There’s an awesome Baroness Von Sketch segment with the title “It isn’t Peri-Menopause, is it?” that nearly had me in stitches. They completely nailed the mystification and utter disbelief that shroud’s Peri-Menopause (both culturally and seemingly the medical community at large). Much like many women’s health issues, there is an apparent lack of genuine understanding and research to help guide women and their doctors through this completely normal and natural transition.
And it all just gives me pause. Why on earth would something that every single woman on earth will go through, not be researched and fully understood?!
I’m only 41 years old and officially in Peri-Menopause. And I’m not alone – in the confusion, misunderstanding or the experience of it all.
In this blog I’m going to share my experience with “the transition.” Much like many of the conversations I hope to ignite around anti-diet, Health at Every Size (HAES®) and Body Positivity, as an “early adopter” I truly feel like I have an opportunity to shine a light on Peri-Menopause.
Similar to our relationship with body diversity and body respect, Peri-Menopause has an “energy” around it. Much of it negative and dread-filled.
But what if instead of negativity and dread we embraced Peri-Menopause as the natural and normal transition it is? And (this is a big one) stop normalizing suffering?!
We don’t need to be miserable having 30 hot flashes per day or not sleeping! We don’t need to “suck up” the massive changes we’re experiencing in our bodies. We can thrive and feel amazing!
Like so much else, it starts with awareness, and getting informed with the right information! In this blog I am going to share my personal experience, as well as what I’ve learned about Peri-Menopause “in the trenches.” My hope is that even one other woman out there will see herself in my story and get the support she needs to thrive and feel amazing through this completely normal and natural transition.
My Peri-Menopausal Experience
Seven years ago at 35, just as I was starting Super You, it was discovered I had a large ovarian cyst. It was too large to “wait and see” if it would resolve naturally. It posed a significant risk of rupture and needed to be removed surgically. They removed it, and part of my damaged ovary, leaving me with a partial ovary on one side.
No biggie, apparently the other one would “pick up the slack.”
Six months later another large cyst was discovered. This time on the opposite side (seriously body?). It also needed to be removed and I would again lose ovarian tissue.
After two surgeries I was left with effectively less than one ovary. I was told I would be totally fine, not to worry.
(note: ovarian tissue plays a big role in the release of both estrogen and progesterone – the hormones that are responsible for a woman’s menstrual cycle among other things).
But it wasn’t really fine. My cycles were a mess. All over the place and heavy. Then the non-stop spotting. I continued to form (and thankfully resolve) ovarian cysts, so the fault for all this irregularity was placed on them.
Finally, my Gynecologist and I decided an IUD would be the solution.
And it was great, until I began having some unexplained back pain. On a lark we decided to remove it to see if it was the source of the pain (IUD’s can in rare cases cause referral back pain). In the end it wasn’t the cause (that turned out to be a prolapsed bladder, but more on that later).
IUD removed, my body should “in theory” begin to have cycles again. But it didn’t. I never really resumed my period. But we assumed it was just my body “taking its time” to resume cycles (which can be the case).
Cool. I can live with not having periods.
Then, just prior to the Pandemic I’d had the “I think I’m depressed” conversation with my family physician. I’d been feeling “flat” for a couple of months. Off and on, not significantly, but enough that I simply wanted her to know so we could be on the same page should things worsen. As someone who’s lived with depression and experienced Post-Partum Depression it felt all too familiar. Thankfully I wasn’t held back by the stigma and felt comfortable speaking about it with my support structures.
Meanwhile I started seeing a Pelvic Floor Physiotherapist for my chronic low back pain. Literally days before the world shut down with the Pandemic, she diagnosed me with a grade 2 Bladder Prolapse (which absolutely explains my chronic low back pain) as well as a minor rectal prolapse.
What is that? Basically my bladder and rectum were trying to “exit the building.” They can’t actually (there are other structures and tissues “holding them in” but they were not staying where they are meant to and this was causing pressure and pulling on my low back (mystery solved). It was also causing urinary urgency and as well as some fecal incontinence when I ran (yes, every once in a while when I ran I’d have poop leakage).
Yes you did just read that. I used to be embarrassed about it. But much like all things body, I think we need to talk about urinary and fecal incontinence. Let’s shine a light in the shadows people. I’m not alone – bladder prolapse happens in 50% of women who deliver vaginally. And over 7% of women experience fecal incontinence. If you’re experiencing this, you’re not alone. And (most importantly), you don’t need to be suffering. There are solutions (aside from wearing dark pants and saying a prayer no one notices).
Ok, back to Peri-Menopause. I mentioned my cycle issues to the Physiotherapist as well and she wondered aloud – perhaps you’re in Peri-Menopause? I said, I thought that maybe could be the case, but I was only 41, wasn’t I too young? She agreed, but she added it to her notes.
