Gina faced many life-altering events in midlife: a cancer diagnosis, career changes, moving across the country, and entering into menopause. In this episode, Gina shares how adopting a “say yes” attitude and changing her perspective on life helped her to persevere and thrive.
In this episode, Gina shares the challenges and opportunities that she faced in midlife. While going through her menopause transition, Gina was met with a cancer diagnosis, and a move across the country. Gina also goes into detail about working in a competitive environment, and how she navigated menopause symptoms and feeling “not cool” in her workplace amongst younger colleagues. She describes her new perspective on life: “And my husband and I adopted this ‘say yes’ attitude to things, we say yes to as many things as we possibly can. If we have the time, we'll find the money, if we have the money, we find the time.”
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.
Episode 3, Gina's Story
MJM:
It's time to unmute menopause.
Hello, and welcome to menopause unmuted.
Whether you are in the foothills of perimenopause, on the other side of the transition or you just want to learn more about this fascinating stage of life, welcome along and thanks so much for listening.
Menopause can present all kinds of challenges and opportunities, but whatever your experience – or life stage – knowledge is power. So, I want to invite you to listen in to a real woman’s menopause story with me, and I hope it’ll serve as a great reminder that you’re not alone.
I'm your host, Mary Jane Minkin. I'm an OBGYN and clinical professor at Yale University School of Medicine. I’ve been working with women and menopause for decades, and I’m happy to say that I see some positive changes in the medical world’s attitude to menopause. But I also see so many women getting educated, seeking help, and speaking out; and that’s something I really want to encourage you to do too.
Lots of you are telling me that listening to real life stories is really helpful, and I want to remind you that we’ve talked about topics from sex to anxiety, nutrition to communication and a whole lot more in our previous seasons - simply follow or subscribe to this feed to start listening.
For a lot of women, perimenopause comes along at a time when a woman’s working life is at its most demanding and rewarding. Today’s guest, Gina was flying high and working hard when life threw her not one, but two curveballs. But you can’t keep a good woman down, and Gina is determined to make the most of life. So let’s unmute her menopause.
Gina
I am Gina. I am 55 years old. I live in Los Angeles, California. I'm a consultant for a risk management firm. And I also have a couple of side hustle businesses that my husband and I own to kind of keep us super busy. So never a dull moment in my life.
Chapter one: I think started I was probably, my early 40s. And I started, I've never had children. So, you know, I've always kind of been hyper aware that everyone's journey is a little different, depending upon how that works out in your life. And I got into my early 40s and started having really just terrible, terrible times with my menstrual cycle. Not only was it heavy, like, I kind of liken it like crime scene not to be too graphic, but it was crime scene where I, you know, couldn't leave my house or it was just, you know, unpleasant for me, and just terrible pain.
And I always had very easy time with it. And then I got into my 40s. And it was, it was awful. What else happened is that it was became really erratic, say 10 years ago, 10, 12 years ago, the apps really became a thing. So, I found an app, start tracking it. And it was like eight days, I mean, literally to have my period for eight days, then I wouldn't have it for 62 days, then I would have it after 20 days. I mean, it was all over the place. So, I never knew it was going to happen. And this was going on for a while.
And I'm in sales, I've always traveled, I was living in Washington, DC at the time I spent my life on Amtrak, which is the commuter rail between, you know, Washington, DC, and Philadelphia, back and forth almost once or twice a week. That's just not a way to live. So, I started, you know, really getting upset about everything. And I went to go see my gynecologist, and they said, well, it's about that time, asking me questions about my mother. And I said, well, I'm only you know, 43, 44 years old, what's going on? And they’re like, well, it's the beginning. It's the beginning and your body is, is changing a lot now. And so, I said, okay, so I started addressing that.
