It’s October Menopause Awareness Month.
When I was in my late 40s, my OB-GYN told me, almost casually, that I was in menopause. I was shocked. I didn’t think menopause was something I would have to worry about for years. At first, I was told it might be early menopause, but later I learned it was technically within the “normal” range, just on the earlier side. However, it seemed too early to me. I wasn’t ready and I didn’t know anyone else who was still going through it. There was no clear cause, no dramatic symptoms that brought me on – just routine tests and fluctuating hormone levels.
To understand what this means, it helps to know the medical distinctions. “Premature menopause is menopause before the age of 40,” she explained Alyssa Dweck, MS, MD, FACOG, MSCPchief medical officer of Bonafide Health and a The Menopause Society– certified medical practitioner. “Early menopause is menopause before the age of 45, occurring in about 8% to 10% of women. Most go through menopause between the ages of 45 and 55, but some as late as 60.”
I wasn’t expecting a strong emotional reaction and I wasn’t prepared for how it would affect me. As an adoptee, I never made having biological children a priority. And I spent most of my adult life pursuing a creative career filled with travel and projects I loved. But again, the diagnosis stuck with me like a cold that wouldn’t go away. I left that office feeling ashamed and crushed, as if I had been quietly thrust into a new stage of life before I was ready.
The emotional burden of an unexpected diagnosis
I consider myself a feminist, some outdated idea of what makes a woman valuable. So, I didn’t think menopause would shake me up. And yet, it happened. I wondered if I had done something wrong to bring it up so early. I was taking good care of myself, exercising, eating well, keeping up with my exams, yet I felt branded, like my body had betrayed me.
Having adopted, I never had a clear picture of what to expect from my body. When menopause arrived, it felt like a loss, not just of fertility, but of continuity. Another reminder that I had no roots or biological ancestry to compare myself to.
“A woman’s maternal experience of menopause is itself a good predictor,” he said Lauren Tetenbaum, LCSW, JD, PMH-Cpsychotherapist and author of Millennial Menopause: Preparing for Perimenopause, Menopause, and Life’s Next Season. “Not having access to a biological family for information about genetics can feel like a loss or a missed opportunity.”
Even among women without the added mystery of adoption, Tetenbaum sees a lot of overwhelm, confusion and loneliness. “Women are often undereducated about menopause. When it happens earlier than expected, they may not know where to turn or who to talk to.”
Why I kept menopause a secret
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A part of me was proud that he looked younger than my age. I didn’t want to be seen as “old” and I was ashamed of what this diagnosis represented. So when I entered menopause, I didn’t tell anyone, not even friends or family. I wasn’t experiencing the classic hot flashes or weight gain, so I stayed calm. At medical appointments, I would write “N/A” for my last period and move on.
“Our culture values youth as an indicator of women’s worth,” Tetenbaum hit the nail on the head. “Women experiencing the menopausal transition often experience loss of identity and fear of aging, and these feelings are exacerbated if menopause occurs earlier than expected.”
The cost of silence
By keeping my menopausal transition a secret, I thought I was protecting myself from being seen in a way I wasn’t comfortable with. But this secrecy prevented me from seeking care. For months, I didn’t ask any follow-up questions. I didn’t schedule exams. I acted like it wasn’t happening. But menopause affects many systems such as the heart, bones and brain – not just the reproductive system. And that meant that even without symptoms like hot flashes, I was still at risk for conditions like bone loss, osteoporosis, heart disease, metabolic syndrome, mood disordersand probably dementia.
The cost of stigma goes beyond my personal situation. Deeply situated culturally in the U.S., Tetenbaum noted, “Because of the stigma, women don’t get the information they need, we don’t fund enough research, and we feel isolated instead of supported.”
But we’re seeing a cultural shift lately with more high-profile women speaking out about menopause. As discussions of menopause become less taboo, women are beginning to talk more openly about this normal stage of life. And access to care is improving, thanks to this increased conversation and relatively new telehealth options.
Taking steps towards health
I had started to notice systematic changes in my body. I wanted to feel more in control of my health and not be paralyzed by the fear of the unknown. I also wanted to feel better emotionally, so I finally started taking small steps. I scheduled one DEXA scan to measure my bone density and checked my cholesterol, both of which came back normal. Even with this reassurance, I chose to make proactive changes and focused on improving my diet.
I also took a closer look at a symptom I had overcome for years: increased anxiety and irritability. I had blamed it on stress, but now I was wondering if it was hormonal. Over time I realized that it was. These changes were part of the hormonal changes of menopause. Acknowledging that helped me create routines to manage them. I committed to my training schedule and added more structure to my days, which made me feel more grounded.
“So many women don’t feel like themselves during menopause,” Tetenbaum said. “When we’re able to recognize what’s going on with us (ie, hormonal fluctuations), we’re better able to get the treatment and support we deserve.”
Given my symptoms, my doctor suggested that hormone therapy (HT) might help ease the transition.
“Hormone therapy in the right person, at the right time, and in the right dose and formulation, can manage symptoms and provide a reduction in risk for cardiovascular disease, bone loss, and cognitive function,” Dweck said.
Despite a flawed study in 2002 by the Women’s Health Initiative that falsely linked HT to an increased risk of breast cancer; the latest guidance shows that HT is safe for most women, especially when started early enough, so I agreed to bring hormones. I started to feel less angry and less angry. I was no longer on an emotional rollercoaster and my life stopped feeling like it was out of control. I started to feel like my old self again.
Breaking the silence
It took time, but I came to see menopause not as a failure or something to hide, but as a new chapter. I started opening up to friends. And when I did, I discovered that some of them were also going through menopause just as quietly. Opening up the conversation normalized my experience and helped me feel more comfortable with my new status as a postmenopausal woman.
“We need to change the way we talk about menopause in schools, with our children, in medical training programs, in politics and in the media so that it becomes normalized,” Tetenbaum said. “When we talk about this very normal phase of health and development, we all benefit.”
There is no single right way to experience the menopause transition. But silence is not the answer. When we share, we realize we are never alone.
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