Poetic Menopause

The Allegory of the Memory by Antoni Pitxot Soler

Long time no write. I meant to write a 'one year on' post, then a 'two years on' post but found I had so little to say, so this is something of a 'nearly three years on' post. I went for my regular check-up recently with the lovely Karen at St Mary's and was told to come back next year for what will be my penultimate visit. It has been particularly nice to see the same nurse each time and that she has been kind and supportive. My hot flushes have faded away after the first year and I only get them very rarely now, and it would be hard to pin down any other symptoms that have caused me any particular trouble. I debated deleting the whole blog because I didn't feel I had anything helpful to say on the subject but decided to leave it just because of the endometrial cancer and how important it is for women to be aware of the risks and symptoms. And also because I like looking out for the very occasional mention of menopause in literature.

Today I bring you a poem. I picked up randomly (it's the best way to pick up poetry) 'How the Stone Found its Voice' by Moniza Alvi (the cover image being the one above) and I found this one:

The Thieves

A period, you'd imagine, is no use
to anyone, but the woman who owns it,
who thought she held it secure

in the safe of her body.
Yet thieves broke in and grabbed it,
took it instead of her jewellery:

She's forty-nine, she won't miss it -
we'll just take the one, maybe two.
On the other hand, we'll have the lot,

stash them away. Nothing to boast about.
Not anything you'd forget, though.
To make off with them on a quiet night - 

it's like stealing the darkness itself,
or taking the moon, bowling it away,
expecting it to retain its glow.

Expensive People

Long time no post. I keep meaning to write a 'One Year On' post but have nothing much to add. I debated just leaving it here but decided I would keep up with my 'Menopause in Literature' posts, just because it amuses me when I come across them. This one is from 'Expensive People' by Joyce Carol Oates, reviewed today over on Silencing the Bell. It was written before she had experienced menopause so I guess she just had to go with the cliché.

"'My mother is inclined to hysteria,' Gustave explained. 'It's the change of life, you know. You can't be too careful with them at that time.'
'What's wrong with her?'
He stared at me coldly. 'It's a biological condition,' he said.
Biological conditions of mothers always frighten me, so I said nothing.
'It began a few months ago, and I knew at once what it was. I had had sense enough to be reading ahead. Father doesn't have the slightest idea what's going on - he wouldn't want to admit his own age - and I can't possibly tell him. How could you tell your father anything so personal? I've left a copy of the Reader's Digest around with a lead article on the subject, but ... My mother gets upset all the time, she cries if the toast is cold for Father, she's always picking on our maid Hortense, and she's always on the telephone, it's embarrassing, and yesterday her parakeet Fifi died and she spent all day crying, then accused Hortense and me of not giving a damn about the parakeet. so she took the corpse into the kitchen and put it in the garbage disposal, and before I could stop her she had turned it on. She was hysterical about that. This is a difficult time of life for both of us,' Gustave said vaguely." (p.55)

Surgical Menopause

It feels a bit like it's all over now. The wounds are all healed, leaving little pink marks that barely look like they will scar, it's most disappointing not to have anything to show for it. I expected to feel more different, like there was something missing somehow, but no. I am officially in 'menopause' and don't have to wait for it to be a year since my last period. There is no more uterus, no more ovaries, no more hormones. Having a total hysterectomy is also referred to as a surgical menopause because it happens all at once, there is no lingering dwindling of your oestrogen levels.

Wiki Commons

It turns out that oestrogen is a bit of a double edged sword. I was worried about the impact of the hysterectomy on my risk of osteoporosis but on having a chat with my GP she reassured me that since I am of normal menopause age it will not increase my risk, since my hormone levels were already in decline. Oestrogen has a protective effect on your bone density which is why the menopause puts women at higher risk of having fractures. If you were to have a hysterectomy at a younger age, say 40, it would substantially increase the risk, because you would be losing all those extra years of oestrogen production and protection. On the other side of the coin however an excess of oestrogen is one of the risk factors for endometrial cancer, for example, experiencing early puberty, late menopause or never having children. 

