Stuck in the Middle with Me

On hormones and a body in between

Celestial Pablum, Remedios Varo, 1958

When I was 44 years old, I woke up on the floor in the arms of my bewildered mother. Betrayed by my body. If I had been paying attention, I would have seen that the supposed betrayal began years before. And, if I’m being frank, I will admit that the idea of feeling betrayed by my body is a tired cliché and an oversimplification of the truth.

It’s not betrayal, after all — it’s destiny, written in our origin code and mapped in blood and bone. I am woman, destined to ride the waves of gendered storms until I fall back into the earth, just ash and memory.

The truth is that a body evolves in the way it’s meant to, guided by broad, boring things like history, gender, genetics, and lifestyle. The truth is that I had busied my body with a big life and ignored these tiny dawning realities. Until I couldn’t anymore.

Until my body knocked me down in the middle and demanded my fealty.

//

Our Western understanding of menopause stands on the pedestal of patriarchy. This quintessential feminine experience has always been viewed, medically, through a masculine lens. “In patriarchal societies — including our own — post-reproductive women have often been scapegoated as threats and burdens,” writes Lynn Stuart Parramore. The so-called witches of 17th-century Salem were merely menopausal. In the 1850s, Victorian physician Edward Tilt determined that the uterus was the “keystone of mental pathology,” after which toxic douches and horror-movie surgeries, often performed without anesthesia and consent, became common treatment. Victorian obstetrician Lawson Tait advocated institutionalization for unruly midlife women. It was Tait’s belief that Jack the Ripper was actually a woman — and a midwife. He also noted that menopausal women liked their drink. The temptation cannot be overstated.

//

More than a decade ago, I passed out at the foot of my mother’s bed. It was actually my daughter’s bed, but my mother was sleeping in it. She was visiting, and she called to me in the night. She was feeling unwell, she said, and then I fell — like a tree, in her telling. A perfect tableau for the narrative that I’ve affixed to the event: My midlife body, limp in the arms of my aged mother, young daughter sleeping on a couch downstairs. Three generations of female bodies in various states of being and becoming. A story.

This was, in my distilled and fantastic narrative, the beginning.

Years ago, I passed out, and when I woke up I was different. A raw and fragile woman; one woman becoming another. The new, ever-evolving me was unfamiliar and terrifying for a while, an awkward deconstruction of the before. But also a nebulous future-me that is still (always) under construction. A body slipped of its husk, loosed from its chains. If this body can weather the storm, it may improve on the body before.

//

“Perimenopause” is the name given to the tumultuous phase in a woman’s life, a vaguely defined and muzzily understood chapter right before menopause. Menopause marks the cessation of menstruation and becomes official when a woman has gone one full year without bleeding. Peri can be a nonstop parade of what seems like a thousand symptoms (or maybe 34) and can last 10 years (give or take), according to typically vague and unhelpful statistics. These symptoms are often so amorphous as to be easily mistaken for the vagaries of life: Mood swings! Anxiety! Allergies! Weight gain! Fatigue! By this measure, we are all (at least some of the time) perimenopausal. I suffered at least a decade of most symptoms.

Will there be a prize?

A woman can begin to suffer as early as her thirties or (as some unfathomably claim) she can never suffer at all. She may be told, as I was, that she just needs a Xanax. That she should take a vacation or try to sleep more. Maybe yoga or meditation. Therapy. There may be tut-tutting about her chocolate habit or her wine consumption, as there are any number of diets that promise to fix any number of female troubles.

The truth, however — the messy, ungovernable truth — is that hormones rule the day. Each day they are dancing incessantly to their own changeable and often riotous soundtrack. Sleep and diets and vacations and pills may help for a bit, they may mask and assuage the nightmare briefly, but the next moment is a new nightmare, one that requires a new fix. There’s no math or science involved, no easy navigation. It’s a weary waiting, a trudge through the fields of discontent, never knowing where next to put one’s foot.

//

My body was so unreliable for so long, I suppose one could say it was reliably unreliable. I expected to bleed with wild irregularity. To never count on sleep. I greeted each strange development as if it was perfectly normal. Tingling extremities? Hormones. Irregular heartbeat? Okay. Burning tongue? Must be peri. In the early days, the symptoms convinced me of my dramatic, impending death, but it became a chapter of expected, nonchalant loss. I’m losing my balance, my vision, my way. I’ve lost my knees, my shape, my stamina, and my stability. At times it seems I’m losing my mind, but, interestingly, the same unhinged mind is whispering secrets. Secrets that just may save me.

