In her own words, Catherine “crashed into menopause.” It made her feel off-balance both physically and emotionally.
In her own words, Catherine “crashed into menopause.” It made her feel off-balance both physically and emotionally. Candidly, she describes the hot flashes, night sweats, and skin changes that characterized her menopause and why she feels a responsibility to talk about it. Catherine
Is the founder of a global online community of midlife women and believes “it’s really important for women to share stories.”
menopause: unmuted is designed to raise awareness, encourage communication, and share information. It is not designed to provide medical advice or promote or recommend any treatment option.
Links
menopause: unmuted
A podcast series to share menopause experiences
Catherine’s Story
It’s time to unmute menopause.
Hello, and welcome to menopause: unmuted, a podcast series sponsored by Pfizer.
Menopause is a time of huge change for women, and it can affect almost every aspect of our lives, from our health to relationships.
And sometimes, it’s hard to talk about; we’re here to help make that easier by listening to how other woman have navigated their menopause journeys.
I think that my body is starting to go, hey, wait a second, I’m going to require something different now.
And if it was a woman that was my age, sometimes I would say something like, I'm so sorry, I'm having a hot flash. If it was a younger girl, I wouldn't say anything.
And believe it or not, my daughter is, she's very informative. She’s probably the one giving me information versus me giving her information.
I’m your host Mary Jane Minkin. I’m an obstetrician gynecologist and Professor at Yale University School of Medicine. Nowadays, many women are finding community and support online, and we’ve been speaking to four women who are sharing and celebrating their midlife experience on social media.
Let me introduce Catherine Grace O’Connell.
I do feel that menopause and all these changes, like I said, including vaginal changes, they really do, you know, have an impact on the way you feel about yourself as a woman.
Catherine dealt with some of the most common menopause symptoms, including skin changes, which can sometimes be difficult for some women to seek help for. But I treat them all the time.
Let’s hear more about her story and unmute Catherine’s menopause.
Hi, I'm Catherine Grace O'Connell and I am a modern midlife woman, and the leader of a global community called the Forever Fierce Revolution, which is an amazing group of women at midlife and beyond like myself, and hopefully like you.
What do I love doing? I love my friends. I also love yoga and meditation and all those things I came to sort of later in life, maybe in the last 10 to 15 years that make me feel grounded and helped me to see life in a really unique way.
I'm 59 years young and I am experiencing these years at midlife and beyond in such a different way than what I saw growing up with my mom and my grandmother. I feel like it's the most wonderful time in a woman's life. And I'm also in this post-menopausal period and menopause, boy did that throw me. So I am so excited to be here today and sharing my menopause experience.
So my menopause journey began what, I guess it was probably four years ago. I'm 59 years young and four years ago, I felt like I hit a brick wall. I literally went from what they call perimenopause into menopause practically overnight. And I didn't know what was going on. But I knew something was going on. I would wake up in the middle of the night, absolutely soaking wet, drenched in sweat, like I'd taken a shower. And that would happen sometimes three and four times a night. So that was really the first experience of menopause where I was like, whoa, okay, nobody told me about this.
And from there, it was obviously sleepless nights and more fatigue and brain fog, and erm also some discomfort down there. I was like really dry and uncomfortable. So I was experiencing all kinds of things. And like I said, it came on for me very suddenly. So it was something that I wasn't expecting. I know when I was growing up my mom never said a word about menopause. And there's a little bit more out there information out there now, but it seems to me that until you really hit menopause, you don't start talking about it with your friends. And then they start opening up and everyone starts sharing things.
So I really didn't know a lot about perimenopause or menopause. But when I was having these, you know, hot flashes and not being able to sleep and just so uncomfortable of course, I went right to my doctor and I remember she ran through all the bloodwork and she explained to me that in basically spring of that year, so this was about four years ago, spring of that year, I had what we would consider normal perimenopausal levels across, you know my hormones, but particularly with the estrogen. And then by fall of that year, my estrogen levels had literally gone down to what she said were clinically unmeasurable, so as close to zero as you can get. So within a six-month period, I literally was crashing into menopause. And that is exactly how it felt.
Although the onset of perimenopause was a bolt from the blue for Catherine, I’m really glad that the early consultation with her doctor was a positive one.
The transition time before menopause is referred to as perimenopause, when the hormone levels, both estrogen and progesterone, decline. Once you are fully menopausal, which is defined as one year without a period, estrogen and progesterone levels are quite low, as Catherine says, as close to zero as you can get. But the perimenopausal time frame can go on for four or five years. Changes sometimes can be subtle. And what’s most interesting to me is that some days the ovaries won’t work at all. And then some days, they are working double time. In perimenopause, one day a woman can have significant hot flashes, consistent with a very low level of estrogen. And the next day she can have tremendous breast discomfort, and no hot flashes at all, consistent with a burst of estrogen. But when the estrogen consistently is quite low and stays that way for a year, you are indeed fully menopausal.
