My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness and create visibility for women at their best age. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber! You can also buy us a coffee.

It was the hunger that was most bothersome. Constant, insatiable hunger, no matter what I ate.

A steak dinner would be devoured, yet within a few hours, there was a nagging urge to eat again. Large meal, small meal — it did not matter. I was eating more protein, like the menopause research recommended, but it wasn’t helping.

Though I didn’t crave sweets, I often had an urge for a spoonful of coconut oil, savoring it while it melted in my mouth.

It was an odd habit that I could not explain, but somehow, it helped curb my hunger.

I chalked it up to hormonal shifts in peri-menopause, but when I had my labs run, there was an alarming surprise.

Pre-diabetes.

Subscribe now

Diabetes as a gateway to declining health

With diabetes on my father’s side and Alzheimer’s on my mother’s, a panic washed over me as I sat with the magnitude of what my future might look like if I didn’t get my blood sugar in check.

My maternal grandmother developed Alzheimer’s a few years after retiring. She moved in with us after my parents’ divorce, and within five short years, she no longer recognized my mother or me.

Recent research by Dr. Lisa Mosconi links menopause with a higher risk of Alzheimer’s, now commonly referred to as Type 3 diabetes. Estrogen’s decline accelerates brain aging, making women particularly vulnerable. Among Alzheimer's populations, women outnumber men by 2:1.

When I learned this, I thought of my grandmother, who survived on a steady diet of sugary coffee, cookies, and bread.

If Alzheimer’s wasn’t terrifying enough, there was also Type 2 diabetes to worry about.

In the US, one-third of adults under 65 and half over 65 are pre-diabetic. The vast majority don’t know they have it because they are asymptomatic.

My father has diabetes, and his grandmother and several of her siblings died of it in the early 1900s, twenty years before insulin was discovered.

When you develop diabetes, you’re also at risk for a host of health conditions like heart, kidney, eye disease, and nerve damage. My mother-in-law, now nearing 80, had developed diabetes in midlife, and watching her struggle with the disease taught me that I should fight like hell to avoid it.

Never waste a good wake-up call

The good thing about health scares is that you can channel your fear to radically change your life.

I reached out to Fatima Abbass, a registered dietician, who reassured me that reversing pre-diabetes was possible — often within 90 days. The keys were nutrition and movement.

She explained that as women age, they become more susceptible to insulin resistance, a condition where the body can no longer effectively use insulin, causing blood glucose to rise. Insulin resistance is at the heart of a multitude of chronic health conditions, including metabolic syndrome, diabetes, heart disease, polycystic ovary syndrome (PCOS), and Alzheimer’s.

Instead of my usual workouts 3 times per week, I would focus on increasing my strength resistance with heavier weights 4–5 times weekly. I’d also move more often, and I committed to 5-minute fitness breaks throughout the day (dancing, wall push-ups, squats) and 10-minute walks after meals.

I started a high-protein, low-carb diet with a goal of 100 grams of protein per day. I also restricted eating to a 10–12 hour window, which meant no more late-night snacking.

Research shows that peri-menopausal women need to increase their protein intake. Once we hit 50, experts recommend consuming 0.54–0.72 grams/pound of body weight per day, but an easy rule of thumb is to aim for 30 grams of protein per meal.

For me, that meant my normal two-egg omelet became a four-egg omelet with cottage cheese and turkey bacon.

Yogurt and fruit now included protein powder and collagen peptides, with reduced fruit and added nuts.

Bread, pasta, and sweets were eliminated. For January and February, I also cut alcohol.

Honestly, I expected the diet to transform my life. I had taken the changes seriously — never cheating — and I wanted results.

But that’s not what happened. Even though I lost a few pounds, I still couldn’t shake the feeling of hunger between meals.

Even more discouraging, after three months, my follow-up lab results showed no improvement in my glucose or A1C levels.

I was still pre-diabetic.

The clues I found from fasting

Frustrated, I met with Fatima, my dietician, again. I’d started tracking my moods and symptoms and had noticed heart palpitations that coincided with my hunger.

Another surprising pattern was that the fewer meals I ate, the better I felt. Eating three meals within a 12-hour window made me feel worse (and hungrier), while eating less frequently felt better. Fatima created a monthly schedule of 12-hour and 18-hour fasts for me to try.