Then I recall being... my husband is very funny. I'm in a restaurant with him, in a deli, and we're having breakfast. And all of a sudden, I have my [my] napkin, and I'm dipping it in the water, you know, very, very uncouth, but I'm dipping my napkin in the water, and I'm dabbing the back of my neck. And I'm just sweating and sweating. And I'm having a hot flash, my first hot flash, really that I had kind of acknowledged and my husband, you know, looks over at me and says: well, I guess I guess that's all the ovaries left just burning out of your body. That was his joke about the whole thing. I said, oh, thanks, you're such a romantic. But it just, you know, I went back to see the gynecologist and said I can't, I can't deal with this. My head is pounding. I feel terrible. So, we started going through some medical options and started address addressing it at that point.
MJM
A lot of people think of menopause being all about the menstrual cycle stopping completely. And indeed, the definition of menopause is going a full year without a period.[1] BUT…what’s less well known is that a woman’s cycle can get very unpredictable during perimenopause – which is the time leading up to the last cycle.[1, 2]
I’d like to offer a little information on this, because it can be quite unsettling, particularly if you’re used to really knowing your body’s usual patterns.
You might experience a random combination of both shorter and longer cycles while in perimenopause and this is fairly common. Estrogen levels do decline, but this isn’t always linear, and they can fluctuate.[3,4] In fact, for some women, perimenopausal levels of estrogen can be even higher than they were in their 20s![3] It’s these changing levels of estrogen and progesterone that dysregulate the menstrual cycle.
It’s also common to find that the duration of your period changes.[4] Perhaps you’ve been used to a 4-day period for years and now it can be 2 or 6 days.
Some women find their periods can get heavier and some women find the opposite, that their flow gets lighter and can resemble spotting as they get closer to their final menstrual period.[4]
Skipped cycles are another possibility during perimenopause. Keep in mind, though, that you’re still fertile at this stage. So, if you’ve recently had sex not using birth control and missed your period, you might want to consider taking a pregnancy test.
But what if your period is becoming like that crime scene that Gina described?
Well, heavy bleeding can be another normal if inconvenient aspect of perimenopause.
We do know that Black women are more likely to have heavier bleeding during perimenopause than white women.[2]
Also, smoking and a higher B.M.I. are associated with heavier bleeding in perimenopause.[2]
So, I hope this reassures you that for lots of women, heavy bleeding is normal, but it can lead to anemia and iron deficiency which can make you feel very fatigued. So do discuss that with your health care provider if it’s becoming an issue. Also, remember that although something may well be “normal” it doesn’t have to mean you need to put up with it. There are many ways to help decrease the heavy and erratic bleeding.
And one more point: if you have bleeding that lasts longer than 7 days per period or is so heavy that you have to change your pad or tampon nearly every hour, you need to talk with your doctor. As it could be a sign that something else is going on.[5]
Remember that some of our previous stories have featured women who have experienced heavy menstrual bleeding, Shauna’s story from season 2 and Sateria’s story earlier this season are both good episodes to listen to.
Gina very sensibly got some good advice and help from her doctor to ease the journey through menopause, but she noticed something else. Let’s get back to her.
Gina
And that was, you know, went along for about three years. And in… I guess it was probably like 47 or 48, I went to go see an endocrinologist because I was feeling really odd and off and I had had nodules on my thyroid. And that began the odyssey of now I was going through perimenopause, but then I also found out I had thyroid cancer. So those two things were kind of a stopping point for me where I said, I really need to understand my health a little bit more and address it. I think at that point, I was feeling very overwhelmed. I'm also somebody that's very good at compartmentalizing things. So, I knew that during the day, I had to live my life, I'm in sales, I'm in a public facing type of a job, and in all ages of people. I had to live my life as if nothing was going on. Because you know, you can't, you know, never explain, never complain isn't just an adage for the royal family. It's also something that you have when you're in sales.
And it's certainly something that you have when you're trying to be a vague age. That's part of it, too, is that it's not really cool to be in your mid 40s. It's not really cool, now I'm in my mid 50s, it's not really cool to be in your mid 50s and be in sales when, you know, I was in the legal sales, legal consulting where I'm dealing with people that are like in their early 20s or late 20s or whatever, you don't want to be the old lady coming in like, oh, my back hurts, whatever. So, you have to compartmentalize that. So, it was like during the day, nothing happening. Everything's grand, but you just kind of have to, you know, soldier on at that point. And inside, I'm feeling terrible, and I'm overheated. And I'm traveling and I can't sleep, and I've been staying in hotels and trying to manage everything dragging my suitcase through busy city streets. It was it's a lot. It's a lot.
