by Gail Sheehy
“Brilliant, Gail! It’s the one thing nobody can talk about. You can talk all you want about sex, but menopause—I’ve never even heard the word spoken aloud.”
I WAS AS IGNORANT AS anyone else when the first bombshell of the battle began. It was a Sunday evening in 1985. Snug inside our marriage, a pillow’s throw away from Clay, we were both contentedly reading while jazz lapped at our ears and snow curtained the window. Every so often we looked up and congratulated ourselves on staying home in the cocoon of love and comfort we had created in what was now our apartment on East Fifty-Seventh Street. As I wrote then, “What was that?” I mumbled.
“What?”
“Nothing.”
It felt like a little grenade had gone off in my head. I tried to go back to reading. But some powerful switch had been thrown. I couldn’t concentrate. When I looked down at the page I had just finished reading, I realized that its imprint on my brain had washed out.
A little while later, my heart began leaping against my chest like a frog caught in a jar. I lay down. But I was too agitated to sleep. In the months that followed, I sometimes felt outside of my body. My memory was as solid as Swiss cheese. Clay and I began having Thermostat Wars.
“It’s freezing in here,” Clay would moan. “No, it’s boiling.” “Did you turn the thermostat below fifty again?” “I’m sorry, I just have to open a window.”
It was the little crashes of fatigue that really disturbed me. Having always enjoyed abundant energy, I was furious at myself for crawling home from a day of writing and falling into bed for a “nap,” from which I had to drag myself up to make dinner. I said nothing to Clay. But it’s not like he didn’t notice my mood swings, which were becoming more like the arcs of a trapeze.
This couldn’t be the dreaded Change, could it? But I was only forty-eight.
The first friend with whom I raised the dreaded subject was a sultry-looking woman of fifty who prided herself on her body, her tennis game, and her youthful-looking husband. I asked if she had ever talked with anyone about menopause.
“No, and I don’t want to,” she said.
“Women don’t bring up the subject around you?”
“One friend did,” she said sourly. “I haven’t seen her since.”
The wake-up call came at a Park Avenue dinner party. It was one of those high-protocol parties where the place cards look like tracings from the Book of Kells. I was feeling especially pretty in my new black velvet suit with its white satin collar, when from nowhere, a droplet of something hit my collar. What the—was the waiter dribbling wine? Could there be a leaky ceiling behind all the beautiful wood beams? I noticed Clay’s gaze from across the table turn to alarm: What horrible thing was happening to me? I put a hand to my face.
My forehead was swampy. Oh, no, not me! The moisture began running down my face in rivulets—plop—onto my satin collar. Should I pick up the white linen napkin and mop my forehead? I reached for the five-hundred-thread-per-inch napery, hesitated—No, all the makeup will come off on the napkin. Trying to pretend this wasn’t happening, I turned to the titan of industry on my right and tried smiling and mopping, chatting and fanning, laughing at his jokes and dabbing, when what I wanted most in the world was to disappear into the kitchen and tear off my clothes and open the freezer door—never mind that it was February—and just stand there.
It was time to see my gynecologist. I had always prized him as a solid clinician. I asked if I could be in menopause.
“Not yet,” he said flatly. “You’re still menstruating.”
“But I have these weird symptoms . . .”
With coaxing, he measured my hormone levels. I was very low on estrogen.
“Could I be a candidate for hormone-replacement therapy?” I asked.
“You have to be menstruation free for a year before I can give you estrogen replacement.”
Finally, shamefaced and stumbling over my words, I tried to spit out my worst fear. “I’ve always enjoyed a wonderful sex life with my husband, but I’m not feeling . . . you know . . . juicy.”
“Decrease in sexual response is a natural part of aging,” he said curtly. “I can’t help you with that.” I had just been handed a one-way ticket to the Dumpster. What’s happening to me? Why can’t I fix this? Am I the only one? But I knew too much about passages by now to know that if I was feeling like this, probably a lot of other women around my age were too. And we weren’t all crazy. I put on my research hat. It didn’t take long to discover that most male gynecologists in the late ’80s were woefully ignorant about the mysteries of menopause. It was only when I found a knowledgeable female gynecologist that I began learning about a passage that is universal among half the world’s population.
