Transitioning...

Thank you for tuning in and welcome to De-Stigma Dialogues. My name is Tamara and I’m your guide on this journey. For those of you joining us for the first time, a little background… This podcast aims to pull back the curtain on the myriad of stigmas that malign our life cycle, and by our, I do mean the female life cycle. As I mentioned in the last episode, each season I will focus on three to four topics, or rather themes. For the inaugural season, inaugural sounds fancy, doesn’t it? Anyway, for our first season, the three themes that were chosen are explosive and really at the root of why I started this podcast. The big three this season are Perimenopause, Feminism and Narrative… I KNOW!! We’ll be doing some heavy lifting ladies, but that’s not unusual for our gender, is it? These particular themes were chosen because I do believe they are intertwined. Each one has stigmas / labels that feed into one another and honestly, I can’t wait to unpack some of these. I’m saying some because, as we continue on this journey I am positive that we will revisit some topics as other stigmas are explored and connections established. For any male listeners, welcome and thank you for your bravery and gird your loins honey, it’s about to be on…

Ok so let’s jump right in… Perimenopause

Yeah, not fun and a condition that I spent most of my life largely unaware of, and that’s not just because it didn’t have a name until 1962, which is bonkers! A little background on that, the term ‘perimenopause’ was coined by this dude, John Kingsbury Frost, an American physician specializing in cytopathology. That is the study of individual body cells to help detect cancer. Now, the first area of the body chosen to be studied was the female genital tract. This is interesting to me for a few reasons. One, together with the inventor of the pap smear (a Greek physician Georgios Papanikolaou) this relatively unknown physician was doing research that would lead to others identifying a variety of cancers that were previously undiscovered. That it was the female body that led to these discoveries is equally surprising and not, but let’s stick a pin here. The work done by Frost was important because cancer has touched my life, and I am sure it has done the same for most people on this planet. These connections that were made were phenomenal, and they have gone on to benefit society, so there is no argument there.

But, remember that pin, I’ll tell you the truth, I had written an entire paragraph that spoke to how women’s bodies were experimented on and used and not given the respect of acknowledgement in this discovery or many other medical discoveries. But after some very well timed and grounded advice from a friend that I was veering heavily into the man-hating/women complaining forest. (she checked me and I wanna say thank you big time! You know who you are ;)p.) So I came down from that particular pedestal and decided against using it. The last thing I want to come across as is a man-hating, uber complainer. I will say though that there may be times where I can go off on a tangent/rant, BUT I will do my best not to, especially if it doesn’t add any value to the conversation. Now another friend suggested that I make my ‘rant’ available for discussion where other Dialoguers can add their own comments and say what they think. I was very intrigued by this notion because as I’ve said, discourse and conversation is the primary goal of this podcast and so I want to thank that friend for the suggestion. So in a section called “tell me what you really think” that rant will be made available in the newsletter. I may regret this, but this podcast is about being open and honest, so here goes. Again, my priority is not to alienate anyone in the tribe and to ensure that this space remains judgement -free, so let’s move on…

I mentioned in the last episode, that when I was choosing the name of this podcast, I did a deep dive on the definitions of the word stigma. One of them was related to medicine… (for new  listeners, in the medical field, stigma is used to define visible signs of disease… let’s just sit with this a minute. This physician, Frost, who coined the term perimenopause, was in search of body cells that can cause cancer, one of our biggest disease-villains, by first exploring the female genital tract… the female reproductive system, the female stigma, the “cancer” if you will to a patriarchal society? Things that make you go… hmmm! Ok so perhaps that’s a reach but then is it? Again the term perimenopause was only defined in 1962, women having been dealing with this condition since EVE, and it was only towards the end of the 20th century that anyone bothered to define it. Before we were just identified as crazy, in need of lobotomies and padded rooms, shoved into attics so that we don’t ‘disturb’ the rest of the family and by extension, society, which incidentally is what happened to women during this stage of our life cycle for centuries. Don’t believe me, check out the literature from the 16th century on up to as late/early as the 1960’s and enlighten yourselves. So this term was coined in 1962, I know I’ve said those numbers a lot but that is mind-boggling to me, but it is only as recent as 2020 that the term really entered into any sort of mainstream discussion. It was all just called menopause. So is my ignorance really unfounded?

