Are You There, Menopause? It’s Me, a Millennial Mom
*The information herein does not and is not intended to constitute mental health, medical, or legal advice – please contact your healthcare provider for your specific needs.
My generation pretty openly discusses periods and puberty, pregnancy and parenting. We were educated by Judy Blume, rated R rom coms and health class where we learned to put condoms on bananas. We’ve supplemented our knowledge throughout each life transition with nonjudgmental discussions with each other (and of course, the internet). We openly talk about struggles with fertility and the maternal mental load, about the need to advocate for healthcare and sexual pleasure. We get empowered by sharing knowledge.
And yet, many of us know far too little about menopause. An informal survey of my friends (both IRL and on Instagram), revealed that most of my peers feel overwhelmed at how little they know about this impending developmental stage. Feeling clueless (even as an educated woman with a passion for women’s rights and a social work practice specializing in women’s mental health), I started asking questions. What do you know about menopause? One friend replied: That I’m not ready to talk about it!
But as I enter the last year of my 30s, I’ve decided it’s time to talk.
What exactly are we talking about?
To clear up any menopause misconceptions as this next life phase approaches, I call my friend Arielle Bayer, MD, board-certified OB/GYN and reproductive endocrinologist and infertility specialist at CCRM Fertility of New York whom I’ve known since we were teenagers focused on first loves and teenybopper concerts. “Menopause is defined as the permanent cessation of your period after a full year without any menses for which there are no other causes,” she educates me. “Perimenopause is the term describing the time leading up to menopause when symptoms start due to hormonal fluctuations, often beginning in your mid-40s and potentially lasting for several years.”
A millennial man with whom I was discussing this topic asked: Menopause typically happens when women are in their 60s, right? Wrong. “The average age of menopause for American women is between 51 and 52 years old,” reports Dr. Bayer. “It can happen earlier due to a genetic predisposition or as a result from surgical or medical procedures.”
A mom friend told me: All I know about menopause is to expect to break into sweat at inopportune times. Dr. Bayer acknowledges: “A hot flash – a symptom 80% of women will experience – can be very distressing and disruptive to daily life, because it can arise out of nowhere and occur multiple times per day. Dropping estrogen levels alter the brain’s thermostat, causing increased sensitivity to temperature changes. Other menopausal symptoms include vaginal dryness, brain fog, mood swings, decreased libido, bone loss, slowed metabolism, low energy, and sleep disturbances.” Symptoms can also include changes to skin or hair, decline in memory, or increased feelings of rage or irritability, particularly before a period.
I wondered: Many of my clients and girlfriends in their late 30s and early 40s would describe experiencing low energy or fatigue – so, are they perimenopausal? “Possibly,” per Dr. Bayer. “Menopause-related symptoms vary person-to-person. The first thing to look out for is changes in your menstrual cycle. Periods can become heavier and more frequent, or alternatively, lighter and more sporadic. If you notice any of these changes or bothersome symptoms, talk to your OB/GYN. They can check hormonal blood work, perform an ultrasound, and rule out other potential causes.”
Why are we talking about it?
It’s important to know our bodies’ baseline so that we know when something seems a little weird. “It’s common for women to ignore symptoms or write them off as due to other stressors. But you deserve to feel heard,” Dr. Bayer says. I certainly see a reluctance to care for themselves among the women I know, and so do many other women’s health practitioners. “It’s so easy to forget to prioritize our own health when so many around us, including partners, kids, parents, etc., need us,” agrees Alicia Robbins, MD, board certified OB/GYN, certified menopause practitioner, and lifestyle medicine doctor who founded The Elm, a boutique women’s health practice for women in New York and Connecticut. “But I am a firm believer that taking care of our mental, physical, and emotional health positively affects those around us.”
When we know what to look out for, we can get what we need to feel good. “You don’t need to muddle around for years just living with (or suffering from) symptoms that make you feel bad,” encourages Brenda Green, FNP-BC, a nurse practitioner and the co-founder of Follaine Health, a New York City-based practice offering personalized treatment to perimenopausal and menopausal women. Brenda has worked in healthcare for decades, but it still took six different doctors over the course of several months to get appropriate care for what she now recognizes as clearly perimenopause. “If you’re in your 30s, the best thing you can do is get educated. Symptoms are so easily managed and alleviated with early intervention.”
Relief can come in a variety of ways, especially since everyone’s experience is varied. Brenda cautions: “‘One size fits all’ is not a good idea regarding menopause treatment. You know your body best. And you deserve attentive and informed care with close follow-up.” Hormones like estrogen or progesterone may be prescribed and can come in various forms and dosages, including topical vaginal estrogen (particularly helpful if dryness is leading to painful intercourse or urinary tract infections), a patch, or a pill (which may also be needed as a contraception, because perimenopausal women can still get pregnant!). Notes Dr. Robbins: “There are many hormonal options and even lifestyle changes we can do to help us feel better now and set us up for the future.”
How should we talk about it?
Unapologetically, I say. Menopause is natural, inevitable, and nothing to be ashamed of. We must be candid with our providers about what we’re experiencing so we can rule out any health issues that may have overlapping symptoms. We may need comprehensive support from various specialists. “I always suggest incorporating mental health therapy during this time because life stressors can also contribute to the negative emotions you may be experiencing with these changes… Take the time to discuss each symptom with your providers and get the right kind of support. Our quality of life is so important.”
On a broader level, we must also advocate for accurate information and a societal investment in our health. Because menopause is considered a women’s issue, it generally has not been prioritized or openly discussed in our culture. “Unfortunately, there isn’t much training at all (if any) on perimenopause in medical school, so most MDs don’t know how to treat it,” reflects Dr. Robbins. First Lady Jill Biden’s new White House Initiative on Women’s Health seeks to change the narrative and is a welcome shift. Collectively, we need to focus on demystifying and destigmatizing these topics, and we need more conversations about what resources are available. “We should be talking about the ways hormone treatment can potentially help menopausal women with all kinds of health issues, including diabetes, osteoporosis, and heart health,” asserts Brenda.
What else can you do to prepare? Share information from reliable resources – with the women and the men in your life. “Men should be mindful that there are so many changes going on for women at this phase,” suggests Dr. Bayer. We both believe that being able to talk about it will lead to better experiences and more opportunities for support. Credible educational tools include books like Happy Healthy Hormones: How to Thrive in Menopause and Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women’s Well-Being and Lengthen their Lives – Without Raising the Risk of Breast Cancer. Help dispel misinformation by following blogs like Alloy’s “The Flash” or Instagram accounts like that of nonprofit Let’s Talk Menopause.
Remember that while menopause is a universal experience, it is a unique one. So your peers may all endure totally different symptoms. “I like to say that each woman’s hormone profile is as unique as a fingerprint,” explains Brenda. “This means it is important for women to get individualized care.” Have empathy and validate the women around you, even if you don’t exactly relate. “The more we discuss it and understand it, the less women will feel that it's all in their head,” expresses Dr. Robbins. “I want perimenopausal women to know, you are NOT crazy!”
And you’re not alone. Millions of millennials – including me! – are with you. And we are so powerful together.
Lauren A. Tetenbaum is a writer, a mother, and a social worker specializing in supporting millennial moms and young women through life transitions. Through her counseling practice, Lauren facilitates psychoeducational groups and workshops to empower postpartum and other women in corporate settings, provides therapy in New York & Connecticut, and contributes to media on topics like maternal mental health, gender equity, and working parenthood. Learn more about Lauren at www.TheCounseLaur.com or connect with her on Instagram (@thecounselaur) or LinkedIn.