Perimenopause Blows

aging gracefully is hard when your body shows you no grace at all

I am turning 43 on September 16th (Virgo Power!). This age feels weird, to be honest. Maybe its because I don’t like odd numbers, or because 43 sounds so…MIDDLE AGED. Which, it is!

My 40th birthday was in 2021, and any sort of feelings I had about it were replaced with the relief that I had not died in a global pandemic. My mother in law had passed away not even a year earlier, and watching her suffer so horribly at the end of her life certainly was a dose of perspective, to say the least. I was grateful to be having wine outside with my newly vaccinated friends, and knowing that if a few things had gone sideways, some of us may not have been at that table.

Once I was 40, everyone was like “welcome to your No-Fucks Forties!”. I did not, as advertised, lose all my fucks when I turned 40. I did almost have a complete and total nervous breakdown. On the other side of my mental health crisis and ADHD diagnosis and treatment, I am in a much better place, but there is no question that things are getting super weird in Lady Town.

Being in my early-but-approaching-mid-40s means that there is a brand new friend at the table: perimenopause. Perimenopause is the time when your body is beginning the transition to menopause, and your estrogen levels begin to rise and fall more unevenly. This comes with a hefty list of symptoms. In some women, perimenopause can last up to ten years before their periods completely stop.

Ten.

Fucking.

Years.

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I am not mad at being older most of the time. I may be getting wrinkles and grey hair, but I am also a happier, healthier, stronger person. However, when I got my period last month and randomly bled through my super plus tampon at my desk like a middle schooler, on top of getting no sleep because these hormone fluctuations render my meds less effective, I was very much like “fuck this straight to hell”. To add to the fun, I had a few hot flashes, which are like the same ones I get from my allergies except sweatier and, mercifully, shorter. At least I know what to do - drape myself in cold towels or throw myself in a shower as cold as I can stand it.

On top of that, as a side sleeper with big boobs, I have developed these lines on my chest that aren’t going away. I took to the internet for remedies, and was directed to a $45 breast pillow. As I am both a little frugal and my nights would be spent searching for said pillow (ADHD = you never know where anything is), I went the cheaper route: wearing a sports bra to bed with rolled up socks stuffed in my cleavage. I also started using retinol on my neck and chest, and got scammed into buying a neck lifting cream on TikTok. Yep, I’m that many years old.

Speaking of boobs…despite my executive function going directly in the terlet these past few weeks, I managed to schedule my mammogram for the end of September. I have dense breasts so I also need an ultrasound as well as a regular mammo. I hate doing this because 1. mammograms are painful 2. my very first mammogram I had to have a biopsy for what turned out to be a fibroadenoma but it was Not a Fun Time and 3. with all the women I know just in the past five years who have been diagnosed with breast cancer, I feel like I’m walking around with two ticking time bombs on my chest. Of course, I am scared of dying, but I am also scared of anything bad happening to my boobs. They are one of the parts of my body I truly love.

All of this is a long winded way of saying that IT IS REALLY A LOAD OF BULLSHIT THAT WE HAVE TO GO THROUGH PUBERTY TWICE, but at least the first time we got cool stuff like boobs and orgasms. Now its like “hahhaha this is literally the reverse and you might lose your boobs AND your orgasms!”

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Women with ADHD often don’t get diagnosed until their 40s or 50s because perimenopause and menopause make our symptoms worse. It’s not just because no one was looking for the signs in girls and women, it’s also because women are so excellent at masking symptoms. This is the same magic we use when we are in public and we pretend like we aren’t having period related asshole cramps that feel like someone is zapping your anus with a cattle prod, and how a woman can fully be in labor and still manage to coordinate child care for her family. Females are strong as hell etc.

The main reason for increased symptoms is the fluctuations in our estrogen levels as we head into menopause. Estrogen aids with the regulation and production of dopamine and serotonin, and dopamine is the “key” when it comes to mood regulation and executive function. Not only that, a drop in estrogen can cause dopamine-producing cells to die off, which is why women are more at risk of developing conditions like Parkinson’s Disease post-menopause.