It was Dr. Patricia Allen, an attending physician at New York Hospital, who identified what I was experiencing as perimenopause—a preliminary phase of this long transition—the three or four years leading up to the end of menstruation, which is often the most symptomatic and anxiety-provoking phase.
We hit it off from the start. She let me know that she didn’t accept passive patients, only those willing to participate actively in their own health care. Fine with me. I guessed Dr. Pat’s age to be early forties. From her appearance—coppery hair swept off her beautiful face, makeup applied sparingly to her delicate features, an intentional switch of her hips when she walked, and a raucous laugh—this was not a woman who would give up on sex after fifty, or probably ever.
“I believe in treating each patient as an individual,” she said. “This perimenopausal period should be a transformation,” she explained, “so that a woman gets to become—physically, emotionally, and spiritually—the best that she ever was.”
“Why do I feel like I’m not me anymore?” I asked.
She leveled with me. “The forties are the decade of greatest anguish,” she said. Women begin to sense a momentous change coming on, but often feel embarrassed to discuss it. Or they cling to the fantasy of endless youth and report to her, when their periods stop at forty-eight, “Surprise! I must be pregnant!” Of the several hundred patients who consulted her about managing their menopause, she said quite a few mentioned feeling depressed, although they had no rational reasons to be. I told her that was true of me.
I was in a thrilling, mind-stretching period of creative redirection in both my career and my new family life, traveling around the country and the world, and coming home to an adored husband and newly adopted child. But I knew I couldn’t take Scarlett’s fiddle-dee-dee approach any longer.
She asked if there was a history of osteoporosis in my family, which brought to mind memories of my mother suffering in her seventies as she sat on her powdery bones. Dr. Pat sent me for a bone density test to the only facility available in the city at that time: the Hospital for Special Surgery. I was a prime candidate for osteoporosis—fair-skinned, thin, small-boned, Northern European extraction—but no one paid attention at the time to Asian women and Hispanic women, who were at just as high risk.
I was already a runner, thank goodness. But now I was educated to add weight-bearing exercises to constantly replenish bone mass. Three mornings a week I tumbled out of bed early to run down to Gilda Marx’s studio on East Fifty-Seventh and pound the boards in a hot and heavy aerobics class. My midsection had thickened. No amount of crunches deflated that tube—infuriating!—until I discovered yoga. Stretching helped. But they could have put me on a medieval rack and I still wouldn’t have recovered my usual trim figure, not until I came out the other end of the transition.
Dr. Pat also took seriously my distress over changes in my libido. “You’re a good candidate for hormone therapy,” she said. But I had read some reports that suggested synthetic estrogen might increase a woman’s chance of getting cancer.
“We just don’t know,” said Dr. Pat. “Why don’t you do some research on different regimens.”
I attended an FDA (Food and Drug Administration) meeting where the question was asked, “What proportio
n of the female population over age fifty would be suitable candidates for long-term consumption of estrogen alone, or combined with progestin?”
“Virtually all” was the answer from the FDA committee. It was a blank check.
“How do they know?” I asked Jamie Grifo, a gynecologist at New York Hospital.
“They don’t,” he said. “The bottom line is, the right studies need to be done for the right length of time, and, clearly, for economic and political reasons, they’re not. Why? Who supports most research? The drug companies.”
I learned that no study had been completed in North America on the possible carcinogenic consequences of combined-hormone therapy, or the long-term consequences for women’s health in general. I asked a public health expert, Dr. Lewis Kuller, “Is it even conceivable that millions of men over fifty—those at the highest levels of the power structure—would be herded by physicians toward chemical dependence on powerful hormones suspected of causing testicular cancer?”
“It’s the largest uncontrolled clinical trial in the history of medicine,” he charged. This was my introduction to the scandalous politics of menopause. Activism was the only answer. I had to talk to the few women in Congress about pushing for a government-controlled study of menopause and the impact of treatments on women’s health. And I had to try to upend the stereotype. “The change” was not a curse that turned older women into victims; it was a freedom that allowed older women to stop trying so hard to please.