Initially, the 18-hour fasts were tough, and I was cranky and irritable. I had trouble focusing and felt weak.

Fatima recommended adding MCT oil to my coffee. MCT oil is a medium-chain triglyceride and the star ingredient in bulletproof coffee. Adding healthy fats to coffee while fasting helps sustain energy, increase satiety, and improve cognitive function.

I’d also add electrolytes and incorporate high-fat-fasting snacks (like olives or almond butter) when I felt hungry.

These tweaks helped stabilize my mood and improved my energy. Most importantly, the hunger disappeared — but only during the 18-hour fasts.

Understanding the hunger

Determined to uncover the cause of my inexplicable hunger, I researched my symptoms and found a condition called reactive hypoglycemia, which causes your blood sugar to drop after eating. Symptoms like shakiness, light-headedness, hunger, and an uneven heartbeat are common.

Like diabetes, the root cause is often insulin resistance.

Since high-carb meals typically trigger hypoglycemia, I could not understand why I would react while eating a balanced diet.

Thinking back, I’d struggled with hypoglycemia since childhood. It was the reason I avoided carb-heavy meals. I thought back to an incident a few months ago when I’d made pancakes for my husband. Instead of making eggs on the side for myself, I had a pancake. Within 90 minutes, I was shaking so badly I had to lie down.

Why would I be having hypoglycemic reactions while eating a healthy diet?

I dug deeper.

Listening to podcasts, I discovered women who’d reversed hypoglycemia, pre-diabetes, and even Polycystic Ovary Syndrome (PCOS).

What the stories had in common was following a ketogenic diet plus intermittent fasting.

Could this be why the 18-hour fasts worked so well for me? Was it higher fats that my body needed?

Dr. Jason Fung’s book The Diabetes Code provided another breakthrough. He argued that most metabolic conditions — including Type 2 diabetes and PCOS — could be reversed with fasting and a low-carb, high-fat diet.

It all clicked. Perimenopause had triggered metabolic changes and insulin resistance, exacerbating my hypoglycemia.

Finding the right balance

Excited, I consulted Fatima again. Based on her experience with reactive hypoglycemia, she recommended I switch to a moderate protein diet, targeting 25 grams per meal. She also suggested adding healthy fats like avocado, nuts, and seeds to every meal, aiming for a 60% fat diet.

I would also incorporate more fermented and bitter foods to support my gut and liver. Finally, I’d continue rotating the longer 18-hour fasts with 12-hour fasts on a fixed schedule.

For the next month, I followed this protocol. Within days, the hunger and heart palpitations subsided.

Recently, I re-ran my labs. Both A1C and glucose levels have returned to normal.

Subscribe now

Personalizing your health journey

With so much conflicting dietary advice — high protein, keto, paleo — it’s easy to feel lost.

My key was to listen to my body and work with a professional who understood metabolic health.

In my case, lifelong hypoglycemia resurfaced in a new way, causing metabolic changes in peri-menopause. The solution wasn’t just high protein or low carb — it was a balance of healthy fats, moderate protein, and strategic fasting.

It took 120 days to reverse my pre-diabetes, but the journey has reshaped my approach to nutrition. It isn’t a short-term fix — it’s a long-term lifestyle commitment to maintain these results.

The trade-off? Hopefully, a lifetime of better health, and for me, that’s worth it.

My Menopause Brain is looking for writers and collaborators who want to share their experiences and raise awareness of menopause. If you’re interested, apply here.

Happy Weekend, everybody. Welcome to another essay about mastering life in and after menopause by . Have you been wondering what it can be like dating after 50? Well, here’s what she experienced and what she learned. Enjoy.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness and create visibility for women at their best age. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy Heather a coffee to show your appreciation.

The change of life hit me like a brick wall, and Mr. Depression came with it in full force.

I don’t know how long I wallowed or how I knew that it was time to haul my butt off the couch and put myself back in the game. But I knew.

And so I did. And when I did, I quickly realized that the game had changed.

In my twenties and thirties, I limited my dating universe to people I had seen, met, or conversed with in person.

Not so upon my re-emergence from Menopause.

In my fifties, it was a New Age, where instant messaging had replaced the telephone, online meetings had replaced offline meetings, and singles events such as speed dating had replaced, “Hi, my name is…”

My dating life had become sparse during my time as a Hormonal Hostage. Any man who did come near me would soon be in hasty retreat.