So, the hot flushes have finally arrived, and I have been quite enjoying them. Is that weird, I'm sorry. I was feeling quite bereft since they seem to be an almost universal symptom. My mum commented that she has found a surprising small benefit of menopause that she doesn't feel the cold as much as she used to. I have certainly felt that my body temperature in general seems warmer. I am guessing that my flushes are probably quite mild as I don't tend to pour with sweat or need to remove layers of clothing. I find them to be quite a pleasant sensation, like warmth washing over your body. They do wake me at night and I just stick my legs out of the covers, but mainly it feels like a positive thing on winter nights. 

I was anticipating something more dramatic, emotional outbursts or something, but rather dry skin seems to be the only other symptom. Life is quietly going back to normal, as if the whole thing never happened. Exactly eight weeks after my diagnosis my nurse called to say that they did not need me to come in for an appointment since my biopsy results were all clear and there was no sign of any spread of the cancer. It must be the shortest time that anyone ever had cancer. I went back to work after Christmas and plan to go back on delivery next week. My tummy muscles feel a bit achy after a day standing up but I'd be hard put to blame my tiredness on anything other than the fact that I sat around and did nothing much for five weeks. 

Doing my bit for medical science

So the operation is all over and done with but I will write about that another day. It felt surprisingly like consolation to be offered the chance to take part in some medical research, I mean when you have something serious it feels important that some small good might come out of it. I got a call from one of the doctors at St Mary's to see if I would take part in a drug trial, and then had a meeting with her after I saw the oncology consultant. The drug Metformin is prescribed to diabetic patients and has something to do with balancing blood sugar (it was explained in more detail than that but I don't recall). It was noticed coincidentally that for women taking it who also had endometrial cancer their tumour appeared to grow more slowly. The trial is seeking to establish if there is a link between the drug and tumour growth and so non diabetic patients with cancer are being given the drug in advance of their surgery to see if there is any effect on the growth of their tumour; I took the tablets for the four weeks up until my operation and then they will compare the biopsy results taken at my hysteroscopy with the ones done after my hysterectomy. It was not part of my treatment and there was, of course, a 50/50 chance that I would be in the placebo group anyway.

The information listed some disconcerting side effects but I was fortunate enough not to really experience anything, though my tea did taste a bit weird for a few days one week. I saw the same doctor when I was admitted last week and she took another armful of blood, and that will probably be the last I hear about it, unless I actually seek out the study when it is published.

The second piece of research is being conducted again through the oncology team at St Mary's and is looking into Lynch Syndrome, an inherited gene mutation. It has strong links to several cancers, most significantly bowel cancer, but also endometrial and ovarian cancers. The purpose of the study is to find out what proportion of endometrial cancers are due to Lynch Syndrome and so be able to argue that patients should get routine screening so that preventative checks for bowel cancer could be offered. The doctor said that they were particularly keen to get me signed up because I did not have any of the other risk factors for endometrial cancer. In this study I will get actual results from the test, either positive or negative for the gene in question, and then the option for follow up care.

Leaflets and more leaflets

If leaflets could make anything better I would already be well on the way to recovery. You find yourself reading them as much for comfort as for information. The fact that they produce such leaflets indicates that this is all kind of normal, happening to lots of people, an everyday occurrence. Imagine having something so rare and frightening that there was no leaflet to explain it to you. 

This post is about to become an object lesson in getting that unusual bleeding checked out. Pretty much the entire of my menopausal symptoms has been unusual bleeding, so this was my problem. Things had been progressing much the same over the last however many months since I last posted, random intermittent periods, some lengthy, some long gaps. Then in June I got a letter inviting me to come for my cervical smear test. Then I started bleeding, so I put it off. And I carried on bleeding. And then it went on a bit longer. It faded in and out a few times but was mostly continuous until the end of August when we came back from holiday. The beginning of September (17th) I finally made an appointment and saw the nurse. When she gave me the 'Can you give me the date of your last period?' question I explained to her what had been going on. I thought nothing more about it but a week later I got a call from the surgery inviting me to make an appointment to discuss it with the doctor. (28th September) She listened to the same description and then did an examination. She said there was a polyp on my cervix and she wanted (because of my age) to refer me to the hospital for further investigation. Like with the breast lump it was one of those 'get an appointment within two weeks' things. Later that week (1st October) Monkey and I were in the Arndale in town on my day off when a nice young man from the hospital called. He said they had a cancellation and could I come in that afternoon.