If you have ADHD and use medication, you probably have noticed that the efficacy of your medication is reduced during PMS. That is primarily because your estrogen levels drop substantially just before you menstruate, which is part of why so many women with ADHD also have PMDD.

When you get closer to menopause, your ADHD symptoms may worsen, and not just before your period. Even women without ADHD who are in perimenopause can experience brain fog, depression, loss of sex drive, and a whole host of other fun things. Since women with ADHD already struggle with those symptoms, it can be debilitating. In fact, many women seek help because the brain fog, forgetfulness, and lack of ability to regulate their emotions make them think they are experiencing early onset dementia. By the time I was diagnosed with ADHD at 41, I had started to fear the same thing. It was terrifying.

This article in Forbes does a good job of explaining how perimenopause and ADHD are Not Friends:

Women enter the perimenopause years before we finally menopause. During this time, our estrogen levels fluctuate, meaning that on any day we can have too much or too little…During perimenopause and post menopause, ADHD women experience a double compromise, because a side effect of low estrogen is also cognitive dysfunction, difficulties with memory, remembering words, planning and organizing. It's another layer of cognitive fog, coming from a different direction, causing a double whammy.

I am definitely experiencing some more crippling symptoms, especially at certain times in my cycle, and the idea that there may be a full decade of this bullshit to go is truly spinning me out. I talked to my shrink about it and she said that we’ll keep an eye on my medication dosage as I age. I’ve been at the same dosage for over a year and I don’t want to increase it unless I have to, mostly because I’m pretty sure I’m going to need to as I age. There are other options to help as well - HRT (the recent links to breast cancer have been debunked), supplements, etc. I have a physical next month and I am going to request a full hormone panel, just to make sure there isn’t something more I can be doing.

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The bad news is that the vast majority of women will experience this hellscape.

The good news is that we are talking about it.

My grandmother did not go through The Change until she was 56 years old. She did not mention anything to anyone, until my mother found out she was still getting a period and forced her to go to the doctor. I don’t know what they wound up doing for her, but it is wild that happened to her and she just dealt with it. It was just not talked about by women of her generation, and my mother’s generation as well (Baby Boomers).

I am seeing writing about perimenopause and menopause every day, just here on Substack.

Eileen Dougharty

writes about aging with humor and grace.

Dr. Jen Gunter

serves up information and truth at

The Vajenda

.

Sari Botton

interviews loads of peri and post-menopausal women over at

Oldster Magazine

. That is just off the top of my head. When women band together, tell their stories, and speak their truth - amazing things can happen.

I am glad to know that there are things I can be doing now to make this journey a little easier, and also that if I do struggle with it, it’s not because I’m going crazy. I know all to well what it feels like to do battle with your body and mind and not know how to fix it, or even what it is. I am hopeful that with this increased awareness, perimenopause will be more extensively studied. We shouldn’t have to suffer through it without knowing the range of our options, and seeking medical attention if we need it.

Updates from The Long Climb:

• I have just not had it in me to do voiceovers/podcasting much this summer. Posting was about all I could handle. I hope to get back to recording voiceovers soon, but as incentive for myself to do it and because it is so much work, I am debating on making voiceovers available for paid subscribers only. I am very open to feedback on this, so please feel free to give me feedback here in the comments or in a private message.

• My sale on paid subscriptions is active until 8/31! 25% off a paid subscription and that is your price FOREVER. 10% of proceeds to reproductive rights up until election day on ALL subs! We are at over $100 now! Woo! I haven’t settled on an organization just yet, but I’d like it to be in a place where it is needed the most. If you have suggestions, drop them in the comments.

• My friend Barbara Sheridan of Bonnie Brae Boutique is selling these amazing “Cat Ladies for Kamala” window charms! She has tons of cute gifts for sale there as well, all handmade. Check it out!