//

Hormone replacement therapy is the much-touted modern medical answer to this natural disaster, an attempt to even out the seesaw levels of estrogen and progesterone in a changing woman’s body. Many women find relief with HRT — I had my own briefly successful affair with progesterone cream. However, much is unknown about how it affects the body, because we just can’t find the dollars or the will to research women’s health. Add to this the fact that the wildly fluctuating hormones of the perimenopausal woman make dosage a daily shot in the dark. I chose the route of kale and wine, coffee and supplements, acupuncture, yoga and weepy walks. The results are mixed.

//

I woke from that terrifying time-out and was force-marched into a surreal new world. Understanding the new terrain was like reading a fantasy land map, someone’s loopy stab at world-building. A dizzy world of weeping; a world filled with fear, panic, and anxiety. A world with wildly fluctuating temperatures and unreasonable demands. I lurched around in an unfamiliar body — missing me, what happened to me — waiting for the after, hoping for the euphemistic change. Between the dizzy spells and the malfunctioning thermostat, I felt unfit for the world; the world not fit for me. In the middle of a headline cold snap, I considered peeling off the layers and bolting out the door into the ice-dry air. The thought of snow on my hot skin was delicious, like a pool in the swelter of August. I’ve come a long way from the girl with cold feet, the girl in wool mittens. I’m a woman on fire now, plump and soft, sore and dizzy. Many years later, I’m edging into the after. The fires are finally quieting.

//

Professionals said all the wrong things and sent me on wild goose chases until, finally, a gynecologist told me the truth: Hormones are doing this to you and it will stop. You are not crazy, she said. This is perimenopause and it is normal.

Normal! A highly respected gynecologist told me that my experience was normal. She also said that many, many women come to her with much more dramatic troubles. Capable, successful women who — on a seemingly ordinary day, somewhere in the middle — go mad. Up all night mad. Screaming naked in the streets mad. Threatening their families mad. Suicide mad.

The body in the middle is not playing and it will not wait. It will respond swiftly to each choice, every slight, and all abuse. Garlic equals indigestion, tennis equals pain, one more glass of wine equals all kinds of hell to pay. Too much noise leads to mania, and meddlesome family members can lead to injury. My body is not my body — or, rather, is becoming my new body — and it will brook no nonsense. It will lash out. Or just fall down.

//

Conventional medicine does not take women’s bodies seriously; this is a truism that we bang our heads against year after year. American culture eats female bodies and spits them out in the middle — we are scrutinized, criticized, and dismissed. This wild midlife ride turns us upside down, and all we can do is hope that it drops us back on our feet. Quietly and well-dressed. In “The Girl Who Cried Pain,” Diane Hoffman and Anita Tarzian found that women are “more likely to be treated less aggressively in their initial encounters with the health-care system until they ‘prove that they are as sick as male patients.’” The Guardian reports a study where only 39 percent of women who have a cardiac arrest in a public place are given CPR, versus 45 percent of men — pointing toward stereotypes in which “men are silent stoics” and women are “hysterical hypochondriacs.”

Just a few years ago, I woke up on the floor at the foot of the stairs. “Who is the president?” an EMT asked. I had passed out again. It fits a writer’s narrative, a poet’s fancy, that my middle decade was roughly bookended by two falls. I was suspended in a middle place, occasionally going to ground. My gynecologist shrugged — fluctuating hormones make fainting more likely, especially in a body like mine. One with high vagal tone, she said, which sounds like a good thing but has me living on the edge. Estrogen, however, is a fickle mistress. My body is her pawn. I waited a long time, suspended somewhere between the before and the after, the rising and the falling. Somewhere in the middle.

🌿 Lisa

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Things to share:

• To Tell You The Truth, a fabulous essay by

  Nicole Morris
  in
  The Audacity.
  It drew me in because of my own experience with an aging father, but the writing is just so good it could have been about anything.

• Knausgaard’s Spring is so good, his writing is like hypnosis. Not for everyone, maybe, but I can’t get enough. “Sometimes it hurts to live, but there is always something to live for. Could you try to remember that?”

• Still protesting and calling, feeling a bit fatigued!

  Jessica Craven
  is helping me through, with info and action.
  Chop Wood, Carry Water
  is a shot in the arm. 💪

• Science says drink champagne. Cheers! 🥂