For most of my adulthood, I have had excellent control over my body.

I’m not just talking about ability to move or athletic prowess, although I have been fortunate enough to hone these skills to an above average level. I knew how to change my diet a week before my period started so that I could have easier cramps and less bloating. I knew at what point on my cycle I should schedule certain tasks. (Right before it starts? Declutter.) I wasn’t always perfect at adhering to these guidelines, but I knew them.

“Well, my period is going to start in three days, I really shouldn’t have caffeine, but I’m on vacation and they don’t have decaf… Just a small latte will be fine…” And I expected a little extra breast tenderness in the next three days.

I say this not to brag, but to impress upon you how unprepared I was for perimenopause.

Now, I am a Xennial, so this will be steeped in the values that were pushed upon me when I was young, but I think it’s applicable to most women going through this right now. Younger generations are changing things, but change is difficult and it might be evergreen for a decade or so to come, so here we go.

Women are taught that they have to deal with their pain, hide their pain, and even be ashamed of their pain from an early age. When I got my period, I got my first purse. The only thing in it was pads because I was twelve years old and didn’t really need a purse. Some girls had purses, I didn’t. I was a tomboy. (I didn’t have the language to know that I was ace at the time, but the signs were there.) I remember sitting in the bleachers in P.E. with a friend who was—for whatever reason—showing everyone what was in her purse. Then she reached for mine.

I slammed my hand over the zipper and said, “Don’t. Please. Don’t.” My face was burning. I was never cool as a younger kid and teetering on the precipice of this mortification was terrifying.

I could tell she was about to push, but then her eyes caught mine and she said, “That time again?” And she let it go.

Because heaven forbid any of the twelve year old boys who were sitting with us know what I was going through. Ridiculous. Half of the planet is women, why shouldn’t the other half know when they’re in pain? I remember being terrified to ask to go to the restroom to change my pad because people would know. And there honestly wasn’t enough time between classes. And heaven forbid you had a male teacher. For a rule-follower like me, this left me painfully adrift.

I had one teacher who I thought was sympathetic. I was a very good student. Quiet, all As. So I figured she understood. She would let me go without comment every month. I was relieved when I got to her classroom. Then one day, she told me my “emergencies” couldn’t always be taken care of during her class. I whispered to her that I was on my period. She nearly rolled her eyes and said, “Yes, dear, I know, but you can’t always do this during second period.”

She let me go, and I remember doing the mental calculations in the bathroom and realizing that I would be moving on to eighth grade before my next period and so I wouldn’t have to figure a new gymnastics routine out.

I’m so glad that kids now have more options; period underwear, cups, and hopefully more sympathetic teachers.

Can middle-aged women get some of that consideration?

I loved my thirties. I was in great shape, I knew my body, I knew what I wanted, and I was working toward it relentlessly. I moved to Nashville when I was forty. This was one of my goals. But the south was different than I remembered (or perhaps than I had perceived as a twenty-two-year-old) and unfortunately, my body was changing, only I didn’t know or understand what was happening.

There are no, “So you’re loosing your hormones” books.

Well, there might be some now.

The first sign was wonky periods. My periods became incredibly painful, lots more blood, and very unpredictable. I mentioned this to my brand new gynecologist. She asked where I had moved from. Chicago. She said that my body was just freaking out and adjusting because that was a big move. I should just keep on and everything would even out.

I remember being so relieved and so thankful that I had such a knowledgeable gyno. Because when I’d moved to Chicago when I was in my early twenties, I hadn’t had this issue. So nice to have someone who would know that this would happen now that I was older.

Spoiler alert: that was bullshit.

This was my very first panel as a debut author at ThrillerFest in New York. I felt like crap right here. I’m wearing a sports bra because my boobs were out of control and I had surprise-started my period, ruining my pants twenty minutes before this panel. I rocked cowboy boots with shorts like I meant it and no one knew.

Over the next couple years, lots happened. Not the least of which was the pandemic. That, in combination with Tennessee’s terrible treatment of gig workers, culminated in me giving up fitness as a career. I went into publishing, but started using a walking treadmill so I wouldn’t go nuts working a desk job.

This all was great for a few years, until I gained weight, but only in my boobs.

I hate my breasts. I always have. I wish I could have lived life an A cup, but I ended up a C. I made peace with that when I was younger and it’s one reason I always kept my fat ratio low. I did not want my boobs to get bigger. Suddenly, this seemed outside of my control.

At this point, I think I should mention that I took birth control once in my early twenties. I tried depo-provera and it wrecked havoc on my body. After about a year, I went off it and refused to ever go on birth control again. Dudes just wore condoms and that worked for me. (And yes, they provided them.)

That time on depo was the only other time I remember feeling so out of control of my own body. It was almost the same now. No matter what I ate, drank, or how I moved my body, my breasts just got bigger. And I hated it. I was looking into a reduction, talking to my doctor, trying to figure it out financially, when my periods went insane.

I have never had easy periods, but they’ve always been manageable. Especially once I figured out how to eat and drink before my cycle to make things easier. All of that was out the window. I was having two periods a month and I was regularly bleeding through my clothes and ruining furniture. I was in so much pain that there was literally nothing I could take to mitigate it. If I hadn’t been working from home, I don’t know how I could have managed. Curling up into a fetal position on the floor is frowned upon in most offices.

Around the same time, my stomach started revolting. Suddenly I was having intense pain when I ate chocolate. Like immediately. I couldn’t have red wine. I couldn’t have coffee. This all happened around the holidays during Christmas parties. Everyone thought I had an ulcer. I went to countless doctors. I had a CT Scan with contrast, which, in case you don’t know, makes you feel like you’re pissing yourself, even if you’re not. I spent HUNDREDS of dollars on my stomach, on my pelvic floor, on uterine examinations, only to find that nothing was wrong.

