When I think about my fears of being thrust into an early menopause because of female reproduction problems, I know they were founded in watching my mother struggle through an early menopause at the age of 23. She voluntarily consented to a hysterectomy when they told her she had fibroid tumors because she did not want any additional children. My father recounts how she changed from the intense and beautiful woman he fell in love with into a sad and irritable woman who saw no joy in life. She was no longer carefree and creative and he was clueless as to how to love her. Instead, they divorced and I was left to watch how her life completely fell apart. I told my gynecologist when he insisted I have the hysterectomy that I was afraid of “losing it” as I had watched my mother do through my childhood. He laughingly coaxed me into acceptance by assuring me modern medicine had accounted for that problem and I should have no problems. Since I had been with him through the birth of my two children and 15 years total, I trusted him when he said I would not have the same experience as my mother.
It was not until two years post hysterectomy that I realized my fears about my mother’s sudden shift in behaviors was not unfounded. I was having the most difficult of times concentrating on tasks I had been completing as a business owner for years. My sadness was so deep that when I realized my kids were actually growing up and moving out of the home, I sat on the floor of my daughter’s room and cried for two hours uncontrollably. Over the next few months, I simply could not get myself together and resented my decision to get a hysterectomy. It took another year of visiting doctors and therapists to locate a specialist who not only listened to me but was patient in guiding me through the process of balancing out my hormones.
Ultimately, it wasn’t until I was speaking in a room full of Black women about all things mental health that I heard a loud amen from the back of the room when I said, “Ladies, do not underestimate the impact of your hormones on your mental health.” There was such a loud sigh of sisterly connection in the room that the energy that surged around the room compelled me to speak further on the topic.
How many times had I listened to the female elders in my family issue a cautionary tale of growing old through the layers of wisdom they gained from one life experience after another? The warnings to pace myself and enjoy life. Or to tame my anger in the space of unimaginable frustration. Sometimes, the warnings were blaring reminders to listen to their words and adjust accordingly. While other musings were quiet and comforting to help soothe whatever hurt had destroyed my sunny day. Regardless of the intensity of the energy, the wise words were uttered to guide me long after their essence departed the earth.
The interesting thing about youth is much of the information is taken for granted until you’re lying awake at 50 taking inventory of your life. You’re thinking about the heightened anxiety and trying to figure out why it is surfacing more now when everything is going about as well as can be expected. While you may not be able to remember the advice verbatim, you recall your elder mentioning to tame your anger because it was just your hormones talking and not your heart. It all begins to come together when you react harshly at your loved ones for something that could have easily been handled.
At that moment, you realize something is wrong but you can not quite identify what it stems from because you have so many other pressing things going on in your life. Such as it is going through hormonal changes as women age. Women talk openly about the moments in time when it feels like every cellular fiber in your body has been lit by a match just to interrupt you while you are ordering food at your favorite restaurant or at the board meeting pitching your great idea. We hear a lot about hot flashes. Women even discuss the changes in sexual desires as they wait out the time when their hormones balance out and they feel the yearning desires once again.
What you rarely hear around the holiday table or at the family reunion picnic is the toll an imbalance of hormones has on the female body whether in puberty or in menopause. Yes, we talk about girls crying more when they begin their cycle or being irritable but do we really explore the depth of the changes for some women? Do we talk openly on the talk shows and the podcasts about the depth of the emotional fluctuations for mature women who are expected to keep their composure at all times?
Therefore, when women experience it, they have no basis on which to understand the anxiety, confusion, anger, sadness, and fear are symptoms of the fluctuating hormones. It just seems ludicrous to think that after years of handling the monthly uncertainty of hormone fluctuations that going through menopause would be that difficult to manage. If only women had an open forum talking transparently and consistently about what happens during menopause, it would all tie together to what their grandmother said years before when they were half listening.
While most women transition into menopause over a year or two, some are slammed into it with a hysterectomy or medical complication. In addition to information about what to expect, women should be told to expect higher levels of anxiety that don’t necessarily mimic regular bouts of anxiety. They should be warned that the sadness may feel bottomless because it is exacerbated by the imbalance in their hormones. Difficulty concentrating may happen more often which will make it challenging to complete tasks especially in a timely manner. It’s not unusually for the lack of focus to mimic the symptoms of Attention Deficit Disorder. And while there could be a lot more, there is research that supports the exacerbation of depressive and episodes for women who have a history of Bipolar Disorder.
Perhaps having a framework for going through the experience would be helpful. Some options to reduce the unexpected impact of menopause and hormonal changes are readily manageable:
Prepare yourself, if not in advance, as soon as you become aware that you have begun menopause, by respecting your responses to stimuli, both internal and external. If you thought negative thoughts were a nuisance before menopause, wait until you are in the midst of an episode and you are trying to juggle the intensity of the feeling along with the task at hand. Understanding what is happening in the moment is highly reliant on how prepared you are. You know the baseline for how you react to irritants so identifying what that would look like on level 10 will help you manage the moment better.
Emotionally, you are more likely to have more occurrences of anxiety, sadness, anger, and confusion. Having a regimen in place that supports overall wellness will help ease the intensity of some of these emotions. This includes your nutrition, your sleeping patterns, immediate environment, and your decompression routines. Plan these as if you are taking a family of ten on a summer vacation. The more prepared you are the better go you will have at it overall.
Additionally, have transparent conversations with your closest family members and friends about what you all can expect during their leg of your journey. A very useful tool is creating a code word when they notice you are having a heightened response and reacting above your baseline. When handled properly, it can serve as a strong supportive tool because everyone understands you are working to cope with the unfamiliar changes as much as possible.
If you do not already have a therapist, find one as soon as possible. You have a physician to help you manage the physical responses of your transition. You have an optometrist you visit who will inevitably tell you that bifocals will significantly aid in reading small print. Your bimonthly visits to the dentist happen without a second thought. Incorporate a therapist into the circle of providers who are tasked with making sure you are firing on all cylinders. You are gifting yourself with an invaluable treasure to walk you through an exceptional part of your life. There is no need to do it without all of the support available to you.
Additionally, carefully consider the medicinal and holistic options available to you to manage the emotional and cognitive symptoms of menopause. You should speak with your physician (preferably a gynecologist) and advocate for yourself by being transparent with the experiences you are having. You may also consider speaking with a psychiatrist if the cognitive and emotional symptoms become too difficult to manage with the support of therapy and routines you incorporate.
Finally, remember you are not alone. One of the reasons women feel alone is because we are not having the transparent and authentic conversations about the experiences. Find other women who have had similar experiences and create a small community amongst yourselves to offer occasional support. Even though you know it is not forever, it does not make it any less intense when you are going through the transition.
Give Yourself Some Space:
While it is unlikely you can take a break from life for the nearly year or so it will take to adjust to the new hormonal levels, you can create intentional moments to decompress and rejuvenate to allow yourself time to recover. Schedule time in your planner for you as if it is the due date for your annual fiscal reports. Set aside time in the evening as you would for your children when they needed your help with their homework. Plan for vacations as you would a weekend to get your tax records together every Spring. Be intentional about it and bask in the times when you have placed enough value in your recovery to support the battle of your entangled hormones.