Getting the initial confirmation that yes, something isgoing on can provide reassurance and put you back in the driver’s seat, even if your treatment plan takes a little while to refine.
Here’s an explainer of the kind of testing your health care professional might undertake.
So as we talked about, hormone production is really quite variable in perimenopause. So if you happen to catch a day that the ovaries are working, your blood levels may be quite normal even in the pre-menopausal range. And then two days later, they may be quite low, but that doesn’t mean you are done with periods!
So, I do very little blood testing in general. If I have a woman who is 52, and getting irregular periods, and is having hot flashes and difficulty sleeping, I will seldom do any blood testing as what will it tell me?
Now of course, we do occasionally see much younger women dealing with these issues. So if we are talking about a 40-year-old woman with those symptoms, I will indeed do some blood work on her to see if it at least gives me some ideas as to how to help her.
In general as a clinician, I will try to help my patients clinically, to help them feel well during the transition.
And we will suggest changes in therapies as our patients develop different symptoms.
Now, what also seems strange is that many symptoms such as mood and hot flashes actually are worse for many women in perimenopause. It’s the fluctuation in hormone levels that seems to affect the mood. The issues like vaginal dryness and bladder symptoms are really much more of a cumulative effect of the decrease in estrogen, not the fluctuations, so dryness tends to get worse the farther into menopause that you go. Which can also be confusing in that some women don’t even think of dryness as related to menopause. They just think it’s something that happens to be getting worse over time!
As Catherine found out, hormones influence almost every area of our wellbeing.
So I would have to say menopause definitely affected me emotionally, I was what I call out of balance, off base. For me my emotional state, I could be really weepy really up and down. And like I said, just not feeling like myself out of balance and so things like meditation and yoga were really, really helpful for me, and also getting the help that I needed from my doctor. And I needed some some real help to kind of pick me up off the floor, get me sleeping again, and get my emotional state more balanced.
So one of the biggest things about menopause is dryness, I talked about it in my skin, but it doesn't, it's not just dry on your skin, it's pretty much dry everywhere. And thatmeans even in those, you know, private parts in your, in the vaginal tissues. So when I was going through the hot flashes, and all that I wasn't in a romantic relationship, but the way I experienced it, I would literally go and and use the bathroom, I was up many times at night. And you know, part of the whole getting older thing is you're urinating really frequently. And when I would go to the bathroom and urinate, it was painful, it was erm it was raw, it was dry, it was sore, it made me feel like, you know, I might have a urinary tract infection. And in fact, it was just menopause.
Even though I wasn't in a relationship at the time, I do feel that menopause and all these changes, like I said, including vaginal changes, they really do, you know, have an impact on the way you feel about yourself as a woman. So if I were in a relationship, yeah, I think I would have felt really embarrassed, I certainly wouldn’t have felt comfortable talking to my partner about changes going on inside of my body. It's pretty hard to hide hot flashes. But I think I would have tried to hide that. And if I were in a romantic relationship, and I was experiencing pain down there, I'm not sure I would’ve felt comfortable talking about it.
Let’s not underplay just how disruptive and uncomfortable the vaginal pain that Catherine describes can be. No matter which aspect of your life it impacts, you’d don’t have to tolerate it.
As we were talking about, some women don’t even think about vaginal dryness as a menopausal issue. They think of it like hot flashes which in general will get better.
The term VVA used to be used in the past to talk about vaginal dryness. It actually stands for vulvo vaginal atrophy. However, understandably, many women feel uncomfortable using the word atrophy. Many think it implies old. So we now have switched to the term GSM or genito urinary syndrome of menopause. Whichgets rid of the word atrophy and very importantly includes the word urinary or bladder. Many women as you have heard complain of bladder symptoms, feeling like they need to urinate frequently or that they feel like they have a bladder infection.
And you don’t have to be having sex to have discomfort from GSM. Women who are not sexually active certainly can have bladder symptoms. And dryness itself can cause discomfort: when you bike, ride, run or even walk!
The good news is that there are many options available to treat VVA of GSM. Some of these are over the counter, some are prescription hormonal medications. But these are other good reasons to be visiting with a health care professional who can guide you through this menopause process.
This is menopause: unmuted where we talk about real women’s menopause stories.
I’m your host Mary Jane Minkin and if you’d like to find out more, visit menopauseunmuted.com or talk to your health care provider.
As Catherine shows, getting comfortable with discussing our personal issues can have a really positive ripple effect for the women around us.
I do believe one of the most important things I've learned is when I open up, other women open up and when other women open up, I feel you know so much more erm, more comfortable opening up myself. So it's this dance. I think it's really important for women to share stories, of course not not forced when they feel comfortable. But it's our responsibility as women to start talking about things like that. Because even though our society makes it feel unnatural, how can it be unnatural because we're all experiencing it, right? Every single woman is going to go through menopause just like every one of us went through puberty so why not talk about it? So women like me don't have to hit a brick wall feeling like it's 100 miles an hour going and crashing into menopause. I could have done it much more easily and graciously had I had some you know, more open communication. So I now I pretty much share just about everything and I hope other women will too.