They wanted to scope me. I finally held up my hand. “Is this going to tell me what is happening and how to stop it?” The answer was basically no, this was going to maybe rule something out that it wasn’t likely that I had to begin with. I refused the scope.

Shortly after, I saw my doctor and told her how I was just in excruciating pain twice a month, hated my breasts, and was ruining pants and furniture on the regular. She asked if I’d like to see a hormone specialist. I said, yes, because at this point, anything would do.

I was given several options. I will list them here.

Go on progesterone. (This is the same hormone that is in depo provera, so I was leery.)
Get an UID. (I have heard several accounts of women saying this is insanely painful. Some say it’s fine, but you just don’t know until it’s in, which bothered me.)
Get a uterine ablation. (This was actually the option I thought I would be choosing as I’d heard good things about it.)
. Get a hysterectomy. (I kind of thought this was overkill.)

There was some discussion. My concerns over UID pain were brushed aside, with the doctor telling me that she felt the statistic I quoted (12%) of women experiencing excruciating pain was inflated. I don’t think that women’s pain is ever inflated. In fact, with how we’ve been conditioned to grin and bear it, I think it’s underreported in all instances. So I refused an UID.

I also wasn’t ready to go full nuclear with my insides. I’ve never had major surgery, let’s not yank organs out at the first sign of trouble.

My concerns with progesterone were alleviated. My doctor told me that depo was an extremely high dose and I would not be receiving nearly that much. Also, I’d be taking pills which I could stop at any time. The only side effects would be more bleeding once I stopped. I knew logically that I was losing my progesterone—it’s the first hormone to go, and the pain killer, in case you weren’t aware—so I opted for the pills. My logic was that this would be the easiest thing to start and stop if it wasn’t working and we could step up from there.

The pills were amazing. I noticed a difference right away, but I was still having painful periods and still having them twice a month. My doctor upped my dose.

Every time she upped it (at least one more time) it made my life better. And guess what? My stomach issues stopped. My boobs went back to normal. And I wasn’t ruining pants and furniture.

My next step was more complicated. In the interests of time, I’ll skip over some boring back and forth, but please know that you can always message me if you’re in the weeds and want some advice. I had to go back and forth with my hormone doctor with a lot of blood tests before I was eventually able to get on a low dose of estrogen.

My friends.

My sleep has never been great, but once I hit perimenopause, it was horrible. In a way, it was good because it forced my husband to get evaluated for sleep apnea, which he has, and is now being treated for. But literally anything would wake me up and then the anxiety about losing sleep would keep me up. My sleep was so delicate and I was exhausted all the time. Combine that with the fact that I was learning a new day job and now working hybrid, I just through that maybe I was mentally and socially overwhelmed.

But I had no energy for anyone. Any social activity had to be planned weeks out. I refused to do anything during the week unless it was ‘very important’ or on a Thursday because I worked a half day from home on Friday and could recover. I figured I was just an introverted adult and this was how things were. I was getting older and had less energy.

I literally had to take a nap as soon as I got home.

The state of the world, and especially the United States, is also horrific. Climate change is evident. We’re worried about a grid collapse, and if you’re a writer at all, AI is haunting you. If you’re not being accused of using it, you’re finding it in the writings of clients, and then you’re in the awkward position of having to return said writing. I digress. Basically, the world is a lot right now.

So being depressed and overwhelmed is normal, right?

My friends, please tell your doctor if you are exhausted all the time, gaining weight or losing muscle in spite of not changing your exercises, having absolutely no interest in sex, or having pain during sex, yadda yadda yadda.

I need to impress something upon you if you’re still reading.

Most medical research is done on men.

When asked to rate pain on a scale of one to ten, men will rate their current pain based on the worst pain they have individually experienced in their life. Women will rate their pain based on the worst pain they can imagine. So if a woman’s uterus is tearing her a new one and causing her to curl into fetal positions on the floor, she may just call it an 8 because surely being burned alive is worse, right?

I am now on estrogen and testosterone (low doses) as well as a high dose of progesterone.

I CANNOT TELL YOU HOW AMAZING I FEEL.

I didn’t know how tired I was all the time until I was no longer so fucking tired. I suddenly was running again like I used to run in Chicago. I thought I was just lazy, old, out of shape, not doing the fitness lifestyle. No, actually, I just had lost my testosterone while I was recovering from Achilles tendonitis. Suddenly I can focus again. I’m not overwhelmed at work. I feel like I can handle new complex tasks.

And I’m not so depressed.

Yes, the world is a dumpster fire and I do have to restrict my social media usage for my own sanity, BUT, I no longer want to put stones in my pockets and walk into the ocean most days.

My uterus-having friends, if you are reading this, and ANY part of it resonates, please talk to your doctor about hormones. If your doctor refuses, please get a second opinion or talk to friends in your area who have had success.

People have never lived this long before. And the effects of hormone loss on women is only just now being studied. Personally, I would rather take hormonal supplements for the rest of my life and feel like myself, then eventually have to take heart pills, osteoporosis pills, and who knows what else.

But just know, if you feel like you’re angry all the time, sad all the time, snapping at people, so freaking tired, can’t do what you used to do, etc etc etc…. you ARE NOT CRAZY.

It’s not your fault. You are trapped in a suit of flesh and the hormones powering it have a lot of control.

It’s not your fault. You are not crazy. And it is possible to feel like yourself again.

Middle Aged Women, you are not crazy