That settled it. I had to be willing to go public with my own menopause to start a national conversation about the silent passage. Tina paired me off with a young editor, Elise O’Shaughnessy, to dig through the trove of information and pare it down into a trim article. Years later, Elise admitted that working with me had given her “a fake menopause” twenty years in advance.
When my article was ready for publication in October 1991, Tina told me, “I’m sorry, Gail, we can’t put it on the cover. We have Jessica Lange on her back with her legs in the air.” Only the tantalizing headline was fit to print: “Breaking the Last Taboo.”
Immediately following publication, I was off to Moscow to research a follow-up story on Gorbachev. I tried valiantly to phone Clay, but the wretched Soviet infrastructure made it impossible to connect with New York for two weeks. Until my last day.
“You have to come home, right now!” Clay pleaded. “I can’t stand it anymore.”
I was touched by his ardor, until he told me, “Every party I go to, women crowd around me and insist I tell them about menopause.”
We laughed. He changed tack. “You should think about doing a book.”
“Are you crazy! Who would want to read a whole book about menopause? It’s bad enough going through it.”
BOB LOOMIS, MY RANDOM HOUSE EDITOR, was keen on the book idea. He was dead right in advising, “This should be an experience book,” rather than a medical approach or a historical tome. I committed to moving around the country and listening to women of as many different class and color backgrounds as I could find to talk to me. The deadline was daunting. Loomis gave me two months, from October to Christmas 1991, to finish. He wanted the book for the 1992 spring list. In those same two months, I had to finish the second Vanity Fair cover story on Gorbachev, “Red Star Falling.”
In kid gloves and high heels, Dr. Pat took to the trenches with me to co-lead focus groups with midlife women from Kentucky to California. We found previously confident and highly competent women suddenly feeling helpless from the ignorance, shame, and fear that surrounded the subject. “Menopause!” shrieked a producer who called from Hollywood. “God, I’ve never seen that word written until I read your article.” It was Lynda Guber, wife of then-head of Sony Pictures Entertainment, Peter Guber. She told me she had run into Joanna Poitier and asked innocently, “How are you doing?” The actress-wife of Sidney Poitier wailed, “I’m a lunatic. I’m going through menopause and empty nest at the same time.”
Losing the magic of fertility—that was a deeper mutation and harder to accept. “For many of us who waited until we were well into our thirties and even early forties before having children, the physical power of giving birth is still palpable—it touches something very deep and instinctual,” ventured Suzanna Rosenblatt Buhai, a Los Angeles psychotherapist.
Vicki Reynolds, then the fiftysomething mayor of Beverly Hills, told me, “I have seen women my age go through menopause totally ignorant of what you are saying. We’re looking to you, boomer generation women, to talk about this openly and explore the benefits of menopause. That’s exciting!”
The vestigial attitudes surrounding menopause would be changed by the way women of our time handled it. I was determined to upend the sorry stereotype and showcase the bold new faces of women in middle life.
MOTHER’S DAY IN MAY 1992 was the publication date for The Silent Passage. Again, I hit the road three full weeks in advance and began giving speeches and feature interviews. Those little sparks set off a word-of-mouth blaze like a spontaneous forest fire. Once the seventeen-city book tour began, I quickly learned that talking about menopause demanded a sense of humor, especially with male talk-show hosts. They were stuck with interviewing this sassy woman about a subject they had never heard mentioned, until a producer shoved an introduction under their nose a few minutes before airtime.
“Menopause,” gulped a Cleveland man on the midday news. “Is that like—impotence?”
“Um, no,” I murmured lamely. Only later did I come up with the right answer. “Baldness. Is that like—Alzheimer’s?”
Stunned to realize the level of their ignorance about such a fundamental physiological process, women listeners responded with a desperate “need to know” urgency. The book began flying out of the stores. My most memorable public appearance on The Silent Passage was in the California Bay Area. Alta Bates Hospital in Berkeley was getting threatening calls from women who were refused when they tried to make a reservation to hear me speak. A protest was being planned. One woman swore she was going to look for her gynecologist in the audience. “If I see him, I’m going to say, ‘If you keep refusing to give me hormones for my hot flashes, I’m going to shout out your name and tear off all my clothes!’”