So a few hours later I found myself at St. Mary's with a camera up my nether regions, having a hysteroscopy. It was actually quite cool to get to see the inside of my uterus, and in hindsight nice that I got to see it before they took it away. She removed the polyp and they took a biopsy and she said that although the wall of my uterus was a little thickened  and I had a small cyst on one ovary everything looked fine and that I should make an appointment to come back in 3 months. I went home, feeling reassured. The letter came from the smear test people and everything was normal.

Then the following Friday (9th October) the young man called again while I was at work and said there had been a mistake and I needed to come back for my test results. I said to him, oh no, I was told to come back in three months. He said he had an appointment for me the following week, and when I tried to say that it was not convenient because I would be at work he told me it was urgent.

That was the first time I cried at work. 

I tried very hard to be calm and rational but the next week was not much fun. As you might imagine stuff went around my head. Thursday 15th October I left work early and sat for over half an hour past my appointment time. Then the consultant I had seen the previous week, plus a nurse specialist, sat me down and told me that I had endometrial cancer. It was a relief to have it said out loud, because once the worst has happened you are in a far better place to deal with it. Then she said I would be coming in for a total hysterectomy within the next month. This includes the removal of the cervix, fallopian tubes and ovaries. Because the cancer is hormone based they are taking away the source of oestrogen completely to help ensure it does not recur. It is very small and early stage. They will not know until after the operation but they are fairly confident that it will be contained within the uterus and that I should not need any further treatment. I was then referred on to a gynaecology oncology specialist and saw one doctor who is on the team on the 28th October, though she will not be the person doing my operation. She gave me their first available appointment, so I am due to be admitted on the 24th November. 

So here is the message: unusual bleeding - go to the doctor, especially any bleeding after you are official post-menopause. Pay attention to your body, take care of yourself, catch it early.

Old lady sex

I have just reviewed 'Love, again' by Doris Lessing over on Silencing the Bell but wanted to add an apposite little quote here. The book is about an older woman (in her 60s), how she falls in love with a very young man, after being widowed and alone for twenty years. She is thrown into confusion by the strength not only of her feelings but of her physical desire for the man who becomes the object of her affection. Her reaction is to opt not to admit her crush to anyone, not even her closest friend, for fear of censure:

"He would have to overcome, for a start, some pretty orthodox reactions. Most men and more women - young women afraid for themselves - punish older women with derision, punish them with cruelty, when they show inappropriate signs of sexuality. If men, they are getting their own back for the years they have been subject to the sexual power of women. She consoled herself with: When this business with Bill is forgotten, I shall still be Stephen's friend." (p.129)

Interestingly there is no sex in the book at all; she finds herself entangled with several men but does not succumb to their advances or her own desires. I was left, rather disappointingly, with the message that it was some weird kind of aberration to fall in love with an old woman and that it was better for all concerned if they just moved on.

Hormonal hotspots in the Guardian

Kibbutz Hagoshrim Wiki commons

Having discussed it recently with my sister I came across this article on the Guardian about HRT and whether it really is the cure-all that has been so often claimed. It makes me cringe that the arguments seem to centre on the idea that the menopause is a disease that can be cured (or at least treated), and it reminds me so much of the medicalisation of childbirth (and how pissed off that made me), the way that pregnancy is also treated as an illness rather than a natural process that the human body has been going through since the dawn of time. Doctors just seemed to jump on the bandwagon with the pharmaceutical companies and there seems to be a distinct lack of decent studies into the long term health effects of taking hormone replacements. It is not about being all 'natural' and not wanting chemicals in my body, because plainly they have relieved the symptoms of millions of women, it's just about women being able to make properly informed consent to the treatment.

The lives and concerns of women-of-a-certain-age seem to be quite a hot topic these days, with all these celebrities/film stars reaching their middle years and 'proving' that women over 50 can still be sexy and attractive. The briefest follow-up perusal of the Guardian's website gave me a handful of other articles that expanded on this most vital of issues. Mariella Frostrup complains about the invisibility of women in our age group, while pointing out that we are healthier and wealthier than other age groups and our predecessors; I did love her comment, "the demographic we share our closest links to aren’t retirees but teenagers. Our hormones are raging, we’re interested in pleasing ourselves and the rest of the world be damned." Old age isn't what it used to be, the problem is that employers attitudes to ageing have not changed leaving us potentially facing mid-life redundancy. She claims dishearteningly that women struggle alone through menopause, too embarrassed to complain or discuss it with friends; not strictly true in my experience, though I did agree with her final quip, "Having our worth totted up in childbearing and rearing for millennia has caused us to view the close of that chapter as a mini death."