He suddenly had to get up early (which they never do), run a space shuttle (even if there wasn’t one to run), or suddenly remembered that his Aunt Millie was going to be on “Who Wants to Be a Millionaire,” and he was her lifeline.

To say that I wasn’t meeting enough eligible singles was an understatement.

Subscribe now

So, when I finally went fishing for Prada, I decided to take advantage of this enlightened era and modify my outdated dating habits from ‘must be in my same generation, zip code, and time zone’ to ‘must be a carbon-based life form from Earth, somewhere between legal age and social security.’

This leap began with speed dating on a Monday night at a chain nightclub. Since speed dating wasn’t around in the eighties when I last dated, here it is.

Twelve men and twelve women sit across from one another for a designated time. You chat, the buzzer sounds, and the men move on.

You each mark yes or no on a scorecard, and when you look up, you are faced with a different man, and the ritual begins anew.

At the end of the evening, everyone turns in their cards to the hostess, and the following day, those with mutual yeses are contacted for future dates.

It’s that simple.

In preparation, I had spent the afternoon at one of my favorite place: The Mac counter in Santa Monica.

It is here that Raul, with his utility belt of brushes and sponges, dabbed some Racey Red here, splashed some Peach Zinger there, and voila, from Midlife to Milf in less than an hour.

When I arrived, a long table littered with confetti was against the lobby wall, and paper Mache hearts hung from the rafters. Nervous chatter mixed with Phil Collins drifted from the bar.

I was greeted by the Hostess and given a name tag with blue lettering:

Hi, My Name Is — and instructed to fill in the blank. This was followed by receiving a scorecard and directions to “mosey over to a table, grab a seat, and get ready to meet the man of your dreams.”

I briefly wondered: How would she know who the man of my dreams was? I didn’t even know who he was. I was still in a casual relationship with Mr. Depression and had only switched from Bonbons to frozen yogurt two nights ago.

I was still working on becoming the woman of my dreams.

I made my way to a chair and occupied myself with the contents of my miniature handbag: Tic Tacs, cell phone, lipstick, and Blockbuster card.

My first man approached: tall and lean, with chiseled cheekbones and olive skin.

For a moment, I imagined lacing my fingers through the curly blonde locks that adorned the top of his head. He reminded me of a straight Chippendale dancer. He sat and flashed a razor-sharp smile; then, he spoke:

“nuqneH.”

“I’m sorry. What?”

“It’s a traditional Klingon greeting.”

“Oh.”

At that moment, I decided I would not date a man over 40 who speaks Klingon.

Next.

“You have great arms. Your biceps are amazing. How do you do that? Me, personally? I’m on a strict diet. Not Atkins, not South Beach. Not The Zone. I’ve created my own diet.”

Is he suggesting I need a diet?

“Oh. Are you a nutritionist?”

“No. I like to look good.”

He paused and arched an eyebrow in my direction.

What was he waiting for? Confirmation? Admiration? Affirmation?

“It’s called 4LA Diet — or Four Latte A Day Diet. Get it? It has two meanings: For LA, like LA the City, AND 4 Lattes. That’s good, huh?”

“Clever.”

“But, you can’t just diet alone. I work out three times a day: weights, abs, and a core workout. That’s on Mondays, Wednesdays, and Fridays. I switch it up on Tuesdays and Thursdays, with cardio; biking, treadmill, you know. Then I slow down on the weekends, mountain biking and jogging. Like, this weekend, I’m doing a marathon. 26.2 miles.”

He leaned back in his chair, flexing his abs in my direction, in what I assume was his impression of a uterus.

A date with him would consist of steaming hot tofu and a sweaty night on the Elliptical Machine.

As I sit in my Sydney Frank patterned chair, butt cheek squished firmly against Julius’ nose, I reminisce about the days of traditional pickup lines such as:

“Girl, you gotta be tired coz you’ve been running through my mind all day?” or, “Help, something’s wrong with my eyes — I just can’t take them off you.”

The buzzer sounds, we exchange courteous smiles, he moves on, and we mark our scorecards.

Next.

“I have my own business writing and directing movies.”

“Awe sweet. I watch tons of movies. Have you done anything I would have seen?”