This period of time for women was just called menopause by society, with the term Perimenopause almost exclusively used by medical professionals. I did biology in high school, and we did the female reproductive cycle, and the textbooks didn’t even use the term. It was never clearly defined as a “period of time”. It was an event, a one-time thing; your period just stopped, and you were in menopause, and life went on. It was never explained that it was an ongoing thing that could last up to 10 YEARS. Yes 10 years is an extreme case, but it is not unheard of. I was flabbergasted when I found that out a few years ago. Sure, I witnessed some aunts having hot flashes and yes, I knew it was linked to menopause, but I still didn’t make that connection. Talk about living in a bubble… Thing is, I am currently living, well surviving this stage of the life cycle right and I want to talk about it and explore it and commiserate with my tribe about it because it’s new and foreign and I’m not prepared and I need to know that I’m not in this boat alone. I think that is something that the stigma of ‘menopause/perimenopause’ did. It isolated us because we didn’t cleave to each other and share this experience. We hid it and made like it didn’t affect us and we could still hold on to who we were. Younger women didn’t think about it in preparation because one, it is decades away (for some not that many), and two, motherhood and living life takes priority.

Ok so I said that I would not just talk about my feelings but also provide some useful data. So now for the technical bits…

According to the Cleveland Clinic, Perimenopause is a period of time prior to the end of a woman’s period/menstrual cycle. It can be referred to as the menopause transition. During this time frame which varies in length of up to 10 years, with the average length being approximately 4 years, your body produces less hormones which leads to irregular periods until you eventually are able to go one full year without a period at which time you are postmenopausal. So there’s perimenopause then there’s postmenopause, so like is menopause the one year anniversary of your last period? Is it the umbrella for everything? I mean, huh…

In an unsurprising twist to programming, another doctor in a youtube video (they’re popping up on every social media platform like whack-a-mole, I swear), Dr. Jen, a Hormone and Metabolic expert, breaks this period down into 3 stages. I’ll leave the link to her video in the newsletter. My personal doctor used 2 stages like the Cleveland Clinic. My point is that the information is conflicting even within the medical community. And this is not a new condition. This isn’t like COVID or a new strain of a virus, this is a stage in the female life cycle that EVERY WOMAN experiences. But with so much mud in the water, how can we navigate a clear path? 

So during this transition, the cosmos of symptoms are mind blowing in two ways, doctors and medical sites and books, often only mention the standard five symptoms. Yes, symptoms as though this period of time that we women endure is a disease… Those of us in the throes of battle will recognize the standard five:

• Irregular periods

• Vaginal dryness/vaginal atrophy

• Sleep problems

• Urinary urgency

• Mood changes

That’s it, like those are the ONLY things to look out for. Not a very clear map is it? Like can you imagine going on a road trip and being told well there’s a left turn, a right turn, a u-turn, a yield to pedestrians and a church on the left corner. I mean how fucking basic. It’s not just the irregular periods, it’s not just the mood swings, it’s the weight gain, this fucking apron, apron really, like seriously what the absolute fuck. The additional belly fat is named after a very specific stereotypical trope/vision of woman?? Really?? Notice that hot flashes, or the medical term Vasomotor Symptoms (VMS) aren’t a part of the standard five, but sleep problems are? Sleep problems/Insomnia, probably caused by the damn hot flashes! Also not mentioned is what I like to call ‘menopause brain’, yeah, it’s a thing like pregnancy brain on hormones, you know the same hormones you are losing that prevent regular periods also turn your focus into swiss fucking cheese. Though it is most likely caused by the lack of sleep (see hot fucking flashes) and the need to pee every 30 minutes to an hour which of course also places you in a state of perpetual fatigue. Oh and this really fun side effect, vag itch brought on by dryness caused by lack of estrogen. The medical term being vaginal atrophy, yes atrophy, the wasting away of your vagina due to underuse or neglect resulting in a decline in effectiveness. How muthafuckin rude!!! I mean I get why the term was used but really how muthafuckin rude!!! You don’t hear penile atrophy but that’s what it is… I mean it’s like the medical community had a little pow-wow and came up with the most disparaging and hurtful names, regardless of ‘perceived’ accuracy. Ok so our now neglected, underused vaginas facilitates another symptom, painful sex. I mean is that surprising? Think of a 600lb human trying to walk, yeah it hurts. Now, to be completely transparent, this particular symptom I can only imagine as I have been sans partner for maybe 7 years could be more, but I digress… my point was that itch is no damn joke ladies!!! Then there’s the increase of facial hair and decrease of head hair, like what the fuck! It’s no wonder mood changes are a primary symptom. I mean men, can you imagine living with this for up to ten years? I imagine then many of you would also be challenges to be around. And there probably would have been more research conducted years ago, just sayin… Add to that the name calling and shame brought on by the stigmas of being old bitches and dried up hags. I mean the accuracy kinda fucks me in the head to be honest. All this rant is saying is that this transitional period is effectively the highest form of betrayal, why? Because it’s self betrayal, fucking ambushed and sabotaged and cut the fuck down by the body that we nurtured and spoiled and yes, took for granted… And by the way, that is just a skim of the symptoms, there are currently 100 symptoms assigned to perimenopause, not that anyone will confirm that… because like many of us were told when it came to our morning sickness, it’s probably just in our heads…

