The Madwoman in the Volvo: My Year of Raging Hormones

by Sandra Tsing Loh

  HOWEVER, AS I suggested, even under my inspiring leadership, it is unlikely that the targeted demographic of women will ever engage in Bloomsday-like readings of Wisdom, as is done with Joyce’s Ulysses. (Groused a girlfriend to whom I was maniacally recommending it: “Why should I bother? Every day of menopause already feels like you’re reading a six-hundred-page book.”)

  So, for the bloated and tired, let me give you the juicy core.

  Writes Dr. Northrup:

  A woman once told me that when her mother was approaching the age of menopause, her father sat the whole family down and said, “Kids, your mother may be going through some changes now, and I want you to be prepared. Your uncle Ralph told me that when your aunt Carol went through the change, she threw a leg of lamb right out the window!”

  Although this story fits beautifully into the stereotype of the “crazy” menopausal woman, it should not be overlooked that throwing the leg of lamb out the window may have been Aunt Carol’s outward expression of the process going on within her soul: the reclaiming of herself. Perhaps it was her way of saying how tired she was of waiting on her family, of signaling to them that she was past the cook/chauffeur/dishwasher stage of life. For many women, if not most, part of this reclamation process includes getting in touch with anger and, perhaps, blowing up at loved ones for the first time.

  Woo-woo! Duck, Uncle Ralph! Go, Aunt Carol! In short, never mind the complicated hormonal science, the wavy-graph technicalities of all those estrogen/progesterone/FSH fluctuations.

  Opines the doctor: “I think it’s useful to get your hormone levels tested. But it’s far more useful to tune in to how you’re feeling than to focus on a lab test, which gives, after all, just a single snapshot of an ever-changing process.”

  What the phrase “wisdom of menopause” stands for, in the end, is that, as the female body’s egg-producing abilities and levels of estrogen and other reproductive hormones begin to wane, so does the hormonal cloud of our nurturing instincts. During this huge biological shift, our brain, temperament, and behaviors will begin to change—as then must, alarmingly, our relationships. As one Northrup chapter title tells it, “Menopause Puts Your Life Under a Microscope,” and the message, painful as it is, is: “Grow . . . or die.”

  Put another way:

  The old story of menopause was that the change was when a woman lost her fertility and her essence and her marbles. But in fact, as I have seen with my own tween girls, before girls start their periods they are just as self-centered and brash and annoying and farty as the next person, babbling on about their own crap, much like anyone else. But then the periods start, and it’s all about boys, boys, boys, hair brushing to look cute for boys, boy bands, boy jeans, lipstick and eyeliner . . . and we lose them for a while to the cloud of fertility hormones, which makes them want to help people and serve people and cut up their sandwiches into ever-tinier squares.

  Thirty years later, though, look who’s back. Fifty-year-old Aunt Carol, throwing that leg of lamb right out the window. Because there never was a “real” Aunt Carol. It was only fertility’s amped-up reproductive hormones that helped Aunt Carol thirty years ago to begin her mysterious automatic weekly ritual of roasting lamb just so and laying out twelve settings of silverware with an OCD-like attention to detail while cheerfully washing and folding and ironing the family laundry. No normal person would do that—look at the rest of the family: They are reading the paper and lazing about like rational, sensible people. And now that Aunt Carol’s hormonal cloud is finally wearing off, it’s not a tragedy, or an abnormality, or her going crazy—it just means she can rejoin the rest of the human race: She can be the same selfish, nonnurturing, nonbonding type of person everyone else is. (And so what if get-well casseroles won’t get baked, PTAs will collapse, and in-laws will go for decades without being sent a single greeting card? Paging Aunt Carol! The old Aunt Carol!)

  Do you see? If, in an eighty-year life span, a female is fertile for about twenty-five years (let’s call it ages fifteen to forty), it is not menopause that triggers the mind-altering and hormone-altering variation; the hormonal “disturbance” is actually fertility. Fertility is the change. It is during fertility that a female loses herself, and enters that cloud overly rich in estrogen. Due to life spans being as long as they are, thirty years of addled fertility in the middle isn’t the “norm” for a woman, that almost sixty years of the relative selfishness of prepubescence and menopause are.