And I did that for years, years and years and years. And you know, I've had a couple you know, work colleagues, but I would just kind of suffer, suffer in silence a little bit, and get back to my room, and just take everything off and just plop down on the couch. And the only upside was, you know, being in a hotel was, you know, like, crank the air, I didn't have to pay for it. So it could be as low as I wanted it to be at that point and just sort of, you know, take a shower, because I would need multiple showers during the day, change my clothes, I had to change my clothes multiple times during the day, and just [just] kind of deal with it and not say anything like, oh, yeah, I was wearing that blouse this morning. No big deal. You didn't you don't see anything, you know, just kind of nothing to see here, folks. That's kind of how you have to live your life if you want to be competitive.
It's a competitive world, you can't, you can't be female. You can't be aging in a world that values being nimble and being kind of cool, I guess. Meantime, you’re burning up, certainly not cool.
Music
They did a hormone test. And they sent it away to a lab and it took like, about two weeks to come back. And then the doctor called me. And I was actually at that point, I had literally, and I'm not kidding, not a hyperbole, I just quit my job that morning, and was switching to another job. So, like 8:30 in the morning, I call my boss and resign. Two o'clock in the afternoon, my doctor calls me because I'd almost forgotten about it. And said, we got all your testing back, they had sent it out to some lab in Pennsylvania. And you have the markers that say that it's 98% chance that you have cancer, and the whole room just went black.
And the worst part is that my thyroid was actually working fine. I didn't have a hyperthyroidism; I didn't have anything. But now I didn't have one, I had a perfectly functioning thyroid that just happened to happen to have cancer on it. And it happened to have spread, but it worked fine. So, I removed it's like removing a part of your body that works - just a little bit of cancer, kind of a soupcon of cancer there it was just really miserable.
Well, it's sort of interesting, because when you don't have a thyroid, you [you] know you're called like euthyroid or something. People say it's not hypo- or you know, hyper or hypo, you just don't have one. But you kind of mimic the symptoms of somebody who has hypothyroidism which is you’re cold. But I'm in the middle of menopause. So, I, and I run hot anyway, I mean, I was always, you know, running hot, in my 30s. So, then you compound that and it's like, it’s kind of, I never had any of the hypothyroid symptoms. That would, the first one would be being cold all the time. I didn't have that. It didn't like balance out. It wasn't like it was an average now like you could be super cold, or you could be super-hot. And now you're going to be in the middle. I still was just hot all the time. But then it adds to fatigue.
So, the one thing is I feel pretty good now but it's, it's been, you know, 2000- 2016 I had my thyroid removed. Brain fog! But I feel good now. But right after you have that surgery, you're exhausted. Because your body now is you've removed the, the regular ability to produce thyroid hormone. So now you have to take a replacement. I take it every day for the rest of my life. I can never not take it.
But I likened it to feeling like you know, there's like old lawn mowers, where you pull the cord, you pull the cord. And now you got like, pull it, and pull it and it doesn't start. That's how I felt. So, I get up in the morning, put my feet on the ground. And I feel like I'm just pulling that cord. And I can't get going. And I'm never, you know, I mean, I had perfect attendance when I was a kid in school. I didn't really take a lot of sick days. But there was from January, through probably July there were more sick days than I had taken in the previous you know, 20 years of my career. I just couldn't, I couldn't get out of bed. So, I mean, I'm going through perimenopause, my head's pounding all the time. I still have to travel. I still have to do that. Even my boss who was super nice guy said, well, there's no rest for the weary just, just get [get] going. And I'm back on the Amtrak train all the time.
And sometimes I just put my feet on the ground. And I'd like, get ready to stand up and I'm like, nope, and just get [get] back into bed. And that was, my husband had never seen me take sick time. Even when I was you know like dragging to work. He's like, why don't you take a day off? Like I can't, I can't and then I was like, nope, going back to bed, pull the covers over my head. See you tomorrow.