“I did Charlotte’s Web of Desire and The Bitch Who Stole Christmas.”

“Oh. I don’t know those. What genre are they?”

“Adult Entertainment in Claymation.”

“Oh.”

“Yeah. Sometimes, things melt or fall off, but it’s easy to whip together another one. I hope this is a stepping stone towards creating real art — like good old-fashioned porn; a little girl-on-girl action, if you know what I mean?”

Why would I know what he means?

Next.

“Hi, my name’s Spike. This is my first time Speed Dating. My friends thought it was time I got back out here, and here I am.”

“It’s nice to meet you, Spike.”

“I’m from Kentucky. I just moved here a few months back for work.”

A Southern Gentleman. And he’s gorgeous — all 6’5” of him.

“I’m from Oregon originally. A country girl at heart. You can take the girl out of the country, but, you can’t take the country out of the girl; or so they say.”

He remains silent.

“So, is that a nickname?”

“Is what a nickname?”

“Spike? Is Spike a nickname?”

“Oh, yeah.”

Another silence, this one slightly higher on the awkward pause meter.

“How’d you get it?”

“Get what?”

“The nickname? How’d you get the nickname of Spike?”

“I gave it to myself because of my — you know, my member. I’ve been told it’s like a spike.”

Mental note: do not date men who bestow their own nicknames.

Spike was followed by Mr. Faux Mohawk Man, Mr. Black Cloak Man, Mr. Leather Chaps Man, and finally, Mr. ‘Big Balls’ by AC/DC is my Song Man.

Somewhere between man six and man twelve, my mind wandered back to my freezer, and I wondered if I had Karmel Sutra or Buried Treasure in there. Whatever it was, I hoped it wasn’t Fat-Free.

Fat-Free had been a mistake.

Then, I had a moment of clarity. I sat up straighter. My skin didn’t feel weary. My eyelids felt lighter. My hair didn’t hurt. Mr. Depression was gone.

I pushed my chair back and drug my fabulous fifty-something ass home, alone, but not lonely, to Ben & Jerry, two perfectly good men — who were waiting for me — in my freezer.

And for the first time in a long time, I didn’t feel anything but joyful when I plunged my spoon into the entire carton sans bowl, plopped my butt on my couch, and tuned into Seinfeld.

I learned a few things that night:

I learned that I didn’t need Fat Free. I was a vision of beauty — not airbrush magazine cover beauty — but the beauty of a 50-something woman who has lived long enough to know what works and what doesn’t in things like hair, makeup, clothes, food, and exercise. And has the confidence to embrace it.

I didn’t need 12 men. I had me, and I knew that ‘me’ was enough.

And…

I learned that dating was much simpler thirty years before when the Terminator hadn’t been governor, and I didn’t need to know Klingon.

Subscribe now

My Menopause Brain is looking for writers. Details on how to apply here.

Outside of my local Ralph’s Grocery Store, I was handed a pass for a ‘Free Week at LA Fitness.’ I know nothing is FREE, but after a short dissertation outlining my 32 easy payment options, I joined for the promise of a ‘new, improved me,’ a ‘ME’ that even my friends would not recognize.

Three days later, I found myself sitting on a bench in the women’s locker room of LA Fitness with Zoey; the once steroid-ingested jock of the nineties turned personal trainer of the millennium.

I looked up, and there it was. Zoey had gone for the complete and utter annihilation of hair down there. Not a little etiquette grooming; the entire thing, the whole enchilada, from front to back. Looking in all directions, there was no hair to be seen anywhere at LA Fitness.

Subscribe now

How long had I been asleep?

When did this happen?

More important, why did this happen?

I was a mountain mamma drowning in a sea of hairless women.

I stared.

“It’s called a Brazilian wax,” said Zoey, pointing to her cue-ball smooth private parts.

“Oh.”

Twenty years ago, bare down there belonged exclusively to women on the pole or in Playboy Magazine. Now the furry undercoat was gone, and The Brazilian was main-stream.

I went home and straight to eBay, where I discovered instructional videos and home waxing kits for about $5.00. On Google, a whole empire had been built around hair removal.

When had hair become so offensive?

I called a ‘hair removal spa’ in Beverly Hills and was guided through the forest of Brazilian wax jobs.

