Power surge – that’s my fancy name for hot flashes…
In all seriousness though, what I love about my Gen X group is our absolute refusal to take this life transition lying down. Previous generations suffered in silence, rarely discussing it with peers and certainly not with the generation behind. What we are finding however is a medical system completely unequipped to address our demand for answers. For goodness sake, prior to 1993, women were rarely included in clinical trials! That means we know very little about the unique responses to medications and surgical procedures that women have versus men. In January of 2024, it was reported that less than 2% of medical research funding globally is spent on the female reproductive system. The picture is even more grim for women of color who face unique geographical as well as systemic oppression health consequences.
Thankfully, things are slowly changing and there are resources popping up to help us understand what is happening and how best to move through it. Unfortunately, some see an opportunity to make a fast buck so there are a lot of “snake oil” options to be found. Finding a doctor who humbly acknowledges the severe deficits in women’s health and is committed to listen and learn is vital for assessing our options and choosing wisely.
But perimenopause/menopause is not just a physical experience. While I have found much content on the physical aspects of this season, I have not seen a ton on the mental and emotional ‘adventure’ of it. When that is mentioned, experiences are often chalked up to hormonal causes. I find this quite minimizing and inadequate. While hormonal changes absolutely impact our emotions and concentration, there are a multitude of developmental changes that have a more relevant effect on what is happening for us emotionally and mentally.
By the time perimenopause begins (around age 47 on average), we have often reached a much more stable understanding of who we are, what we want, what we will tolerate and what we will not. There is a shift happening toward setting boundaries, speaking up for ourselves and caring less what the world at large thinks of us. This is also the season when the discrepancy between who we now understand ourselves to be and the life we actually built become glaringly obvious. Is it any wonder that irritability, depression and anxiety might manifest? All of this awareness with no place to go is a recipe for trouble all by itself. Add in hormonal changes, and you can see where the ‘fireworks’ come from!
Something else I don’t see talked about much is the wrestling match we engage in with the illusion of control. We live in a society (here in the US at least) where health is one’s personal responsibility. There is little acknowledgment of what we call the “social determinants of health” which actually have 64% of the impact on our health. Perimenopause really brings that reality to the forefront but everything around us is still saying it’s up to us as individuals to conquer the symptoms we are experiencing. With this kind of gaslighting, does it make sense that depression and anxiety might show up?
Also largely missing from the conversation is the actual developmental growth we can lean into: greater body appreciation and even liberation, as well as improving self regulation, boundary setting, and time management skills. This is a wonderful season for self awareness and examination. There is also an opportunity to take our spiritual development to the next level – one of integration and comfort with mystery.
Finally, a vitally important piece to the perimenopause puzzle is the need for grief work. Perimenopause by definition is a transition to a different state of being. While there are gifts on the other side to be discovered (see developmental growth above), there are also significant things we are letting go of, and that must be honored. To move forward unhindered, we must surrender what is passing away (versus desperately clinging) and purge what no longer serves us. That is the point of grief work. It allows us to get on with mastering this new season and awakening the gifts of post-menopause.
To continue this conversation, check out my video series on YouTube. Leave a comment here or on our videos with your questions or experience. What have you found missing from the perimenopause dialogue?