So I live like that for a very long period of time until I kind of figured out the balance and I went through multiple doctors and I was able to get, make some medical decisions that would help me but that took about three years to get to that point, and now I feel pretty good.
MJM
There is never a good time for a cancer diagnosis and every patient needs a very specific plan, but it’s completely normal to feel totally wiped out by surgery or treatment. Combine that with perimenopause and all the traveling and it’s no wonder that Gina just had to slow things down and rest.
Gina was dealing with thyroid cancer, and I’d like to offer you a little more information about that:
What is the thyroid? It’s a gland in the neck, and people sometimes refer to it as the master gland, but the thyroid basically controls our body’s metabolism.[6] Many women have hypo- or hyperthyroidism and that does not necessarily indicate that you will be high risk for thyroid cancer. And they have very different symptoms.
Symptoms of thyroid cancer include neck swelling, voice changes, difficulty swallowing.[6] Gina noted nodules on her thyroid, and she was very sensible to get them checked out. Interestingly the average age for a thyroid cancer diagnosis for men and women is 51[7] – the same average age for women to reach menopause. Most thyroid cancers can be cured and respond very well to treatment.[6]
Midlife can often seem like a time when an increased risk of cancers and other long term health issues creep up. But it’s not all doom and gloom, many of the women we’ve heard on menopause: unmuted talk about how they have reassessed their health and as they have reached this new life stage, created positive new habits.
A very good habit that I want to encourage you to develop is staying on top of screenings and health checks. Try not to put these off, do keep a record of any changes that you notice to your menstrual cycle, and discuss any concerns with a health care professional. The internet can be a useful source of information but there’s no substitute for a discussion with a qualified professional.
[music]
This is menopause: unmuted, where we talk about real women's menopause stories. I'm your host, Mary Jane Minkin. If you'd like to listen to other women's stories about their menopause experiences, visit menopauseunmuted.com. You can also talk to your healthcare provider to get more information about menopause.
Let’s return to Gina’s menopause story and her thoughts about her relationship with work.
Gina
Work. So work is an interesting thing for me, because I like to do a lot of things: I like to travel, I like to go to concerts, I live in Los Angeles, there’s plenty of things to do, and you need money to do those things. So that is part of, you know, recognizing, there's a utility to it. But I like, I like connecting with people, I love being in sales, I love, you know, having an opportunity to solve problems for people. So, I get, I get a lot of gratification from the work that I do. I have a pretty interesting job now where I work with people that are, you know, help them make decisions about business, that they are going to be, you know, things they’re going to be acquiring, where they're going to be doing different things. And I'm a part of that, and you feel really vital in the community, when you're able to do that.
It is always challenging, it has been challenging, since I've had to accept the fact that I'm now quote older, that you don't want to feel older. And I do think that the way that I kind of present myself to the world is I don't admit, any kind of an age. And you have to kind of be like that, because you're going to feel, you're gonna feel old. So, I kind of say I'm over 40. And that's kind of where I leave it. Because you don't want to feel like you're the oldest person, you know, the oldest mom on the playground, the oldest everywhere, it's always, you know, I look around, and I'm at an event I was at one a couple weeks ago. And I hate to say this, but I'm counting and I'm like, I'm older, I'm older, I'm older, oh they're older than me, like you, there's probably like 400 people there.
And I do that. And I have to stop myself from doing that. And just say, you know what, people come up and want to talk to me, I'm not begging people to have a conversation with me, I'm an engaging, funny person, I can be delightful when need be. So, I'm just going to put the rest of it out of my head. Because if I focus on it, then I'm going to feel like, I'm not cool. I also don't need to be, you know, hanging out with, you know, super young people that I don't have anything in common with them. But if somebody reaches out to me who's younger and says, Hey, can I ask you for advice? I'm readily give it.
