Rachel’s story is about trying to navigate the emotional turbulence and physical changes associated with menopause, “I'm a badass ... and badassery just gets more creative as you get older.”
E2: Rachel’s Story
From feeling invisible to invincible, Rachel’s story is about trying to navigate the emotional turbulence and physical changes associated with menopause, while managing other personal pressures. “I'm a badass ... and badassery just gets more creative as you get older.”
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
• http://menopauseunmuted.com
• https://www.pfizer.com/health-wellness/diseases-conditions/menopause
menopause: unmuted
A new podcast series to share menopause experiences
E2: Rachel’s Story
It's time to unmute menopause.
Welcome to menopause: unmuted, a new podcast series sponsored by Pfizer.
Menopause is a major life transition accompanied by a multitude of symptoms, health and relationship considerations that women, unfortunately, don't talk about enough-̶ and we want to change that.
Women from across the US have been coming together to share their menopause stories.
“When I think about how the menopause affected me, I have to talk about the things that I went through at work.”
“Sex becomes very painful. And it's like a switch. It's like one minute sex is fine. And then next minute sex is not.”
“I don't look at it as something that is bad. I just look at it as growing up, and that's the place I'm at, because that's life.”
I’m your host, Mary Jane Minkin. I’m an obstetrician gynecologist and a Professor at Yale University School of Medicine and I’d like you to join me as we listen to Rachel’s story.
“I think when people ask about how my menopause experience has been, I think they're mostly talking about the physical changes. For me, it's more of a marker of stepping into the next phase. It's more of a philosophical place where my energy is going and not so much coping with physical changes.”
Rachel’s experience of vaginal atrophy, changes in mood and hot flashes is really common. And many women deal with their menopause alongside some major life changes. Whether that’s caring for aging parents, or navigating turbulent teenage years within the family, it’s not unusual to get to this point in life and think ‘what’s next?’ In Rachel’s case, she was dealing with the breakdown of a long-term relationship.
Let’s unmute Rachel’s story.
“My name is Rachel. I'm 54. I work as a midwife. I've been a midwife for 20 years. I live in Cleveland. I am divorced one and a half times. I have two teenagers. I do like telling people that I'm a badass and when they laugh because they don't believe me, I remind them that I once had a black belt. I used to teach self-defense for women and badassery just gets more creative as you get older.
“So, I believe I first started realizing or questioning whether I was having symptoms of menopause in my late 40s. And that was manifesting as mostly sleep disturbances and a lot of night-time heat, then some hot flashes during the day. And at the same time in my life, there was a lot going on in my personal life and I was also experiencing a huge amount of rage, which I was very keen to try to figure out how much of that was the circumstances in my life and how much of that may have been exacerbated by, by the menopause. So, all of that was going on around the same time, probably in my late 40s.
“So in terms of the rage, I ,again, I was trying to figure out what was circumstantial and I needed to deal with my life, my partner, my kids, and how much was physiologic or psychological, but I was working really hard on not minimizing or invalidating my concerns, and my disappointments and my complaints. You know, we, we do that to women a lot, you know, we say, ‘oh, she's on the rag’, ‘oh, you must be expecting your period’. You know, and we'll dismiss ourselves you know, ‘I'm sorry for being so emotional, I’m premenstrual’, we dismiss our minds and our emotions and our reactions and responses to the world based on our hormones, and I was trying not to do that. I wanted to figure out can I separate; you know how much is exacerbated because I know what I'm feeling is valid. I know what I need in this relationship is reasonable and valid. And I don't want anyone to say, you know, you're acting like a crazy menopausal person, because then the rage would really take over and the badassery would really come out and I'd have to be really mean to someone.
“I don't remember the onset of the rage. I just remember being very angry a lot of the time when I was in the house, feeling unhappy a lot of the time when I was out of the house, and being very quick to be triggered to the rage. Even now my daughter, she even the other day said, ‘I remember when you were really mean’. I said, ‘sweetie, I was not mean’, she goes, ‘oh yeah, you were Mom, you were really mean, but it was just the menopause, and then you got better.’ So, she's kind of internalized maybe how I look at that time in my life, at least, at least partially.