  In short, if it comes at the right time, menopause is wisdom. For Northrup—whose own passage through menopause included a traumatic divorce, a narrative she relates with sadness but finally no regrets—this seemed to be so. In Northrup’s generation, menopause’s liberating narrative dovetailed elegantly with a typical female baby boomer’s biological and chronological clock. When a woman gets married in her twenties, has children in her late twenties or early thirties, and begins to detach in her forties, look where her nuclear family is by the time she reaches her menopausal-wanderlust-filled fifties: Her grown-up (say eighteen-year-old) children are leaving the nest; her perhaps slightly older (say sixty-ish) husband is transitioning into gardening and fishing; her aged parents have conveniently died (let’s say back—and wouldn’t it be lovely?—when they slipped and injured a hip at, oh, seventy-eight).

  Compare that timeline, however, with the clock of my own generation of late-boomer/Gen X women. Putting our careers and ourselves first, we adventured and traveled in our twenties, settled down and got married in our thirties, got pregnant (or tried to—fertility problems being the first surprising biological wall we hit) in our late thirties or even early forties. What scenario will we face when we hit menopause?

  Oh my God! You’ve just witnessed it! Look at our parents! Owing to medical advancements, cancer deaths now peak at age sixty-five and kill off just 20 percent of older Americans, while deaths due to organ failure peak at about seventy-five and kill off just another 25 percent. So the norm for seniors is becoming a long-drawn-out death after eighty-five, requiring ever-increasing assistance for such simple daily activities as eating, bathing, and moving. This is currently the case for approximately 40 percent of Americans older than eighty-five, the country’s fastest-growing demographic, which is projected to more than double by 2035, from about 5 million to 11.5 million. And at that point, here comes the next wave—77 million of the youngest baby boomers will be turning seventy. Move over Hurricane Courtney, here comes Hurricane Grandpa! Meanwhile, in terms of my children? In my case I have had the experience of combing lice out of my own wiry gray-and-white hair—a sobering sight one ideally wants to pair with nosebleed-high self-esteem, which few of us enjoy.

  All of which is to say, how often have I felt, in midlife, as though I am in a strange Island of Doctor Moreau–like science experiment? My preteen daughters are flashing more and more midriff as they cavort to the gangsta rap of Radio Disney (PG or R? If I could only make out the lyrics!). My ridiculously old father is a giant baby who wheels his own crib into traffic, pees into a Starbucks cup, and still wields, intact, his own power of attorney. No wonder I’m feeling ever more sullen about it all; all gynecologists agree that at our age we should be living alone in a perimenopausal cave. It’s not illogical to feel crazy. Oh no, feeling crazy is a reasonable reaction. Feeling crazy means you are being realistic about all that is on the Chinet plate.

  What is not logical is to believe you can handle it if you keep spinning enough plates.

  So who will supply all the caregiving when a whole sandwich generation of fifty-ish women checks out? Maybe it will be men.

  I think, thank heaven, of Mr. X, my girls’ fifty-something father, he who holds up the other end of the fifty-fifty custody balance beam. He is unfailingly calm and patient, buys them fashionable new jeans and tennies, braids their hair, punches new holes in their pink belts, takes them camping, cooks them baked beans, and butters their corn on the cob. By a natural chronology that doesn’t imprison him in this Island of Doctor Moreau–l
ike timeline—given that he would not have dreamed of wanting to do all this as a touring musician of twenty-five—my ex, I think, became a father at just the right stage, which is to say older. At his age, my girls have such a wonderfully nurturing father he might as well be a mother. And he is a better cook. And he teaches them discipline (“Get up on your feet, girl!”). And keeps their roof fixed. Thank God.