A couple of weeks ago, while scrolling Instagram, The Real Slim Sherry (if you don’t follow her, ask somebody, she’s hilarious because she comes from a place of her truth so I can relate) anyway, she posted a photo of a frog sitting on a log and the caption said one day you’re young and the next day you are sitting on the edge of your bed and I laughed so hard, because it honestly resonated with me. That is exactly how I saw myself the last time I caught a glance at myself in the mirror. I took a snapshot and I forwarded it to all my friends in a pop-up survey to see how many would respond honestly. I was surprised by how many related to it, like I did. Of course, there were deniers… I know them and they should be more honest, just saying… Regardless, it proved my thesis that as a gender, we rarely share honestly with each other what this transition is doing to us, our bodies in this case and even our minds. And, I think the reason that we, no I can not speak to everyone, the reason I didn’t at first talk about the changes that I was going through was the embarrassment that came with it and that is apart from the stigma attached to this particular period in a woman’s life. I was embarrassed that my body no longer behaved in the way that I had grown accustomed to it doing. I no longer felt in control of my body. I could no longer eat what I loved, which is dairy. I love bread, butter and cheese. This favourite go-to now triggers the most severe heartburn and indigestion and bloating and gas bubbles. I could no longer exercise away the extra belly fat. I could no longer remember simple things or even focus throughout the day. I found myself repeating the same question over and over. It was like my body was conspiring against me. I know how it sounds but it is how I felt and continue to feel most days. This transition that we ALL experience instead of strengthening our bonds, isolates us, from each other and from society. I can sorta understand now why the procedure for dealing with this type of madness in the past called for women to be locked up in attics…

One of my greatest fears is losing my mind and that is what it felt like and on some days continue to feel like. I was embarrassed that I may have early onset dementia. It’s not impossible. I was embarrassed that my energy level depleted with the speed of a pissing ram goat. I previously revelled in the fact that I never went on a diet in my entire life but now I was looking up diets because I can’t shed what now looks like a newly formed 3 month pregnancy. I’m embarrassed that none of my clothes fit like they did. I am embarrassed to be embarrassed about my body. I am embarrassed that I find myself prescribing to the stigma that I am now a woman of a ‘certain age’ and since I failed to secure a partner when I was viable, I will be alone for the rest of my days. I am embarrassed to mourn the possibility of never being kissed with passion again, which by the way is one of my favourite things in the world. I am embarrassed that I find it harder to love myself, and according to Mama Ru, if you can’t love yourself, how in the hell are you gonna love somebody else, or get someone else to love you!