Why did she know, before me? She asked because there is some loss of tone in the pelvic floor musculature that is associated with Peri-Menopause due to dropping estrogen levels. Nice foreshadowing body. Nice.
Then the Pandemic hit. And I went from feeling a bit flat-lined and distraught by my new bladder and rectal prolapse diagnosis and into Pandemic Pivot your business mode. Overnight I was pivoting my business, schooling my kids at home and our entire family was home – all. the. time.
And I gained weight (and it was ok…sort of).
I first gained some weight about a year ago. I was truly embracing Intuitive Eating (and realizing that as Body Positive as I’d become, I still had some lingering diet rules to give up). And with that freedom from restriction, my body was settling into what I truly believe to be my natural set point weight range.
I upsized my clothes and embraced this awesome body as is. And I was actually really ok with it. In fact, I wrote a blog about it.
But now, a year later, it was happening again.
My upsized clothes were getting tighter. And nothing had really changed, or so I thought. I was still eating the same way, moving the same way (give or take) and was generally healthy and well. I’d fairly recently had some bloodwork done and everything checked out. It didn’t seem to “make sense.”
Being the firmly Health at Every Size (HAES®) advocate and anti-diet crusader I am I thought to myself, “what the actual F*@k?!” (honest truth)
Talk about shining a light on your beliefs to see if you really believe them. Can we say confronted? (more on that in a sec*)
Initially I chalked the weight gain up to pandemic stress, because stress and weight gain are again…NORMAL.
Geeky side-bar: When we’re under acute stress (read: short term being chased by a wild animal or chasing a deadline stress) there is a hormonal and systemic blunting of hunger and metabolism (you’ve got more pressing matters!). However, chronic stress (read: ongoing deadlines or global pandemic stress) has the opposite effect, related to intrinsic (read: hormones) and extrinsic (read: comfort foods are well, comforting) factors. Both of which, result in natural, normal weight gain. This is your body looking out for you during stress. It’s “stocking up supplies” (read: body fat/ storage of energy) because it reads stress as a threat to homeostasis. Your body’s job is to protect homeostasis at all costs! And once the period of chronic stress resolves, most bodies will naturally re-settle into their set point range – no dieting required. This is why I was so ticked when everyone and their memes started freaking out about the COVID-19. It’s normal people, breathe (you can read that blog here).
So, mostly assuming my weight gain was Pandemic stress. And I was (working on) trusting that my body will settle back into my natural set point range with time. So I got to work accepting my body (aka. practicing what I preach).
*Personal sidebar: for those who wonder if this is easy for me… it’s not. It’s not at all. This is hard you guys. We are surrounded by messages everywhere that tell use weight gain is bad/ unhealthy and we must not gain weight – pretty much at all costs. In fact a lot of the Peri-Menopausal information out there is focused around the (very normal) weight gain. In fact I’ve had a few practitioners counsel me to “be careful” not to gain any more. So when I say I was confronted. I was confronted. And I had to dig in and use the tools I use with my clients to find my way to peace. I’m still in process around this, and it’ll likely take some time. But I will say this: the size and shape of my body doesn’t define me as a person, an athlete or a coach. I’m healthy and well. And being in a bigger body now than I was pre-menopausal doesn’t change a thing. Other than the size of my super cute clothes.
The final straw (in tampon form)
Then after 5 months of no periods…in March my body decided to open the floodgates (what felt like literally) and I had my period. It was heavy and long. Then after just a brief week of respite, I had another one. Nothing for almost 6 months then 2 heavy cycles in one month?! What the heck body?
Good lord what is happening? I legit started to blame 2020, just like everything else (insert funny – but not – meme here)
So let’s just do a recap checklist…so far I had mood disturbances, depression, weakened pelvic floor tone, weight gain and irregular heavy periods.
And yet still I thought, “it’s not peri-menopause, is it?” It couldn’t possibly be. I’m too young!
A conversation with my body
Body: Um, hello, Gillian…are you paying attention to this?
Gillian: Yeah, I got you body, I hear you loud and clear. You’re F’d. What the hell? Why do you make my life so hard?! (insert tone of frustration and anger).
Body: Girl, I’m just doing this totally natural thing called Peri-menopause, why are you fighting me?
Gillian: I think you’re mistaken. You see, I’m 41. That’s something that happens to women in their 50’s. Don’t age me prematurely!
Body: Sorry friend. I know you’re a bit ticked about this, but seriously, it’s time.
Gillian: I’m not ready. This is making me feel like I’m at the beginning of the end of my life. Over the hill. Heading into the abyss.
Body: Dramatic much? I know it feels early, and it feels like the beginning of the end, but it’s not. You’re still going to be the kick-ass, active, healthy middle aged woman you already are. Just with slightly different hormones….K? Can we be ally’s, not adversaries?