  I think of a phalanx of us one time, standing in my father’s dining room in Malibu, trying to figure out a schedule for his care—or at the very least for his capture. In the room at that moment were a failing Alice (seventy-two), myself (forty-nine), Filipino nurse number one (female, sixty), Filipino nurse number two (female, firty-nine), and Filipino nurse number three (male, forty-one). Which of us were going to take care of my dad? By the end essentially everyone had quit except for Thomas, the forty-one-year-old male, who alone has the strength to heft my dad’s wheelchair in traffic, needs the money to support his own family of six, and is paid accordingly (which is to say well—far better than many young college graduates I know). Thank goodness his ring tone is so festive (I think my girls have set it to “Skater’s Waltz”) on my iPhone. Wherever it is.

  POINT IS, the take-home from The Wisdom of Menopause is that rather than being a decline, due to increased longevity and improved health, this almost second half of our lives can be the best time of all. We can feel better, we can feel freer, we can feel clearer, and we can get more done in the world. Northrup believes that our hormones are literally rewiring our brains to get us ready to do this. As part of the process, “attending to our emotions is a crucial part of remaining healthy because the part of the brain that allows us to feel emotions has far richer and more complex connections with our internal organs, such as the heart and cardiovascular system, than does the area associated with logical, rational thought. . . . Your thoughts and your emotions affect every single hormone and cell in your body.”

  So now is the time to deal with all those old emotional memories/habits that have literally shaped your neural circuits. Fortunately, via “neuroplasticity,” we can actually change our thoughts and emotional reflexes. Rather than endure panic attacks and fear and loneliness and anger and grief, it is interesting to start to think of some of these episodes as flooding hormones. Two in particular were interesting to me. Norepinephrine is the fight-or-flight hormone. “It makes your heart pound, blood rush to your heart and large muscle groups, your pupils widen, your brain sharpen.” It gets you ready for battle, but if you withdraw adrenaline from your “account” too often, “you’ll eventually be overdrawn.” And then there’s DHEA, or dehydroepiandrosterone, “produced by both adrenal glands and ovaries. . . . It helps neutralize cortisol’s immune-suppressant effect. DHEA can actually be increased by focusing more on loving thoughts, loved ones, favorite pets, a delicious meal, a sweet memory.”

  In short, apparently your thoughts can direct your emotions and your physical responses. You can actually say things like “I am fine,” and “All is well” in the middle of these panicky moments to bring your stress level down. You can change your thought patterns from dread into pleasant anticipation, depending on what end point you’re fixing on. I guess that damned Eckhart Tolle was right—but I still reserve the right to absolutely abhor his papery T. S. Eliot “The Hollow Men” voice.

  And dealing with the grief that we’ve been carrying for decades is the way to physical and emotional health.

  But if all of that is too complicated, here, finally, is a fun way to think of it.

  WISDOM OF MENOPAUSE ONE-SHEET: MENOPAUSE AS LABOR

  Christiane Northrup helpfully describes the various physical discomforts of perimenopause as “labor pain necessary for rebirth into happy, healthy, fulfilled” women ten years later. Rather than being a dethroned queen who is leaving the human race, you are pregnant with future potential, and what you’re giving birth to is your next, true self.

  She suggests you think of the giant, seemingly uncontrollable waves of emotion—from anger to depression to grief—as labor pains. They are completely natural, developmental, and in the end quite healing. You just need to keep breathing deeply and to let these waves wash over you with no judgment.

  You can think of hot flashes in a similar, if slightly more complex, way. Dr. Joan Borysenko, the author of A Woman’s Book of Life: The Biology, Psychology, and Spirituality of the Feminine Life Cycle, compares women experiencing hot flashes with Tibetan monks who follow a practice called tumo (“fierce woman”) yoga. In tumo yoga the monks strip naked in freezing Himalayan caves, wrap themselves in wet sheets, and then miraculously dry the sheets via huge heat waves produced in their bodies through meditation. In consciously moving their internal life energy from their lower chakras up to their crowns, the monks believe they are burning away erroneous acts, wrong beliefs, and ego attachments.

  So as middle-aged women we get to say how wonderful it is that our bodies are naturally doing that all day long! God (Tibetan?) knows we are busy multitasking, and perhaps do not have the air miles or time to go strip ourselves naked in a freezing cave in Tibet. What a lucky break! All this therapy is being done for us free of charge! Thank you, bloated, depressed, hotflashing body! Hurray!