These emotions all go against everything that I believed I stood for. This new chapter in my life is playing me and playing me hard. Like damn! Another thing that makes you feel crazy, or like you aren’t getting the whole story are the treatment options, another head fuck! First of all, let’s be clear, there is NO treatment to STOP perimenopause. The treatment options are merely a means of managing the most severe symptoms, which can differ for everyone. The big one is Hormone Replacement Therapy. This is an attempt to reintroduce estrogen and/or progesterone to the body through pills, skin patches, gels, creams, rings, or sprays to help stabilise the hormones in the body. It can relieve SOME of the symptoms (remember they are Legion and not all acknowledged or accepted by the medical community), but this relief only happens if the therapy is started within the initial stages of perimenopause. So, if you aren’t sure what is happening to your body but you are not of age for perimenopause and don’t have the (BIG 5) then odds are your doctor wouldn’t confirm you are in perimenopause so then you miss early stages, so no treatment, at least no ‘timely’ treatment. You can think you are going crazy! It is a Catch-22! Of course, this treatment is also linked to increased risk of uterine and breast cancer, heart attack, stroke, blood clots and gallbladder disease. So Russian roulette anyone? Then there’s the ‘alternative’ treatments such as eating a plant-based diet, weight bearing exercise, avoiding screens before bed, meditation, stopping smoking, limiting caffeine and alcohol, and adding rounds of vaginal creams and antidepressants. Sorry, but that’s it? That’s all? Why not add no raking of leaves in the fall, don’t talk to strangers after dark, only eat three day old eggs? It all seems so random, like throwing everything against the wall to see what sticks…

So this now steady diet of tofu and soy and weight bearing exercises will help me get rid of the fucking apron? No I hadn’t tried that? But let me tell you, I don’t mind adding a round of antidepressants to my alcohol and coffee! Now it’s a party! Hold on, let me meditate about this while I sit in an airconditioned sauna. Am I crazy or do these ‘professionals’ still not know what they are talking about when it comes to our bodies? For starters, there is no one size fits all and there never was nor will there ever be. Each of us women are different and our experience is going to be different. What works for some may not work for others, and that’s just a rule for life in general. This podcast is meant to help flush it out so that younger women can start thinking about and preparing for this stage of life and so that those that like me are trying to survive it, is aware that we are not alone and if you are feeling a certain way or your body is doing something it’s never done before, then yeah odds are, it’s another fuckin symptom.

I feel like this is lopsided. We have a galaxy of symptoms that I spent most of this episode barely scratching the surface of and only a band aid of treatments to help manage them. And, I do think that one of the major treatments of this period goes unsaid and unrecommended. That treatment is perspective and control. We can choose to see this period of time as its symptoms or we can take control of our perspective and change the narrative. Instead of calling them hot flashes, what about ‘power surges’? Instead of bemoaning that nothing fits like it used to, why not take this opportunity to go shopping and re-invent your sense of style? When insomnia hits, how about getting up and doing something just for you? Instead of leaning into the narrative that perimenopause is the end, why not pivot it into being the beginning?

This change in perspective is something that I lucked into when I started this podcast and book club. Yes for those of you tuning in for the first time, De-Stigma Dialogues has a companion book club. It was while reading the books shortlisted for this season’s selection that I really bought into changing my perspective, and walking the walk and not just talking, ok well I do talk but thinking about it. In this season’s book club selection A New Moon’s Arms by Nalo Hopkinson, the protagonist Calamity has to do just that, alter her perspective so that she could embrace what comes next. This book reminded me that I too possess a latent power. I believe we all do and my perspective is that this period is my time to tap into it.

I’m not done talking about perimenopause and there’s a lot more to discuss but I think this is a good place to pause. Plus that was a lot for you to digest and I’m sure you’re getting tired of listening to me. So join me next week when I will try to wrap up this topic. In the meantime, please subscribe, like, share and comment. This Wednesday, the first issue of our newsletter will go out so keep an eye on your inbox. A book from the runners-up club will be featured, some of this episode’s talking points and links to the video from Dr. Jen I mentioned earlier. Please reach out and let’s engage. Email me at destigmadialogues@gmail.com. I want to hear from you! Remember there are up to 100 symptoms in this transition, I know that I didn’t hit them all, let me know what I missed or a treatment plan that worked for you, or just say hi. Until then, my name is Tamara and enough with the nods and whispers, let’s talk out loud…