of great sex! And this level of understanding of something that was previously thought embarrassing or shameful is awesome.
Now we need the same sort of awareness for women so that women can also know what to expect so they can anticipate the changes and make their own conscious decisions about their bodies—not just during childbearing years, but beyond.
There are medications, hormone replacement, bioidentical hormones, creams, and homeopathic remedies that really and truly make a huge difference, and therapy and counselling to help you with coping as you go through these changes.
But women have to have information and confidence before they can seek support or hunker down for the long haul.
None of us asked to take this particular vacation, but every single woman reading this will go through this (if you haven’t already), and every man will have a wife or girlfriend or mother or coworker or sister go through this and need support.
So, no…Menopause is not Disney World (or a cruise on the Mediterranean for that matter), but it can be less hellish and quite a bit more tolerable with a guidebook. At least when you know where you’re going, you can plan ahead and make good reservations.
Know what the locals do—because like it or not, you’re a local now. We all will be someday.
Author: Amy Bradley
Editor: Renée Picard
Photo: Jean-François Gornet at Flickr