I will say I'm super disciplined. And that's something that comes with age. And I've had ups and downs in my career. So, I know that if I am not super disciplined that the downs are going to come, and I don't like this, that's you know, motivation enough, on top of liking what I do. I don't worry about things I think that other people might worry about, that does give you that freedom, like you find yourself a little bit as you get older, and you have less of a concern about, about the other stuff. I'm not walking around trying to like approach people and start confrontations, but I will say hey, that's not something that that…I don't think we should have a conversation. I had that happen yesterday, actually, where there's two people on a on a Teams call and I feel like they were kind of at loggerheads. And I said, okay, let's wait a minute, this persons at this is this place, and they have to get this done, and you're over here and you're both right. Let's just leave it there as opposed to, you know, getting in an argument. So, all of that stuff helps me stay a little more grounded.
Music – sting
I talked to a lot of my girlfriends about, you know, menopause and their menopause journey and everybody's brain fog, fatigue, I feel terrible, I have hot flashes, blah, blah, blah. It’s like, I have all of that. I have all of that. And sometimes more, sometimes less. I mean, I didn't sleep well last night. I think I was a little nervous about having this conversation, but I was also just in a puddle.
But you know, you everybody who gets to live a long life. If you're a female, you're gonna go through this. In some iteration things are gonna happen in your life. You know, you maybe you have a hysterectomy, maybe but your, your body will change. And I think I don't know if we talked about this before, but you know, my father died when he was 47. And he had this huge life. And about a year ago, he was inducted into a local Hall of Fame in the town where he grew up. And I had an opportunity to speak about it. And I kind of went through all of these things that he did and all the places that he went and all the cool people that he got to meet, and it stopped at 47. I am convinced that he would have done incredible things if he lived longer. I'm much older than he is now. And my husband and I adopted this ‘say yes’ attitude to things, we say yes to as many things as we possibly can. If we have the time, we'll find the money, if we have the money, we find the time. And that's how I ended up going on a couple of really great trips. That's how I ended up moving to Los Angeles from Washington, DC. People just don't do that.
Not everybody gets the gift of a long life. So, if you can say yes to things, the gift of being older is that you do have sometimes a little more time. So, any of the other things that bother you that you know, oh, my knees or my hormones or whatever. Just think about the other side of it that you know, my dad was 47 and he was that was the end of it. So not to be too you know, morose, but that is a fuel to remind me like that's really young. I still feel pretty young. I'm wearing a jean jacket. I look like I'm cool. If you don't remember those things you're going to be, the back half of your life is, you're not going to live a full life.
MJM
Carpe diem, Gina! Isn’t it great to see a woman in midlife striving to make the most of every day?
I found her thoughts on work and aging so fascinating – you know in my line of work, it’s pretty normal to have colleagues who are well into their older years, in fact they are often revered and respected sources of wisdom. Yes, we live in a youth obsessed culture, but I like to think that we have so much to offer the world as we grow in age and experience.
I recently had a great honor: one of my favorite professors from when I was a resident 46 years ago came to a menopause lecture I gave, and I was so honored when she told me she enjoyed it and learned something: and she’s 99!
I’m so glad that Gina was diligent about monitoring her health in her forties, and that she was able to persist with finding the right treatment program for her. I want to thank Gina for sharing her story with us today and I wish her all the best for a full and healthy life.
I’m Mary Jane Minkin, thank you for listening to menopause: unmuted.
As you know this podcast is all about sharing stories about menopause, so if there’s someone you know who would benefit from listening, I’d be so grateful if you could share this series.
In our next episode, we’ll be listening to Deborah’s story.
Deborah episode 4 clip: “it felt like it took quite a lot of courage to actually say to my husband, I'm not feeling this desire that I used to feel. And that was a huge loss. I remember having the first conversation and just sobbing because I said, you know, I don't think anyone can quite understand what this loss of desire represents. And, and how sad I feel that something very fundamental in our relationship is changing or has changed.”
MJM
Before I go, I’d just like to say: 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 Women's Health team at Pfizer and to Studio Health for producing this series.
Talk soon.
[Disclaimer]
[Pfizer sting]
The podcast is powered by Pfizer.
References