TW: Graphic talk about lady parts.
“Happy belated birthday,” my gynecologist said as she snapped her gloves on and began my very first rectovaginal exam. I was informed of this new addition to my annual visit seconds before the felicitations. Apparently, turning 50 came with more surprises than I could imagine.
I’d been putting off all of my annual appointments because of the current pandemic but after my last bizarro period, I needed a check-in.
I first got my period the summer after I turned 14. I remember I had slept in the basement the night before because that July was oppressively hot. I woke up feeling sticky between my thighs, looked down at my new white satiny underpants covered in rust-colored blood, and walked upstairs to find my Mom. Since I was a lazy teenager enjoying summer, I’d slept well past an appropriate hour for showing up in our kitchen undressed and unannounced. When I got to the doorway, I saw that my mother was having coffee with one of our neighbors. Her annoyance with me was palpable. Before I could say anything, she walked down the hall into the bathroom to grab a maxi pad. She then handed it to me and picked up her conversation where she left off. We never exchanged another word about my period. In my resourcefulness, I found Planned Parenthood shortly after and they all but saved my life a few times. They provided everything my family and teachers did not – an education about my body: how each part functions, how we get pregnant, how we change and grow. (I ended up volunteering for PP in my early 20’s as a sex educator in California public high schools but that is a story for another day.)
I’ve been a stalwart menstruator since I began – every 28 days. Being on the pill for a while may have helped cement that cycle but regardless, it was a rare month that she didn’t come on time. I was either pregnant or out of whack from multiple timezone crossings. This is what I thought might be happening about two years ago when for many months in a row, my lady parts would not do as they had promised the previous 30+ years.
When I started dating my husband at 41, I sensed my biological clock quietly ticking away. At the time, my doctor assured me that I was still fertile and could likely have a healthy baby. I had always wanted a sibling for Jackson but my husband already had two little girls. It felt like we were just starting to dream about our future lives post-raising kids. The idea of having a baby, in the midst of blending our families, was too much to wrap our heads around. I’d have been in menopause when the child graduated from high school, which felt like an eternity away. I told myself that it was the responsible thing not to do. I was sad for a while. I realized, though, it was less about not having a baby with my husband and more that I was never having a baby again. Period. Ever.
Shortly after, I started noticing that something odd was happening to the skin under my chin. It wasn’t that I had an occasional rogue hair poking out, no, that had happened a few times since giving birth to my son. This was as if the skin had detached itself from… where it should have stayed. But I chalked it up to being dehydrated, which I often am.
Then came the dark circles under my eyes. I had a fair amount of stress in my life at the time, so I figured that when things calmed down, these would disappear. I probably just needed more sleep.
One time, I woke up in the middle of the night irritated and hot. The next day my husband agreed it was too stuffy in our room so we vowed to get a ceiling fan.
And then a host of things seemed to happen in a wave:
- the back of my usually toned arms suddenly lost their shape and were replaced by fat
- my underwear stopped fitting me to the point of leaving indentations on my hips
- my pms symptoms were on steroids so my normally gentle clumsiness was just shy of falling-down-stairs-breaking-neck
- my period was so irregular that I’d stress out taking pregnancy tests despite the 99% effectiveness rate of our chosen birth control
- my already fine hair began thinning at my forehead hairline
- and then there was the day I failed the pencil test (google it.)
I could no longer ignore that my body was changing, and fast.
For my upper lady parts, I was less concerned. I have always had dense (read: fibrocystic) breasts, so mammograms and ultrasounds were not new to me. I have had a few biopsies and titanium markers injected, and everything seems to be alright. The sag in my small breasts was nothing that couldn’t be fixed with a solid underwire (read: uncomfortable) bra.
But down south, nothing felt normal anymore. I had months where I was five days late or 50 days late. One time, early on in the pandemic, I was going on 75 days late when it came in the middle of the night, ruining the sheets. Months where it would last two days or ten, where I’d be functioning normally or curled up in bed unable to move.
So, when my doctor recommended an endometrial biopsy, especially in light of the fact that my mother had recently been diagnosed with endometrial cancer, it sounded like the right thing to do.
That rectovaginal exam was easy-peasy comparatively speaking, that’s all I will say. The good news is that what is happening to me is normal, no malignancies. Just perimenopause.
So, why don’t we talk about these changes more openly if it is normal? Normal is clearly a relative term, of course. There are some women for whom this transition goes smoothly, without incident. Lucky ladies. I never understood why it has become a joke or something to be embarrassed about, though. All women experience it on some level. Why is it ok for our men, our family, our culture to make jokes about frigid, old, dried up, over the hill, sagging, droopy women? Why aren’t we powerful, wise, and strong instead? What is ‘old’ anyway? Do I look good for a fifty year old woman or do I just look good? And by whose standards?
I’m starting to wonder if I care that I can’t fit into my pants anymore. Should I buy new clothes? That would be fun but expensive. I am beginning to understand now why older people wear polyester and prints, why they ‘let it all go’, why the big bulky weird sneakers and slip on shoes. Comfort is key as we age.
Oh, I know. I could just put myself on a progesterone iud and never get a period again. Or so that’s what the pamphlet says. Or I could get an ablation – secretly jealous of those ladies who got ‘em early and have been period-free for years. And maybe I will do those things. Or maybe I won’t. Maybe I’ll keep the extra pounds around my belly and start wearing mumus. Stylish ones, of course. Maybe I’ll keep eating cake and start loving my sagging neck skin. Maybe I’ll design a device that reads my internal temperature so when I wake up in the middle of the night feeling like it’s 847°, I won’t be imagining what the earth’s core is like before erupting a volcano. Instead, a little a/c unit will start blowing cool air to put out my fire, so I don’t miss a moment of beauty sleep.
Since my doctor tells me this perimenopausal state could last for years, it seems I have plenty of time to decide how to manage it. In the meantime, I’ll be over here fanning myself and working with a contractor on how best to install a fan on a sloped ceiling. Wish me luck.
Aging Health Menopause Perimenopause Self-Care vulnerability Women Women's Health aunt flo blood changes gynocologist iud menstruation middle ages old crone over the hill Perimenopause period planned parenthood progesterone wise