Jeanette Winterson takes an entirely different tack and goes on the offensive against HRT, with a lengthy exposé about her search for a more natural response to her menopausal symptoms. Thanks to private health care her doctor looks in closer detail at the other things that are going on in a menopausal body and she goes down the route of bio-identical hormones. Don't take her advice and google 'Premarin' if you are currently taking HRT, though she gives you a brief run-down of the worst of the gory details of its production. Thought provoking quote of the article, "Hormone treatment is not a miracle cure for misogyny. Society does not value older women, and often, older women do not value themselves."

Helen Walmsley-Johnson's article was more annoying (she writes a blog for the Guardian called Invisible Woman, about 'clothing, body image and getting older'). She lost me pretty much completely with her opening paragraph: 
"At the end of the Women Starting Over conference in London recently, delegates were handed a little bag of treats containing two magazines (one of which was Countryfile), a card from a meditation coach, two lots of 50+ multivitamins, two sorts of anti-wrinkle moisturiser, a pack of artificial sweetener and two condoms (one male and one female), plus one anonymous envelope containing "natural intimate moisturiser". Not a bad insight into what women entering, or emerging from, the menopause are expected to be interested in."
Well, no. I would not be interested in any of those things. While I did like her annoyance on the idea that women still need to feel that they have to be given 'permission', be it to love their bodies, to eat what they like or to engage in middle age sex, she lost me again with the assertion that we all grew up with 'a good deal of baggage' around sex. Having said that I agree we could all do with a little mojo reclamation. 

Lumps and Bumps

The anxieties of growing old really are multiple. Sometimes it feels as if every week you find a new bit of your body failing you. Most of them you manage to keep in proportion and even smile ruefully, but there are certain things that strike fear deep in your belly. Finding lumps is one of those things.
I followed a link on Facebook to this fabulous video aimed at raising awareness of the importance of checking your breasts regularly:

So I did. I found a lump. It was late on a Friday night and my first reaction was 'oh shit, the doctors will not be open for two whole days!' and I had a pretty sleepless night. The next day I calmed down and did some research and found some helpful advice that reassured me. It was very smooth and rounded so I rationalised that in all probability it was a cyst. However telling yourself that things will be fine only works up to a point. So deciding that I was going to continue to feel anxious without some medical reassurance I called the surgery on Tuesday morning and made an appointment. On the Friday after a week of sleepless nights, I saw a lovely doctor who was very calm and relaxed, and she agreed there was a lump (the other anxiety is thinking you are just being paranoid, since breasts are very lumpy things at the best of times.) However she said that because of my age, and because it can be difficult to tell just from the feel of the thing, she was going to refer me to the breast clinic down at Wythenshaw hospital. It should take less than a fortnight to get an appointment she said, and if I had not heard by then I should chase it up with the surgery.

The appointment letter arrived promptly and two weeks later I found myself waiting at the tram stop to travel down the new airport line, which very conveniently goes right past the hospital. I waited for a while and then I waited for a while more. Two trams to Didsbury went past but the tram to the airport still showed 9 minutes. Then it showed 20 minutes. We (myself and an old bloke also heading to the hospital) waited another half an hour and the time on the display seemed to go up and down somewhat randomly. After a 50 minute wait it finally arrived, by which time I was extremely stressed about being late for my appointment. But everyone at the Nightingale Centre could not have been more lovely. It is a what they call a one-stop-shop for breast care. First I saw a doctor who checked out the lump, and also agreed that it was probably a cyst. Then I went for a mammogram. I've seen pictures of women having it done but I had no idea. "The breast is placed on the X-ray machine and gently, but firmly, compressed with a clear plate. Two X-rays are taken of each breast at different angles. Most women find the procedure uncomfortable and can occasionally be painful." Breasts really are not designed to be crushed like that; uncomfortable has to be the understatement of the year. Then I went for an ultrasound and had the cyst drained with a needle. That made me nervous, but it did not hurt a bit. A tiny amount of dark greenish fluid was all that came out of it. The doctor said she was satisfied that there was nothing there to be worried about. The whole thing took only about an hour and a half. I came away very reassured.

