TMI
I could tell I was going to get my period. Once I started continuous menopause hormone replacement therapy, otherwise known as MHT it comes a swift 21 days. It gets closer together before becoming drawn out, as your ovaries strain to keep up with the deluge of follicular stimulating hormone your pituitary is pumping out, desperately trying to get your ovaries to crank out eggs like they had for three-ish decades prior, almost like clockwork (if you’re one of the lucky ones who doesn’t have some hormone-based menstrual affliction like polycystic ovarian syndrome, like endometriosis, like primary ovarian failure).
A quick synopsis of POF for those curious
My limbs are heavy, my back and my knees especially ache, my belly swollen. I’ve been hot at night, felt that buzzy alive feeling when Astrid wakes me up in the middle of the night. I also pee constantly right before I start, and am constipated. I was always fluent in my mind-body connection as it related to my cycle but after it went off the rails in postpartum, non-existent for up to six months at a time I got serious about writing down my symptoms in my daily planner. I also wanted to have something physical I could call upon as I started hormone replacement therapy. It’s not an immediate, one-size fits all solution, nothing ever is. It’s a process and as my sex hormones wane, or shut off and come back on as can happen in Primary Ovarian Failure, I will need to work with my provider to tweak dosing and work with myself in habits that support my mental and physical well being through hormone fluctuations.
I want to write “my story” (gag) but it doesn’t feel like the right time, and so it may slowly be revealed in glimpses as I try to engage with this platform. It is frustrating knowing I probably have a severe case of endometriosis and not having a way to know without cutting me open and filling my abdominal cavity with air before poking around to see what is inside. Since starting MHT I’ve had sensations return that had gone away—mainly the feeling of deep, pelvic pain that is sharp with certain activities. It comes and goes. I want to see what I look like in there!
I wonder what it looked like in my early thirties while I was drinking alcohol, working night-shift, slamming a coffee before taking HITT classes three days a week, engaging in these routines without fail, without recognition that internally my energies wax and wane cyclically. Ignoring bodily sensations, tamping down emotions in order to serve a regularity in my life that was calming in the sense I willed it to be, it was controlled with a capital C. It is akin to the mentality of someone with disordered eating; creating rituals and hard-lined boundaries that from the outside could be read as “healthy”, when in reality it was fueling a dissociation from my feelings that were large, taxing, and inconvenient. There was comfort in working a bed-side nursing job at UMMC's Shock Trauma tower that always felt urgent; it required a calm exterior when shit hit the fan while my nervous system wreaked havoc on the inside. This wiring had been installed much earlier, the pathways affirmed over and over since I was a kid. As much as I ever felt connected to my cycle, I was always rushing into some other inane task or social event in order to not “feel” anything, never pausing.
And so, while many of the women on my father’s side anecdotally have endometriosis, some requiring surgeries to remove parts of their colon ensnared in endometrial adhesions, these same women also suffering premature menopause, my doctors suggest there is no use in knowing for sure. All I can do is engage in behaviors that decrease inflammation in my body. I try to be more intentional now that I have a cycle again. I drink warming foods and liquids that are easy for my digestion, starting my days with warm lemon water. I eat protein and fiber-rich breakfasts to sustain my energy levels, and also try to not beat myself up if I don’t get to everything I had planned to tackle. I read or journal before bed, with lights out at ten pm at the latest. I choose restorative pilates classes and weight-train only if I have the energy, avoiding high cardio during certain phases.
Living cyclically takes diligence and practice, privilege also playing its part-we live in a society that is business as usual forty hours a week, five days a week. Catch up on errands and soul-nurturing activities on Saturday and Sunday. Have a kid? Good luck, I rue the day my weekends or weekday evenings are filled with practices, scrimmages, birthday parties and the like. It requires you to be selfish. It ignites guilt. For me, it is necessary. I have chronic stress pathways I am trying to amend. I wonder what it will mean for my child—to have someone model life by phases, to see someone rest with intention when its needed. Not all of these activities have to be you-focused. Engaging in productive and creative, meaningful connections with neighbors, friends, family, your community, your city, radiating out, it is medicinal.
I was having coffee with a new friend last week who’s a playwright and she was telling me that people love when you tell the truth. The truth is what is missing; transparency about our periods, about menopause, about postpartum, these huge hormone events. A sea change around menopause is occurring right now and I am hopeful for generations following mine. I am hopeful for my own generation as well—help is out there although it feels like a needle in the hay at times. There is a community to tap into, a collective knowledge that can be built, we don’t have to live in subreddits (I am forever indebted to the POF subreddit for its support, knowledge and space to exist). Maybe it is what drove me to become a nurse but TMI is what I want, do you know a nurse? TMI doesn’t exist, send us a picture of your phlegm, we got you. I have a need for TMI about our periods, about our menopauses.