My journey started with menopause in 2020. The world was dealing with COVID and me with perimenopause. “I have not conquered it all,” it is a journey I am traversing and learning as I go along.
When COVID was at its peak, there was a 3-month period when I was bleeding the entire 90 days. I could not visit my gynecologist due to the lockdown, so I managed it somehow. Then started the hot flashes, night sweats, insomnia, anxiety, depression, palpitation, and even a panic attack. I was ticking all the boxes for perimenopause, as my gynecologist and later psychiatrist simply put it.
Pre or perimenopause?
Perimenopause is the phase before you finally hit menopause. A woman not getting her menses for a continuous 12 months is medically termed as menopause.
Wanting to know how long I must bear with my periods, I enquired with my gynecologist, “How long is the perimenopause phase?” His answer was not heartening, “any time from 4 to 11 years! Just like menarche, menopause is also unpredictable.”
My symptoms
It started with heavy bleeding, then irregular periods followed by the symptoms mentioned earlier. It took me almost three months to realize I was going through something different. I reached out to a few batchmates and family, but none of them, including my own mother, seemed to have faced the symptoms I was struggling with.
At one point, I had three bouts of insomnia, one lasting five nights. This episode was a memorable one. My spouse was out of town, so I asked him to return in desperation. As soon as he arrived, we visited the ER of a nearby hospital. The ER doctor commented, “We cannot keep you here; all your vitals are normal. We cannot admit you as well, as there is no emergency.” Not happy with this response. I begged, “Please, doctor, give me something to make me fall asleep. I am deadbeat tired.”
After some explanation of my history, they called the on-call psychiatrist, who was on leave; however, she prescribed a low-dose sleeping tablet. We came home, I took the tablet, and it worked immediately; I slept soundly after five sleepless nights. As advised, I met the psychiatrist for a follow-up after a week. After a few visits, I was put on a mild antidepressant instead of a sleeping pill. She explained, “Your core issue is anxiety and depression, not insomnia; the latter is a side-effect of the former.”
Not wanting to continue the antidepressant for long, I tried homeopathy medicines. It helped the bleeding to finally stop but did not offer any solace to the anxiety.
After every month, for about two weeks, I would be anxious and depressed. Once, I had a bad bout of depression and an equally lousy anxiety attack. This was when I changed my psychiatrist, who has now seen me through thick and thin.
“Women are always being tested, but ultimately, each of us has to define who we are individually and then do the very best job we can to grow into it.” – Hillary Clinton
The unpredictability
Every day was different; I would be perfectly fine one day, and the next day, I would feel low and anxious. Things I could normally do and activities I could multitask; on my low-mood days, I would find it a burden to complete even one. For example, helping with my daughter’s studies or simple home chores.
Initially, I had continuous sobbing episodes. Crying in front of my husband and daughter, saying, “I don’t know why I am crying!”
The nagging question was, “Am I meeting the right doctors?” “Am I getting the support I deserve?”
My mental health
The most crucial aspect of the hormonal imbalance is the impact it had on my mental health. My low phases meant a loss of confidence which came with the anxiety/depression. I was brain fogged, could not think straight, my decision-making was skewed. Even minor decisions like to clean something or not seem like a huge one.
In this phase I turn into a lethargic person, mornings are unwelcome, even hobbies like watching movies or reading books, I am uninterested. I just want to sleep, which also, I cannot do properly!
I get stressed about the minutest activity, making a cup of tea seems to be an enormous job! I feel so helpless, the bigger things seem insurmountable. I overthink; will my kid be ok to manage everything independently? What if I am unable to help her, will she be motivated enough to study? Is my mom, who is 78 years old and living alone, fine? What if something happens to her, will we be able to handle it on time? And so on.
“This is your moment to reinvent yourself after years on focussing on the needs of everyone else.”- Oprah Winfrey
My family and friends
At home, my husband and daughter have no option but to accept me the way I am but what about others who are not seeing me day in and day out?
Making social interactions seems challenging. Otherwise, a social person, I prefer to be left alone. I hate stepping out of my safe zone (home) or even chatting with friends/family on the phone.
Normally, I share with people who are ready to listen, but with my mood swings, I am at a loss for words and action. When I am okay, I feel the need to explain or apologize for my odd behavior, but when I am down, I do not want to communicate. Being quite self-aware, if it took me three months to realize I was depressed, how was I to disclose my inner thoughts with those who have not been in the same place, ever?
I cancelled a couple of commitments because I was not in the mood to go. I wanted to be there, but just could not make myself show up. Who all and how much to explain this absence?