Afraid of getting old

Random things pop up in life ... and on Facebook. Today on Bored Panda (a source of much procrastination) an entry appeared with the title 'Illustrator turns people's deepest and darkest fears into comics'. It is drawn by a guy called Fran Krause and available for perusal on his Tumblr. The one that really struck me as poignant amongst the silliness was this one. It says something quite existential about how we as humans feel about getting and being old. Old age is something unknown and unknowable by the young, and they fear it, seeing it as something terrible. It is somehow reassuring to find that as you approach, it doesn't seem half so bad as you feared.

Menopause Cake

I have several very wholesome friends who tend towards the herbal tea/soya milk/vegetarian/I-might-have-some-sugar-at-the-back-of-the-cupboard-somewhere school of thinking about the way they eat. While I do occasionally cook with lentils and last year we ate veggie for a month, I tend to avoid obsessiveness where my food is concerned. My sensible home cooked diet is well supplemented with jelly babies and chocolate (though I do buy Green and Blacks when I can afford it). But my generally level of feeling run down and lack of appetite made me perk up my ears when Jill (she of the lego fan) mentioned her 'Menopause Cake'. It started life as a 'Birth Cake' given by a friend after her first baby but really it is a substance designed to nourish the body at any demanding stage of life. I have adapted a little based on what I had in the cupboard.

Menopause Cake

4oz soya flour

4oz oats

4oz wheat flour

(Basically 12oz of dry ingredients, I used oatmeal for one part. I used porridge but you could use coarser oats to give more texture. Substitute others types of flour if you want gluten free.) (Edited 24th February: Also tried rye flakes for variation.)

4oz linseeds

2oz pumpkin seeds

2oz sesame seeds

2oz sunflower seeds

(Grind the seeds in a processor or coffee grinder. Again use any combination depending on your preference. You can leave them whole but they do digest better if ground.)

2oz flaked almonds (I missed these out as I did not have any, or add any kind of nuts you like)

8oz dried fruit (chop up bigger stuff like apricots, kitchen scissors work much better for this than a knife) (Edit 24th February: I have upped the fruit content to 1lb in subsequent bakings)

(Edit 6th September 2017 - I have recently discovered dried cranberries and crystallised ginger makes a wonderful combination)

Finely chopped stem ginger - optional but tasty

1/2 tsp ginger

1/2 tsp cinnamon

1/2 tsp nutmeg

(again go with personal taste on your flavourings)

15 fluid oz soya milk (I used about a pint of ordinary cows milk)

2-3 tablespoons of molasses

I also added 3 big tablespoons of honey as I felt there was not enough sweetness in it.

Put all the dry ingredients in a big bowl.

Heat the soya milk with the molasses just enough to melt it.

Pour the warm milk/molasses into the other ingredients and mix well.

Leave to absorb for 30 minutes to one hour - it will be quite sloppy and looks pretty disgusting but smells like Christmas cake mixture.

Spread the mixture in a deep baking tray lined with greaseproof paper.

Oven - Gas 5 190C or 375F

Jill's recipe said 1 hour+ but I only baked mine for about 50 minutes (I had to take it out as I was making a roast dinner at the same time and the veggies needed to go it.)

And what came out was pretty f***ing wonderful. I was anticipating something rather dry and earthy but it is moist and delicious. It is very dense and you can practically feel it doing you good. I cut it into little fingers but can easily eat two. I have been taking it to work with me.
Edit 19th March 2015
Most recent batch made with ground hazelnuts and glacé cherries.

But for our afternoon cup of tea I confess I still prefer a slice of this:

