![]() Imagine that some significant portion of the male population started regularly waking in the middle of the night drenched in sweat, a problem that endured for several years. Their doctors’ responses prompted me to contemplate a thought experiment, one that is not exactly original but is nevertheless striking. (“I thought, hey, aren’t you a vagina doctor?” she told me. Another friend who expressed concerns about a lower libido and vaginal dryness could tell that her gynecologist was uncomfortable talking about both. A colleague of mine seeking relief from hot flashes was prescribed bee-pollen extract, which she dutifully took with no result. When one friend mentioned that she was waking once nightly because of hot flashes, her gynecologist waved it off as hardly worth discussing. My friends’ reports of their recent doctors’ visits suggested that there was no obvious recourse for these symptoms. “I couldn’t think of the words.” ‘It suggests that we have a high cultural tolerance for women’s suffering. “Menopause,” she told me without hesitation. I was haunted by a conversation I had with a writer I admired, someone who quit relatively young. Even more distressing was the hard turn my memory took for the worse: I was forever blanking on something I said as soon as I’d said it, chronically groping for words or names - a development apparent enough that people close to me commented on it. At times, hot flashes woke me at night, forcing me straight into the kinds of anxious thoughts that take on ferocious life in the early hours of morning. In the weeks leading up to each period, I experienced abdominal discomfort so extreme that I went for an ultrasound to make sure I didn’t have some ever-growing cyst. I knew I was in perimenopause because my period disappeared for months at a time, only to return with no explanation. The body is in a temporary state of adjustment, even reinvention, like a machine that once ran on gas trying to adjust to solar power, challenged to find workarounds. Women often gain weight quickly, or see it shift to their middles, as the body fights to hold onto the estrogen that abdominal fat cells produce. In women who have a genetic risk for Alzheimer’s disease, the first plaques are thought to form in the brain during this period. As levels of estrogen, a crucial chemical messenger, trend downward, women are at higher risk for severe depressive symptoms. During this time, a woman’s period may be much heavier or lighter than usual. In response, some hormones - among them estrogen and progesterone - spike and dip erratically, their usual signaling systems failing. The shift, which lasts, on average, four years, typically starts when women reach their late 40s, the point at which the egg-producing sacs of the ovaries start to plummet in number. Technically, it is known as perimenopause, the biologically chaotic phase leading up to a woman’s last period, when her reproductive cycle makes its final, faltering runs. Then last year, I reached the same state of transition. ![]() Another felt a pervasive dryness in her skin, her nails, her throat, even her eyes - as if she were slowly calcifying. Another friend was plagued by as many as 10 hot flashes a day a third was so troubled by her flights of anger, their intensity new to her, that she sat her 12-year-old son down to explain that she was not feeling right - that there was this thing called menopause and that she was going through it. One friend endured weeklong stretches of menstrual bleeding so heavy that she had to miss work. Some lost hours of sleep every night, disruptions that chipped away at their mood, their energy, the vast resources of good will that it takes to parent and to partner. The symptoms they experienced were varied and intrusive. The cause of their suffering was something they had in common, but that did not make it easier for them to figure out what to do about it, even though they knew it was coming: It was menopause. For the past two or three years, many of my friends, women mostly in their early 50s, have found themselves in an unexpected state of suffering.
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