I asked my psychiatrist what I should do. He was pragmatic, “people who know you, you can explain; people who do not, it does not matter. It is not in your control to make everyone see your point of view.”
I tried his recommendation, but every time I cancelled, it made me feel guilty. It took my closest friends almost a year to accept this new me.
The backing I received from my family has been phenomenal. Initially, as I brushed aside the issue, they did not even catch what was going on. Slowly, as it dawned on me, they became supportive. We even termed my low phase – MSM (Mumma support movement!). So, each time I was in MSM, they would become more caring and encouraging towards me.
“Menopause is a time when a woman’s body goes through significant changes and it can be challenging, but it’s also a time of empowerment and self-discovery. Embrace it and don’t be afraid to seek help when you need it” – Angelina Jolie
My team of doctors
Not finding my regular gynaecologist too empathetic, I switched to a homeopathy doctor and met at least two more before finally locking on my current one. We were ready to try all possibilities to solve this medical issue, even ready to venture outside our city of residence (Mumbai) if there was a doctor offering an appropriate solution.
Most doctors gave me one piece of advice – accept the situation and move on. I heard them saying, “you are not the only one going through this. There have been women before you and there will be ladies after you who have undergone the same thing and have sailed through it.”
My former gynecologist wanted me to get an IUD (intrauterine device) inserted. My oestrogen levels are low, and progesterone is normal. I would need to take the oestrogen orally in tablet form (also called HRT or hormone replacement therapy) while the IUD would settle my heavy periods. Another gynecologist agreed with him. The third one went in a different direction, “you need a lifestyle change rather than an oral oestrogen supply.”
While conducting this research, my low mood continued to haunt me. After about two weeks, I have had a knotty feeling below my abdomen. Especially while lying down, I can feel that knot. Now, I can easily recognize when this gloomy feeling surfaces.
Currently, I am under the care of a team of doctors: an empathetic gynecologist whom I must meet to get my blood panel, thyroid, scans, etc., done; a psychiatrist who continuously monitors and prescribes my medication; and a clinical psychologist who counsels through talk therapy or CBT (cognitive behavioural therapy). The psychiatrist and the psychologist, especially, are closely associated, so my treatment is well-rounded.
Ayurvedic Journey
After homeopathy and allopathy, I also tried an ayurvedic wellness program at a retreat in Kerala. The one-week program was holistic inclusive of the stay, diet (strictly vegetarian), yoga and therapeutic massages, based on my body condition and assessment by the doctors. The sessions were extremely relaxing and rejuvenating. It remains to be seen how effective this treatment regime has been.
My coping mechanisms
With this medical team around me, I hope things only get better. Both my doctors insisted that I keep a routine every day despite my condition.
To have a physical regimen, I joined a mixed workout class. We are a batch of ladies who do cardio, yoga, meditation and Zumba. It gives me an energy boost and yet another place to bond. I have revised my diet to gluten-free meals by switching from wheat to ragi. I regularly consume fruits when I used to like only mangoes and bananas. Hydrating better through intake of buttermilk and increasing water input to keep my hot flashes in control. Following a fixed sleep routine is another way of keeping my body and life in a balance.
To keep my brain continuously working I take up creative assignments like personalised photo albums with a crafter friend, solving puzzles with friends, gardening and cooking. I love to travel so I plan atleast one trip every 2 months. The planning keeps my mind active and the vacation gives me time with my loved ones while letting us unwind.
As a family we regularly watch plays and music shows, movies/web series and listen to music for relaxation. Talking about my state, I found women in my network who seemed to have gone through similar issues made me feel calmer and not all alone. Writing about my experiences comforts me too.
Conclusion
It has been four years since I was declared perimenopausal and one year since I have menopause. Most symptoms have weaned out, but depression and anxiety are something I need to deal with regularly.
As per my psychiatrist, “You have focussed on yourself, hence seen a large improvement.” I also believe that working part-time and not having the stress of a full-time job is the reason my condition has not intensified.
While I try to lead a balanced life, it is challenging when my hormones are not cooperating. When I am depressed, I find it extremely hard to keep up a routine. But I am learning to keep sailing with the tide.
I keep reminding myself, “Tomorrow is another day.” I might have menopause but my life has not paused. There is so much more to do, so much to explore, so many things to experience. This condition cannot defeat me; my hormones cannot defeat me; I must keep fighting, that too with my own body!
“Menopause – the ultimate metamorphosis where we shed the skin of our past and embrace the wings of our future.”