VVA and HRT

NAMS

While everyone else at knitting club was bemoaning the hot flushes and joking about Jill's piece of lego board that she carries in her bag to use as an emergency fan, I was feeling left out because my symptoms have been much less of a cause for mirth. The dreaded vulvovaginal atrophy is caused by the drop in oestrogen levels that results in a thinning of the tissues of the vagina (as shown in the fun illustration). The ph balance of the vagina is affected causing a reduction in the natural lubrication. The tissues become less stretchy and much more liable to damage and infection. It can also lead to frequent bladder infections and general dryness and discomfort. It was a nasty infection that had me calling the doctor a couple of weeks ago. I had a course of antibiotics prescribed over the phone but by the time I actually saw her the worst was over and she couldn't find anything. However she said that the skin looked very dry and she suggested I try an oestrogen cream that would help to repair any damage and restore the vaginal lining. Although she asked me if I had considered HRT she didn't actually say that the cream she prescribed was HRT; it was only because I read the leaflet in detail that I realised that it is considered a form of HRT. Because it is applied internally it just absorbs into the tissues there and does not have an impact on other menopause symptoms. I am reserving judgement at the moment as it says it can take several weeks for any improvement. As well as this drama my summer had been mostly taken up with two long periods that dragged on for weeks, so I am hoping for an uneventful autumn.

Mid-life Crisis

Life has pottered on through the summer, I've had my own version of a mid-life crisis and dyed my hair for the first time ever ... and no, not to cover up any grey, just for the hell of it. However I am totally in sympathy sometimes with the reaction of Eva in 'The Woman Who Went to Bed for a Year'. When you have spent half your life seeing to the needs of other people you can see the appeal of just retiring to bed and refusing to get up again. While the book was pretty dire it made me laugh quite a bit, including this lovely exchange between her weird genius twins:

" 'No,' said Brianne, 'tell me now.'
Brian Junior said, 'It's nothing much, but Dad rang and said that after we'd gone Mum went to bed wearing all her clothes, even her shoes, and she's still there.'
...
Brianne said, 'That's what happens to women when they get to be fifty. It's called the men-o-pause.'
'So what do they do?' Brian Junior asked.
'Oh, they go mad, shoplift, stab their husbands, go to bed for three days ... that kind of thing.'
Brian Junior said, 'Poor Mum. We'll phone her after the Fresher's Fair.'" (p.38)

Three year anniversary

Three years on from the original post that started this blog the moon is still waxing and waning along with my cycle. It has continued to be gloriously unpredictable; a nasty flood Christmas week was followed by long pauses and stop-start periods that couldn't decide if they were coming or going. The only other symptom appears to be a long term drop in my energy levels; I come home from work exhausted after what should really be just ordinary days. I begin to wonder how long this will go on and if there might be a 'normal' to get back to.

I had the interesting experience of discovering that a friend on Facebook who I went to school with (I mean 'is the same age as me') had her first baby at the beginning of May. Looking at the photo of her holding her tiny premature son was quite moving, it must be incredible to feel that you missed your chance, and then to have such a miracle. Having been broody for so many years I now cannot imagine having a newborn baby. I definitely feel glad not to be back at the beginning of the process of raising a family.

Instead I was being wild and reckless in Costa Rica.

 I think I could enjoy growing old disgracefully.

Uteruses can be cuddly

Just a random thing I came across today via This Isn't Happiness which led me to a really fun site called I Heart Guts, which it says is inspired by the "intersection of the gross and the cute" and sells cuddly toys of internal organs, including a fabulous cuddly uterus, and all sorts of other organ related paraphernalia. The above image comes from their 'Periodic Table of your Period' and I just loved the idea of the cuddly uterus getting to throw all those tampons in the bin ... excellent!

Magic Prescriptions

So, I'll add the photo when I get my computer back but I am taking a break to write a blog post about magic prescriptions. I know it's been ages since I posted here, that's mainly because nothing much menopausal has been happening. I have still been living in limbo land expecting some kind of 'real' symptoms to start occurring, but they haven't . Then about a month ago I started what I thought was just another ordinary period ... but then it went on, and on, then it seemed to fade out a bit, then it started up again, and went on, and on, until I was feeling a little anxious. I started searching, as you do in the interweb age, for information about my symptoms, reassurance that it was normal menopausal body behaviour. As with everything else on the net there is no consensus on the subject. I promised myself if it didn't stop by the end of the week I was going to see the doctor. The one thing there is consensus on is that if you have weird symptoms it's ok to go and seek a bit of professional advice. I haven't actually seen my doctor since having any menopause symptoms; I mentioned it in passing to the nurse when I went for a 'Well Woman' checkup but she was not prepared to express any opinions and told me to see the doctor if I had any questions, and since it was so vague at the time I didn't bother. So, cut a long story short, I popped along on Monday and was duly reassured, periods that go on and on (and even on and on) are par for the course and not really a cause for concern. Since undoubtedly they were causing me some bother (since blood exiting your body is a real drag we all know) she said she could prescribe me something that would stop it and 'reboot' the system. Even though I was a bit doubtful about messing with my hormones she said she would give it to me so that if I changed my mind in a week I could fill it then. So I duly took home my prescription for Norethisterone, which is taken in a very specific manner: 3 tablets for 3 days, then 2 tablets for 3 days, then 1 tablet for 3 days (by the time you've done all that if it hadn't stopped you would probably have stopped caring anyway, or be due the next one). Anyway Tuesday morning I had lost no more blood overnight and then I had a tiny bit during the day, and it seems to have pretty much stopped today ... and I haven't even bothered to get the prescription filled yet ... that is one very effective treatment if you ask me. Fill me out a prescription for HRT and I'll pin it to the kitchen notice board to keep the hot flushes at bay.