Permission. Permission is a big one. Right? when we're growing up we're looking to somebody else to give us permission. Our parents are teachers you know, whoever to do something, but when we're older, I mean that's the beauty of being at midlife and beyond, the only one that we need permission from is ourselves. So, we live in really stressful times for heaven sakes, so frazzled, yeah, a lot of us feel frazzled. And the best way to de-stress or unfrazzle yourself, is inside out, honestly. It's taking care of yourself. It's loving yourself to pieces, it's telling yourself kind things. It's slowing down. It's appreciating life, being grateful for what you do have, not what you don't have. And, erm you know, I think stress is always going to be there, we can't get rid of stress, we don't control stress, outward stress, we control inward stress. So we control our response to stressful situations, we control the way we react. So erm, the more grounded you are, the more you feel, you know, loved and taken care of and appreciated yourself, the more you appreciate others in life, the more life and others are going to appreciate you.
So what I would say to someone who is on the other side of that brick wall and maybe either entering perimenopause or entering menopause from perimenopause is, educate yourself, you know, be as awake and aware as you can, there's so much information out there, if you look for it. Talk to your doctor to you know, get a sense of what might happen, you know, so you're not surprised by it, talk to your girlfriends talk to anyone that you can who's been through this, to get as much information to help you. I really believe, had I known more, had people opened up more, had I maybe, you know, poked and prodded a bit more, I wouldn't have been so shocked, I wouldn't have hit that brick wall, I could’ve, you know, slowly put thebrake on over time and, you know, educated myself. Everything, like I said, from the foods and supplements to eat to meditation and yoga to perhaps even you know, experimenting with some hormonal therapies that would have helped me really gradually ease into menopause rather than crashing into it.
We hear a lot of talk these days about self-care, and that’s really what Catherine is advocating here. And it’s not an indulgence; you wouldn’t start a new job or go to a different country without doing a little research.
This journey through menopause will definitely be easier if you can prepare yourself, physically, by finding exercise plans that you enjoy and can maintain, mentally, by building time to learn and adjust to this new stage of life and by having strong relationships with your support network.
And also, I strongly urge people to have a solid relationship with your health care provider who can help give you guidance.
Remember that perimenopause is a time of transitionand you will find a new normal. Many women will actually verbalise their change from perimenopause to menopause, things seem to settle down. And as we talked about, some of the ups and downs of hormonal levels are stopped at this point and you go to a sort of low level of hormones, but it’s constant. And many women will feel better. Mood will feel better, hot flashes will feel better. However, unfortunately, the vaginal dryness issues probably won’t resolve on their own, but the hot flashes will tend to improve as will mood and cognitive changes.
But again, I define a problem as something we can’t take care of, and we can easily take care of vaginal dryness as we’ve talked about, with over-the-counter remedies, prescription medications, no problem, a good health care provider will get you through all this.
I’d like to leave you with Catherine’s thoughts on aging, which I think are so positive.
Well, I would say my journey of menopause through menopause has definitely changed my outlook on aging. I do believe that I've always had a really positive outlook on getting older. But with that said, my mom was an actress so the way you looked was really, really important to her. And so, I watched aging with my mom really affect her in a negative way, it was really, really hard for her to get older. So I suppose on some level, I learned at a younger age to sort of look at aging a different way. And so menopause has definitely impacted things like my skin, it's much much drier, it's certainly you know, lost elasticity and there's saggy areas that weren't there before. But I also know that's part of the process of aging. And that doesn'tdefine me. By the same token, I'm all about embracing getting older, like seeing the positive all this amazing wisdom and life experience, but also disrupting the heck out of things like dry skin and you know erm that the outward signs of aging. I don't see them as a negative, but I do see them as something, erm a challenge to sort of tackle and experiment with different things that make me look, look as young as I as I feel and feel as young as I look.
Thank you so much to Catherine Grace O’Connell for sharing her story with us today.
Menopause can throw us all sorts of challenges from sleeping to sweating. Whatever it has in store for you, it’s important to talk to your health care provider who can help you find the right treatment plan.
I’m Mary Jane Minkin, thanks for joining us today, check out our show notes at menopauseunmuted.com.
And in our next episode, we’ll be unmuting Carla Kemp’s story.
And now I'm putting on that white t-shirt and it's like has rolls around my belly and I just did not like that look at all, so that was kind of my motivation, and putting on clothes and just kind of seeing how they were fitting differently.
Don’t suffer in silence. Don’t worry about speaking up about your menopause.
Women should be able to discuss menopause with their health care providers. A woman can speak out about menopause with her OB/GYN, primary care provider, nurse practitioner or midwife. There are even designated menopause practitioners that a woman can visit if she needs more information.
Special thanks to the Global Women's Health team at Pfizer and to Studio Health for producing this series. Talk soon.
Disclaimer.