  Speaking of which, no one has mentioned bloating in this particular context, but I think it naturally follows. During much of my time in perimenopause, and frankly since—since the new “me” is experiencing a fairly long gestation, possibly similar to an elephant’s—my middle has been so distended (even while literally fasting) it has felt as if I’ve been pregnant with a watermelon or baby walrus seal. But no, now I realize that fetus is myself. My belly is pregnant with myself!

  So instead of being depressed about being bloated or trying to fight it too much, one can happily anticipate the new self who will one day arrive (perhaps when I am seventy-two, it seems). One is free to work on a new nursery for the baby or wonder what the new baby will look like. Will the new postmenopausal me be a happy if frizzle-haired lady in a housecoat with a mustache and three cats, and will she be called “Gladys?” Doesn’t matter! I am feeling absolutely no panic whatsoever. Ommm.

  I’m just delighted to be giving birth to a new self. A new self who will possibly need diapers, and that’s all good!

  In fact, why shouldn’t we menopausal women contemplate throwing each other baby showers? We can register ourselves at As We Change and partake of festive party platters stocked with chocolates, wine, and Ambien (not the generic kind, the good kind—because we’re worth it!).

  I can’t wait to see where the new me will end up going to college!

  The Contents of My In-box

  From Isabel:

  I was recently told by my gyno (the wild and wacky Dr. Hamel Azarian) that I was no longer permitted usage of estrogen if I wasn’t willing to add progesterone to the mix.

  It had been so long (four years? five years?) since I first started ingesting estradiol pills, then switching to compound-pharmacy creams (the progesterone in that gentle form still gave me raging depression), I’d forgotten what it was like not to be continually dosed with estrogen.

  It’s been a month since I went cold turkey, and man! what a difference!

  Of course there’s a good news/bad news aspect, but for me the good far outweighs the bad.

  Firstly (speaking of “weighs”), I lost 5 pounds of estrogen bloat that had been there so long, I figured that’s what it’s into now.

  Without even thinking of cutting carbs, fat, whatever, FIVE POUNDS dropped.

  That’s the good news.

  The bad news is continual hot flashes. And with the weight loss, I was convinced the flashing actually burned calories. But probably not.

  However, things are becoming manageable with ESTROVEN MOOD AND MEMORY FORMULA! And I apologize for this e-mail starting to sound like an ad, but I’m totally in love with ESTROVEN MOOD AND MEMORY FORMULA!

  Sure, I had difficulty recalling the word “refurbish” while telling Rich about our new neighbo
rs and the house they’re working to . . .

  REFURBISH!

  But I remembered it about a minute ago, thanks to ESTROVEN MOOD AND MEMORY FORMULA, and its amazing ginkgo biloba.

  Plus there’s tons of soy, and evening primrose, which does help with hot flashes. But, unfortunately, so does abstaining from wine (and coffee, which isn’t going to happen either). However, a wine/caffeine flash is fleeting, once on the ESTROVEN MOOD AND MEMORY FORMULA regimen.

  I’m seeing light at the end of the tunnel. I am 170 days from being officially pronounced menopausal, and like my friend Jan, I expect to “dance a fucking jig” to commemorate it.

  Hope you’re well.

  Love,

  I

  From Kaitlin:

  Papa walking. Next on water. . . .

  From Thomas Flores:

  hello boss,

  just letting you know that everything is fine with FLORES team. eugene is ok and able to walk again. we have 5 days straight schedule in wise.i just hold lexapro pill since it was prescribe for he is ok and very cooperative with me. anyway thanks for trusting us and we do hope that everything will be ok again for this week.by the way if you have time pls. make my deposit tom or wed.(aug 21 or 22) instead on thurs.(aug.23), I made check dated wed and im worried about bank charges. thank you so much.best regards . . .

  Thomas

  From Kaitlin:

  PS. Even if it’s not true about Papa walking again and even if he isn’t even alive anymore (aka: Weekend at Bernie’s) isn’t it awesome to get these wonderful e-mails from Thomas?