Posted with Blogsy

Wise Children

Continuing my series of random references to menopause in literature I have just reviewed 'Wise Children' by Angela Carter and saved this lovely little quote. It seems that sex and having babies gets mentioned regularly in fiction but periods and menopause are still rather a taboo subject, so this rather matter of fact comment by Dora Chance is quite refreshing:

"We started the very same day those two were born, as it happens. Funny coincidence. I went to have a wee and there was the evidence, all over my underwear. I hotfooted it to Nora and she took a look on her own account. Same thing with her. Grandma got us some cotton wool. Although we are asymmetrical, in many ways, we always, funnily enough, came on in unison until we stopped, short, never to go again, the tap turned off just twenty-five years ago." (p.74)

Debates in the world of anthropology

This has been hanging around in my news feed for a while now with the intention of posting it here. Over at Scientific American Kate Clancy (who I have mentioned before, so she must be good) blogs at 'Context and Variation' about "human behaviour, evolutionary medicine ... and ladybusiness." In this article "Lady anthropologist throws up her hands, concedes men are the reason for everything interesting in human evolution" she picks apart of piece of research that looks at the reasons for women having a lifespan that extends beyond their ability to reproduce. Some of it is a bit 'science speak' for me, and you probably need to be a serious student to understand all the references without looking them up, but you can get the gist of the argument:

"Despite citing the overwhelming literature on the topic, these authors situate human menopause as an “evolutionary puzzle.” They then point out that a model that recognizes male mating preferences for younger women, with a splash of infertility-causing mutations, produces the evolution of menopause. What this suggests is that if men choose to mate with younger women, female-specific, infertility-causing mutations that affect later reproduction could build up, since those women aren’t reproducing. Ergo, the uselessness and undesirability of older women – we all know how that is – leads to their becoming infertile and menopausal."

"I used to think that part of the reason humans are menopausal may not be because menopause serves a particular purpose, but because we have extended lifespans. We may have extended lifespans not because longevity is selected for, but because longer periods of childhood and social learning were selected for."

"Before my revelation that the men are all who matter, I would have also favored the grandmother hypothesis. This hypothesis isn’t mutually exclusive with the others. Originally the grandmother hypothesis contended that post-reproductive life evolved because grandmothers are important to the reproductive success of their offspring (Hawkes 2003; Hawkes et al. 1998; Hawkes et al. 1997)."

She uses her argument to also pick fault with the sexism and cultural bias that exists within this academic sphere and concludes:
"So really, even if men had little to do with menopause, they get… well, they get pretty much everything else, so long as you whiz by several decades of egalitarian anthropology research. Which is fun, like roller skating!"

The comments section is just as interesting as the article, where several male commenters miss the point altogether. It is interesting to know that there are so many people out there concerned with the whys and wherefores of menopause. I'll just go back to quietly menopausing now.

