Perimenopause is NOT my friend: Episode 1

When Izzy was little she would name the bugs and creepy crawlers around her. She named them all Liam. Every last one. Liam. 

She would turn to a spider walking by on the baseboard and exclaim “That Liam is NOT my friend” stressing the NOT for added emphasis.

I talk about perimenopause a lot these days. I have elected myself into the court of women who refuse to make this stage of life the taboo, shame-inducing, embarrassing, not to be discussed phase that it was for generations past. 

When I start weekly rose-bud-thorn meetings with a team of people much younger than I, my thorn is often perimenopause. I look around the table at the smooth-skinned humans from Iraq, Jordan, Britain, France, and the US born in years that start with the numbers 20. They look back at me and I realize that in some—most—of their—our cultures I am breaking real rules. 

When people ask how I am, I tell them—this phase of life is a lot. My daughter is entering puberty and I’m battling the fiercest stage yet of my hormonal journey. Perimenopause is NOT my friend.

Finding care in Jordan hasn’t been easy. From what I can tell, there is one menopause specialist here. OBGYNs abound, but most OBGYNs are interested in the bringing babies into the world phase, not the “were shutting this whole thing down” era. People don’t talk about it and when they do they typically prescribe to the “I guess this is just a phase of life we suffer silently through” camp or they are hobbling together an international triage to tackle ALL THE SYMPTOMS.

A year ago I realized I was depressed. I had only been depressed—clinically depressed—once before in my life. In my first trimester of pregnancy, I went on Zoloft—and a few weeks later I was finally able to get out of bed, go back to work, and make it through the next seven months. Because I knew my body believes that hormonal changes are NOT my friend, I figured this depression was “the change.”

I posted on an expat parents’ WhatsApp group for a psychiatrist recommendation and I picked the one that had experience with pregnant women. Treating women. Check. Treating hormonal changes. Check. Dr. Mohammed saved me. After two sessions he diagnosed me with depression and “prescribed” me Zoloft—it’s in quotes because in Jordan, Zoloft is over the counter and costs less than $10 for a month's worth of doses. No insurance game needed.

I booked an appointment to see the one menopause specialist in town and waited—an unheard of time in Jordan—two hours to be seen.

“What brings you in today?” she asks, glancing at me from across the imposing wooden desk.

“I think I’m starting perimenopause,” I respond in the calmest, most factual, reasonable patient voice I can muster.

Without looking at my intake form, she peers at me over the top of the reading glasses perched on her nose. “A little young, aren’t we?”

My chest gets hot. I am at the same time furious and so deeply frustrated. No, maybe sad? Disappointed? I’m furious that time and time again women get treated like this in doctor’s offices. Like they don’t know what they are talking about. Like they are not the experts of their own bodies. 

My eyes fill with tears that I’m struggling to hold back. I’m frustrated that this supposed specialist is yet another person who doesn’t believe or want to listen to me. I’m sad that I’m alone in this struggle. That generations of women before me were alone in this struggle. And I’m disappointed that I’m going to walk out of this office as lost and unhelped as I walked in. And a little more crushed.

“I’m 45. That’s a perfectly normal age to start perimenopause,” I choke out as the tears begin to fall. 

She performed a Pap smear and took some blood to test my hormones to have scientific proof that I’m in perimenopause. But it doesn’t work like that. I’ve read the books and listened to the podcasts. Because hormones fluctuate so drastically from day to day, you can’t do a hormone test to determine if someone is in perimenopause. And anyone who relies simply on blood tests to determine perimenopause in a word, a quack. 

My hormones at the moment the blood was drawn may have been fine. An hour later, likely not. An hour after that, a totally different story. THE most reliable way to determine if someone is in perimenopause? If SHE thinks she is then by-golly, believe her. 

I walked out. Dejected. Unheard. Invisible.

At the same time I hired a personal trainer, got a therapist and a PT (free thanks to the hubs’ benefits package), took a break from work (paid), started taking vitamins after a barrage of blood work, and was generally kinder to myself. It all worked. After a while, I felt almost new. I felt almost revived. I felt almost like me. 

Eventually other symptoms appeared. 

My already thin hair decided my scalp was NOT its friend and I’d lose clumps every shower. My finger and toe nails became so brittle they would break off if I accidentally brushed them on a step or the edge of a counter.

My pelvic floor felt weak. Weaker. The fact that I peed when I sneezed or coughed was no longer funny. My skin got oily. Like a hormon-y little teenager. Every time I brushed my teeth, my gums bled. And yes, for the record, I was flossing. 

I started sweating through the sheets. Every night. I’d wake in the early hours of the morning, a ball of anxiety spinning in my head, peeling the sheets off my body, change my clothes and be unable to crawl back into the puddle that was my side of the bed. 

Anxiety woke me up. Anxiety kept me up. Anxiety followed me around my house and hopped in the car with me. Anxiety sat next to me at every meeting spinning tales in my brain and even occasionally speaking up—never adding anything of use and quite a few times, taking the literal air out of the room.

My cycle got less predictable and lasted longer. Every month. I started getting migraines. Migraines! Never had one before. Now I know what y’all are talking about. Holy hell. Those are a bitch. I’d go into my bedroom, close the doors, pull the room darkening shades, put an eye mask on, crawl under the covers, and pray to any god I could muster that I’d find the strength to sleep it off.

I lost interest in sex—something I have never been short of interest in. And after compiling exhibits A through double Z above, I think I might have an inkling why. 

A year after the original symptom of depression appeared, I found myself due for a Pap smear. I had also collected a few additional symptoms—ones that were very much affecting my life. The hot flushes had joined their friends, the night sweats, making me unable to regulate my body temperature at any time. 

I now bleed so heavily every month that I think I might lose enough blood to spontaneously die. My muscles and joints are twisting themselves into pretzels so regularly that my PT makes weekly house calls. And my brain is so foggy that it literally took me hours of writing to recall this symptom. 

After compiling the new list of additional symptoms with the original list, I posted again on the WhatsApp group.

Looking for an OBGYN who specializes in peri/menopause who is not Dr. Judgyface.

But I used her real name. Radio silence. People don’t talk about this. Especially here. After a while I got a few responses.

I don’t know if she’s a perimenopause specialist, but I love my OBGYN!

Not helpful.

I love Dr. Doctorface (not her real name). I don’t know if she specializes in menopause though.

You are NOT my friend.

Eventually a few people sent me DMs. 

I went to see Dr. Doctorface and she refused to prescribe me hormones. Let me know if you find anyone.

I’m going to see an endocrinologist next week because the OBGYN was so dismissive.

You haven’t gotten any recommendations, right? I’m not surprised. No one talks about that here.

Have I mentioned that perimenopause is NOT my friend?