“But I've been really trying since, since the separation from that relationship. And that's been about a year and a half. I've been really trying to give my developing adult children space to define that time in a way that works for them and trying to give them space to have that imperfect mother but also, hopefully, forgive her and know that they're strong as a result of being able to articulate that and being respected for it.”
Many women, as Rachel describes, are experiencing significant mood changes as they go through menopause. There has been historically always, this image of the crazy menopausal woman, and I believe that actually, many of these crazy menopausal women were women who were just very sleep deprived. And of course, sleep deprivation for men and women can make you pretty crazy.
I think it’s wonderful for women to have friends in whom they can confide, family members that they can speak with and also importantly, to have a health care provider that they feel comfortable sharing these concerns with because that health care provider can then give you some guidance as far as how to improve these symptoms to make your life more tolerable.
While Rachel didn’t suffer too badly with physical symptoms, there was one aspect of menopause she experienced which is often the hardest to discuss. And I’m so grateful for Rachel’s honesty here.
“Other than the sleep disturbances, the hot flashes, and the emotional psychological effects, changes, other than that really vaginal dryness was, was the only significant change. It didn't concern me in any way other than the details of how it might impact my sexual relationships. And you know, I'm going to have to deal with that. For the rest of my life. I hope my time as a sexual person on this planet is not over. When I say that that's going to be with me for the rest of my life. What I mean is, the changes to the vagina are permanent. There are some changes that are treatable, but they're pretty permanent. It's not just dryness, it's really atrophy of the tissue, which becomes very, not stretchy, right, like a wonderful vagina that is meant to, it's meant to be very stretchy and accommodating. And after menopause that stretchiness goes away, the tissue becomes very thin and fragile. And so, it's not only a matter of dryness, it's also a matter of that kind of youthful type of mucosal tissue. It is for the rest of a woman's life, a matter of symptom management.”
Rachel is absolutely correct in that the vaginal changes, unfortunately, over the course of time, can get worse. However, that doesn’t mean we have to put up with these symptoms. There are many interventions which can really take care of these changes, and reverse them, so that one doesn’t have to put up with these symptoms of discomfort and lack of stretchiness. As well as talking to your health care provider, I strongly encourage my patients to talk to their partners.
“Well, I can imagine the kind of conversations I would have to have with someone new. In my mind, I'm very open and straightforward and brave, in order to say, here's what's going on with me at this time in my life, and if we become sexual, this is what I'm gonna need from you.
“I think the conversation would have to be very explicit. Some things that are easier to say like, intimacy is not the same as intercourse. So, a lot of physical intimacy, arousal can take longer. So, we may have to talk about more foreplay. I would need to make sure that any partner-̶ I'm stealing this line from someone-̶ but that any partner was not ‘illcliterate’, that they were aware of female genital geography. And I would have to be very open and clear about what I needed from myself and from the partner and that person would have to be very patient and responsive in the moment because sometimes that means stopping, or changing, or slowing down.
“I am describing a considerate lover but more importantly, I’m describing being a person who tells what will hopefully be a considerate lover, what she needs. You can have a considerate lover and never open your mouth and still not get your needs met. You know. So, it's more about that two-way street and I think that would have to be initiated by me, you know, I'm sure male sexuality changes with age as well. And women throughout their whole life, I think we should be talking to our partners much more throughout our whole life. But I think it's truly, truly vital after menopause, because things work vastly differently.
“You know, I remember when I was teenager, man, before I had ever had sex. I was scared of those things. Man, it was like those things are not gonna fit, that could not be comfortable, that could not feel good. It was all sorts of things like that. And that fear has come back because now I know it's gonna hurt again.
“And I know it might not feel good. So that that's part of that communication, you know, to really say, you know, I hope I find someone I can say I really like you. And please keep your pants on for now cuz I'm a little scared of that.
“Call me in a couple years and I'll tell you if I've had success, or even an opportunity.”
This is menopause: unmuted where we’re listening to real women share their 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.
How common is it for menopause to disrupt a woman’s sex life? Very common. However, there are many things that can be done to help take care of these problems, and really improve the sex life tremendously.
Do try to talk, in any way that you can. It is a generalization, but many men just don’t realize the extent to which menopause can affect a woman’s sexual function, and that lack of awareness can create real distance and isolation within a relationship.