It was explained that a skilled professional would take me from Grizzly Adams to Sinead O’Connor — or anywhere between — in as little as 15 minutes. Afterward, aloe vera and coconut palm oil would be applied to reduce reddening and swelling while leaving me silky smooth and, I assume, smelling like a Pina Colada.

Before treatment, I should know that the first time might be uncomfortable, there may be small spots of red body fluid, and going from being covered to being exposed can be jarring.

Finally, depending on my hair growth, I could stay hairless for anywhere from ten days to three weeks. Also — and this cannot be overstated — I should be in a good mood when I arrive.

This ‘hair removal spa,’ like many, offered an exclusive line of designer merkins that could be custom tailored while you wait.

What is a merkin? I’ll tell you.

A merkin is an accessory that hovers between your legs to cover your newly bald private parts. It can be cut, dyed, and made into any shape using any fabric, for example, a fuzzy leopard-print flower or piranha, your company logo, or the American flag.

Best of all, they come in three convenient sizes: petite, standard, and Sasquatch. Merkins have been around since the 1400s when they were donned by risqué aristocrats in grand old Paris.

But this is not a history lesson because The Brazilian is not about merkins, the abandonment of your .39 cent Bic, thongs, or hygiene.

The Brazilian is about sex. Period.

Share

When was the last you were sitting on your couch, watching Dr. Phil, eating bonbons, and suddenly thought, “This house is a disaster. I bet a Brazilian Wax would inspire me to pull out my Hoover and vacuum.”

Or, “Damn, I think a good ole bush waxing would put me in the mood to bake those cookies for the PTA Meeting.”

Yeah. Me neither.

Women want great sex. We’ll settle for good sex, but we’d prefer great, and in pursuit of that goal, we get our bodies ready, and our brains follow, which is exactly the opposite of men. But, we prepare.

We get our nails done, toes buffed, and hair coiffed. We put our legs behind our heads and allow complete strangers to pour hot wax on us and rip out our hair.

If we are going to go that far, I say, don’t stop there. Pull out some magic markers and draw in directional arrows; have a merkin made with a big, yellow S on the front, attach lights to the landing strip, and put up some tiny traffic cones. Do not be limited by your imagination.

Maybe it’s because I’m from a generation punctuated by Reganomics and the great debate: who’s better, Michael Jackson or Prince?

But, sitting on that bench, I realized that I don’t understand life much better than I did in my twenties, but in my fifties — I’m old enough to admit it.

I decided that I was going to keep all my hair down there.

And…

Regarding the great debate of the eighties, the right answer is Prince.

My Menopause Brain is looking for writers and collaborators who want to share their experiences and raise awareness of menopause. If you’re interested, apply here.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness and create visibility for women at their best. If you read our blog regularly and value the information it provides, please consider sharing this article or becoming a paid subscriber! 

You can also buy us a coffee instead.

I’ve always been open-minded about health and wellness trends. Over the years, I’ve tried random supplements, yoga, meditation, and probiotics. I even make my own kefir and kombucha. For a while, I actually attempted to start my mornings with a shot of apple cider vinegar—never again.

Menopause has been difficult for me; I have written about it a lot, so I’ve tried a lot of ways to alleviate my symptoms. Still, the weight gain, the mood disorders and the brain fog are hard to keep in check. So when my friend Sara started raving about intermittent fasting and how it had transformed her menopause experience, I paused. Was this the answer?

Sara and I have been friends for years. Together, we’ve weathered all sorts of changes— careers, relationships, the slow but steady downward trajectory of certain body parts and the arrival of fine lines on our faces. So I listened when she told me how intermittent fasting (IF) was helping with her energy levels, mood swings, and even her bulging belly problem. I mean, what menopausal woman wouldn’t be intrigued by anything that promises more energy and fewer mood swings?

Sara isn’t alone. IF is discussed everywhere, and it seems like it’s the solution for every ailment, from toe fungus to metabolic resistance. So, how could you go wrong with it?

But what most people fail to consider is that no matter how popular and healthy something is, it still isn’t for everyone. And IF definitely isn’t for me.

Subscribe now

What is Intermittent Fasting, Anyway?

For those unfamiliar, intermittent fasting is an eating pattern where you cycle between periods of eating and fasting. It’s not about what you eat, but rather when you eat.