Gillian: Ok. I’m going to do my best. Can you settle down on the hot flashes a bit though? I’m so tired. And hot. And sweaty! I just want to sleep!
Body: Roger dodger. I’ll do my best. Let’s do this.
Status: Peri-Menopausal (and owning it… sort of)
Bloodwork and a trip to the Nurse Practitioner confirmed it. It was indeed Peri-Menopause.
And I’d hit it pretty hard (I’m dramatic like that). Meaning my hormones that seemed to be in a pretty “normal” range were all of the sudden, not. I will say that with irregular periods it’s hard to know what “normal” is in regards to hormone levels because they cycle within the month. But cycle or not, my Estrogen, Progesterone, Testosterone (yes, women have it too), and DHEA were all very low, signifying that I was indeed in Peri-Menopause.
We talked about options. Because I’m (relatively) young in terms of Peri-Menopause onset, my Nurse Practitioner (and later my Gynecologist) recommended Hormone Replacement Therapy (HRT). There is evidence to suggest that not replacing hormones at my age could contribute to increased risks of osteoporosis, heart disease and certain gynecological cancers. Then there was the quality of life factors. I couldn’t keep up this frequency of hot flashes, nor the lack of sleep. It was impacting me significantly. For me it was the right call.
Before you go and string me up or rip into me about the risks of HRT, please hear this: this is not a decision I made lightly. I had several conversations with both my Nurse Practitioner and then my Gynecologist. We talked about my hormone levels as well as the pros and cons of both treatment and no treatment, and determined for me, due to a number of factors including my age, HRT was the best course of action.
For me, HRT has been a godsend. The hot flashes have reduced to almost none and I’m back to sleeping like a baby. My mood is much more stable and overall I’m feeling quite good.
I still have all the new curves (and they’re likely here to stay). Did you know it is normal for women to gain 5kg (about 11lbs) over the 5-10 year span of Peri-Menopause? Take that Diet Culture shaming. This is normal and totally ok!
I’m actively doing the work to embrace this peri-menopausal body.
I trust that my body is wise – it’s doing what it needs to do. And when I have one of those days where I struggle, I just look in the mirror and say “F*@k Diet Culture, I’m awesome.” I’ve purchased more up-sized clothes, and I’m rocking this healthy body – my way. Including my pelvic floor exercises (to success BTW, my Pelvic Floor Physio is thrilled at my Pandemic progress!).
Important: I am in no way advocating for you to do HRT. Just like absolutely everything else with regards to your health, how you choose to transition to Menopause is up to you. Please talk to your chosen medical professionals and trust your inner wisdom. You do you (always).
Why I’m sharing this
I’m writing this blog and sharing my story because I think it’s important that we talk about Peri-Menopause. It’s a natural and completely normal transition that every single woman on the planet will go through. But there’s an “energy” out there about it. A hush hush, complain behind closed doors or around water coolers vibe, that I think is completely unnecessary and completely disempowering!
We don’t need to be miserable as we make this transition. We don’t need to struggle. We need to seek out information (validated by research) and be empowered to ask for the supports we need.
And we need to advocate for more awareness and education for both women and our medical system.
If you’re keen to start learning more, check out this article. I’ve decided to attend the virtual UBC Women’s Health Seminar. Especially the seminar titled “Women’s misunderstood, confusing and long midlife transition,” with University of British Columbia endocrinology professor Dr. Jerilynn Prior. She also has a book called “Estrogen’s Storm Season: Stories of Peri-Menopause” and an incredibly informative web-based resource hub called the Centre for Menstrual Cycle and Ovulation Research.
As women we are all going to go through this transition – at some point. It typically starts around 45, but can start as young as 35, when women still have their menstrual periods. Yeah. Let that sink in.
Let’s talk about it.
Let’s shine a light on the shadows and bring it out in the open. Our gynecological and mental health is vitally important to our health and well-being. It’s not some weird shameful dirty secret. It’s normal.
But let’s not normalize or minimize the incredible challenge that Peri-Menopause is for some women (some women have relatively no symptoms, but for others it can be extremely miserable!).
Let’s advocate for ourselves and advocate for change. And let’s raise the cultural consciousness, knowledge and awareness in the medical community, and our personal empowerment about our health and the health of women in general.
Let’s do this Peri-Menopause. We’ve got this. Legit.
If you’re ready to talk about it (and all things body) and truly embrace your body for all it is consider joining us as a member in the all ages Body Positive community in the Super You Studio. In the StudioCrew nothing about health and body is off limits. It’s a safe space to talk about the ups (and downs) and the many in-betweens that come with listening, honouring and challenging your awesome body and discovering your unique approach health + fitness. Join us!