But it’s not all bad! This time of life presents opportunities.
“I used to when I was in, my, boy, I think probably like, throughout my 40s I would always talk about when I'm through these difficult years of raising young children. I'm going to enter my ‘Susan Sarandon years’ where I'm going to be free and sexy and adventurous and all these men of all ages are going to want to be with me and women of all ages are going to want to be me, and I'm just going to be this incredible self-actualized woman. And so here I am towards the end of this kid-raising thing, after that, there is nothing stopping me. And that is very intimidating, makes me smile thinking about being in ‘Susan Sarandon years’, but it's also something I've got to start not just saying with humor, I've got to start turning that around for myself and, and building something that isn't there now and hasn't been there in a long time.
“But when I think about the future, in my ‘Susan Sarandon years’, I am a planner and the truth is, really anything is a possibility. But this is one of those, without jumping off the edge of a cliff, one of those moments where it could be a really fulfilling time, but it's on me to make it so. There's no school to teach me how, there's no relationship that'll make it happen, there's no particular place that I feel is my, you know, the destiny of the place I will live, or the people I will wind up living with it's just, it's just all open which is, I guess, sometimes exciting, sometimes scary, sometimes lonely.
“But I will say on a different note, that one thing that I've talked to many women about and it starts in the 40s, and I talked to women in their 40s who say that they have just now started experiencing this. And anyone who might hear this who's in their 40s, I'm just here to say it gets worse. No doubt it gets worse, but this sense of becoming invisible in, in the world, which is this feeling, it's very strange at first that you feel like something is just a little changed when you're out there in the world, you know, going to work or riding on public transportation or doing your grocery shopping, going to restaurants whatever that you know, we see women a certain way in society and so much of that is around youth, physical appearance, vivacity, and I can be vivacious at my age, but that word is really associated with, with youth.
“But there is the sense that you start walking through the world and people kind of walk by you and there's less eye contact. It's a very strange, strange feeling. And at, at the same time, very recently now in my mid-50s, I, I do feel like I'm starting to become a little more visible to a different group and that is group of older women who I feel like are maybe seeing me as one of theirs now, and almost tacitly smiling at me and accepting me into their fold. And we do this to people throughout their lives. You know, we, we scare women who are pregnant with their first babies. ‘Oh, you just wait and see, you just wait when you have labor’, right? We do this to scare women. And then once they become mothers, it's almost like they've joined a club.
“And I kind of feel that that is happening, maybe less intensely. But there's, there's a similar sense of, you're in the next club now. And speaking of that, that dynamic, I do think a lot about the female archetypes of the maiden, the mother and the crone, with the crone not being an ugly, scary old hag of a witch, but the crone being an older woman who embodies power and wisdom and possibly even magic. And if I've gotta age, that's who I want to become.
“It's hard to think about advice for someone younger because you just don't know until you're there. You know, it's the same thing with every single stage in life, you know, when you go to college, you just don't know until you're there. When you go into childbirth, you don't know until you're there. And then when you go into parenting, you don't know until you're there, you know? So, I think it's, it's the same thing I think, you know, it's like when you first get your period, that is your body and your emotion. And even though people can tell you how to deal with the bleeding and how to deal with cramps and what to expect from your cycle, what's going to happen to you in your mind is very, very individual.
“And so once that happens, you know, people are going to talk about it in the way they do, and I'd be happy to be there and let them know it's okay.”
It can take real bravery to talk openly about such personal and intimate issues but talking about our experiences can make a huge difference to the people around us, so I want to say a big thank you to Rachel for sharing her story with us.
Many women struggle to speak out about vaginal and sexual symptoms of menopause and the impact on their personal lives and their relationships, but it is something that many women experience.
And finding ways to communicate effectively with both health care professionals and loved ones can lead to greater understanding and intimacy.
I’m Mary Jane Minkin, thanks for joining us today, and check out our show notes at menopauseunmuted.com.
And in our next episode, we’ll be unmuting Charlene’s story.
“At work, I was not present. I was very forgetful and moody. I was irritable. I had messed up a lot because I was so focused on not trying to show my symptoms that everything else started to fall.”
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 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
This podcast is powered by Pfizer.