Kitty

I read 'The Hours' by Michael Cunningham over the weekend, a wonderful book capturing the lives of three very different women, and made a note of this small passage. I liked it because it is just a nodding acknowledgment of the ageing process (Kitty is the friend and neighbour of Laura Brown):

"Kitty looks at her coffee cup with elaborately false, foolish absorption. She seems, briefly, like a simple, ordinary woman seated at a kitchen table. Her magic evaporates; it is possible to see how she'll look at fifty - she'll be fat, mannish, leathery, wry and ironic about her marriage, one of those women of whom people say, She used to be quite pretty, you know." (p.107)

Howards End

Another into a brief foray into literature. From Howards End by E. M. Forster, this is a description of Jacky Bast; I don't think she is strictly a menopausal woman being only in her thirties, but it is about the judgements that are made of women as they age. I won't quote the whole gory description of her appearance, described as 'not respectable' but 'awesome', from the boa, to the pearls, to the cheap lace and the flowery hat, but here is how it concludes:

"It was the face of the photograph, but older, and the teeth were not so numerous as the photographer had suggested, and certainly not so white. Yes, Jacky was past her prime, whatever that prime may have been. She was descending quicker than most women into the colourless years, and the look in her eyes confessed it." (p.49)

Menopause is wisdom

Via a recommendation on Facebook I arrived yesterday evening at this article entitled 'The Bitch is Back' by Sandra Tsing Loh that argues wonderfully that menopause is in fact a return to a more normal emotional/psychological/hormonal state and not some kind of aberration. She begins by lambasting the vast majority of menopause literature that plugs away at the 'problem' but then she arrives at 'The Wisdom of Menopause' by Christiane Northrup and has an epiphany.

I'll quote for you here what she refers to as the juicy core of the argument:
"A woman once told me that when her mother was approaching the age of menopause, her father sat the whole family down and said, “Kids, your mother may be going through some changes now, and I want you to be prepared. Your Uncle Ralph told me that when your Aunt Carol went through the change, she threw a leg of lamb right out the window!” Although this story fits beautifully into the stereotype of the “crazy” menopausal woman, it should not be overlooked that throwing the leg of lamb out the window may have been Aunt Carol’s outward expression of the process going on within her soul: the reclaiming of self. Perhaps it was her way of saying how tired she was of waiting on her family, of signaling to them that she was past the cook/chauffeur/dishwasher stage of life. For many women, if not most, part of this reclamation process includes getting in touch with anger and, perhaps, blowing up at loved ones for the first time."

She describes the fertile phase of a woman's life as having been under a hormonal cloud of nurturing and the explanation for the supposed crazy behaviour is:
"And now that Aunt Carol’s hormonal cloud is finally wearing off, it’s not a tragedy, or an abnormality, or her going crazy—it just means she can rejoin the rest of the human race: she can be the same selfish, non-nurturing, non-bonding type of person everyone else is."

It was interesting because I had observed this myself; not only in the lack of broodiness that had plagued my adult life since the age of about 18 but also a sense of release from responsibility for taking care of people. It has coincided with my children reaching adulthood so I had not interpreted it that way but on reflection it seems to fit. Yes, I feel suddenly more selfish, occasionally feeling a bit like I am being self-indulgent to spend my time attending to my own interests rather than those of other people, but quite enjoying it nonetheless.

Bits of the article I found irritating in the way I often do because of the assumptions it makes about 'middle class' women's lives and the route they follow. I have not had a career and had my children young (all born by the time I was thirty). I am not experiencing the "clanging chime of her 10-year-old voice, note by note, draining your will to live" because now I can just try and relate to my children as adults. And this whole description of the life of a 50 something woman has absolutely nothing that I relate to:

"A third, related, survival tip is to have no shame. The middle-aged women I know, clawing their way one day at a time through this passage, have no rules—they glue themselves together with absolutely anything they can get their hands on. They do estrogen cream, progesterone biocompounds, vaginal salves, coffee in the morning, big sandwiches at lunch. They drink water all day, they work out twice a week, hard, with personal trainers. They take Xanax to get over the dread of seeing their personal trainers, they take Valium to settle themselves before the first Chardonnay of happy hour. They may do with just a half a line of coke before a very small martini, while knitting and doing some crosswords. If there are cigarettes and skin dryness, there are also collagen and Botox, and the exhilaration of flaming an ex on Facebook. And finally, as another woman friend of mine counseled with perfect sincerity and cheer: “Just gain the 25 pounds. I really think I would not have survived menopause—AND the death of my mother—without having gained these 25 pounds.” "

but all in all I found the article enlightening and very amusing, I was annoying Dunk by giggling and not explaining myself as I always demand he does when he finds something amusing on the interweb. So hop on over and feel a bit better about the process, and maybe try and relish the return to normality instead.

(Image credit Ellen Weinstein from The Atlantic)