The hospital’s auditorium would hold only 250. The hospital administrator told me they were afraid that something like a thousand women were planning to beat down the doors. The day before the event, the venue was moved to an old burlesque theater in Oakland. When I arrived, there was a double line of women around the block. But that wasn’t what hit me. It was seeing my name up in marquee lights for the first time:
GAIL SHEEHY IN MENOPAUSE
THE CALL FROM OPRAH WINFREY’S TALENT BOOKER was a magic wand. In 1992, Oprah was the model of the new self-made celebrity. She had established the ultimate compassion pulpit. Having broken the silence on so many of our secret shames and wounds, from the eternal battle to shed pounds to the revelation of incest, certainly Oprah wouldn’t flinch from talking about middle age, menopause, and how to bring back a woman’s sex drive. Oprah incorporated my attitude into the philosophy of her pulpit, shepherding women beyond self-doubt into believing this is the stage when we can become our most authentic selves.
After that appearance in June of 1992, Random House began printing books at five thousand a clip; a few days later it was ten thousand, then fifteen thousand, and on one Friday, forty thousand books were slapped together. “That oughta hold ’em,” said Loomis. Demand began to spread to the most remote little burgs in Alaska, Virgin Islands, Hawaii—it was a phenomenon.
The first leap onto the New York Times Bestseller List—at number 8—came a month after the first shipping. That same Sunday, the Times reviewed it, giving the assignment to Barbara Ehrenreich, an angry feminist, who wrote, “One can imagine Ms. Sheehy . . . scanning feminist works and deciding they just weren’t—well—scary enough.”
Ouch! Was Ehrenreich trying to say we should keep the realities of menopause in the closet, since it pointed ou
t how women are different from men?
By the time Tina and Harry threw me a book party at Barbetta’s on June 30, 1992, a Random House executive told me they had shipped four hundred thousand books. Liz Smith, the reigning gossip columnist sitting next to me, printed it.
Clay and I were in London with Mohm, having our own idyll with Shakespeare, when Loomis called to report the good news. “Well, now the Times is going to have to print you’re on the bestseller list whether they like it or not.” By that time, the book was review-proof.
Only four days later, we learned the book would leap to number 1 the next Sunday—astonishing! I was sitting in a publishing escort’s car in Toronto when the Random House representative called me. I sat mute for several minutes. That said it all. The taboo had been lifted, the silence broken. The experiences I had related did reflect what millions of women were going through or anxiously expecting. Once more, I was speaking for strangers.
Then came streams of flowers, masses of white roses from Tina and peonies from Harry Evans, with a card reading, simply, “Natch!”
The bidding for softcover rights began. These rights had not been sold before because Loomis wanted to see what happened to the hardcover, figuring Random House might want to keep the hardcover in print beyond the normal one year. Random House’s paperback line, Ballantine, offered $25,000. My agent, Lynn Nesbit, said, “That’s insulting.”
At a delightful book party thrown for me by Lesley Stahl and Aaron Latham on a sunny summer evening in June, we had just spilled out onto their penthouse terrace when Harry Evans burst in and made a beeline to my side to say, “I just got an offer for $650,000, it’s fabulous, but from here on it will start falling back. It’s a twenty-four-hour offer,” he panted urgently. “I’m off to London tomorrow, so I hope you’ll take it.”
I had to catch the last shuttle to Boston, but I stayed up half the night to finish writing a speech for a League of Women Voters convention. Before six, I was up to take a run in the Boston Commons and back just in time to dress. When I spoke about The Silent Passage, I received warm applause. A long line was waiting for me at the book-signing table, probably 150 to 200 women out of the audience of 1,200. Each one had a story to share. I listened avidly. I have always loved connecting with my readers one-on-one. But I was late getting back to the hotel. Rushing to pack in time to make the next shuttle, I almost didn’t answer the door when a bellman knocked to deliver an urgent message. Call Mort. Heart in my mouth, I phoned Lynn Nesbit’s senior partner, Morton Janklow.