Some people follow the 16:8 method, fasting for 16 hours and eating within an 8-hour window. Others opt for a 5:2 approach, eating normally for five days and significantly cutting calories for two days. There’s even the OMAD (one meal a day) method, which, honestly, sounds like medieval punishment to me.

The science behind IF is compelling. Studies suggest that intermittent fasting can help with insulin sensitivity, reduce inflammation, and even support brain health. Some research even indicates that it could ease menopause symptoms like night sweats, fatigue, and brain fog.

A study published in The Journal of Clinical Endocrinology & Metabolism found that intermittent fasting may improve insulin resistance in postmenopausal women, reducing their risk of type 2 diabetes. Another study in Cell Metabolism highlighted that time-restricted eating might support better metabolic function in women over 50.

So, for many women, it might be worth giving this a shot, right?

Research vs. Reality

There’s no shortage of research touting the benefits of intermittent fasting, but there’s also a catch. Many of these studies focus on younger participants, often men.

For women, the situation might very well be different.

Especially Menopause is a whole different ball game. Our hormones—specifically estrogen and progesterone—fluctuate in ways that affect metabolism, appetite, and even how our bodies handle stress.

Not surprisingly, there is some conflicting research. In 2022, the Menopause Review wrote that IF may lead to increased cortisol levels, exacerbating stress and sleep disturbances—issues that menopause already brings in abundance.

Some studies do suggest that IF can improve metabolic health in menopausal women. For example, a 2018 study in Obesity found that intermittent fasting helped postmenopausal women lose weight and improve insulin resistance. But, another study in Nutrients highlighted that fasting could actually increase cortisol levels in some women, leading to more stress and disrupted sleep. And if there’s one thing I don’t need in menopause, it’s more stress and worse sleep.

Intermittent Fasting Doesn’t Fit My Schedule

I’m a night person, so mornings are already stressful. Some days, I don’t even get to eat breakfast, making my schedule feel like involuntary intermittent fasting—just without the supposed benefits.

Then, I dive into my full-time tech job. My schedule is unpredictable. Some days, I have back-to-back customer meetings; other days, I handle escalations or troubleshoot urgent issues. Because my work is so variable, I never really know when I’ll have time to eat, making it impossible to stick to a rigid fasting schedule.

If I were to start intermittent fasting, my eating window wouldn’t open until mid-morning or even lunchtime. That means I’d be running on nothing but willpower for hours. Not a good combination for my mood, which is already volatile, or my ability to focus. Is it brain fog, or are my sugar levels low? A fun new assessment to make every day, not.

Then there’s the evening. My husband and I try to eat dinner together, and I’m not about to stop sharing a meal with him because my eating window has closed. Food is more than just fuel—it’s social, comforting, and part of our relationship.

Like Bob, I’m Angry When I’m Hungry

Over the years, I’ve learned that hunger makes me feel bad. I get dizzy, irritable, and lose focus. Some people can power through hunger like it’s a minor inconvenience, but that’s not me. I can do it, but it really doesn’t bring out the best in me.

I try to eat something when I feel hungry to keep focusing—otherwise, my productivity tanks. And let’s be honest, Bob already told us that a hungry (wo)man is an angry (wo)man. Just ask anyone who's tried to have a conversation with me when I'm running on empty.

Menopause already comes with its fair share of discomfort—I don’t think I can cope with much more without turning into one of the furies. No, not the movie version, but the original ones.

Some women find that IF helps them feel more in control of their eating habits, but for me, it feels limiting. If there’s one thing I don’t want to do at this stage in my life, it’s impose more rules on myself. I’m finally learning to listen to my body instead of fighting it.

The Mental and Emotional Toll of the Change

One of the biggest revelations of menopause for me has been that I can’t power through but need to be kinder to myself. The days of mind over matter and making things happen by the pure force of my will arr over.

Instead, I’m trying to focus on balance—eating whole foods, getting enough protein, prioritizing sleep, and moving my body in ways that make me feel good. Just trying to uphold the status quo feels like a full-time job; I don’t need an eating schedule that makes me feel like I’m failing whenever I have a snack outside my designated testing window.

Instead of fasting, I’m finding that listening to my body, allowing myself to eat when I’m hungry, and meals with plenty of protein and fiber work best for my menopausal body. I focus on stabilizing my blood sugar instead of letting myself crash.

I make sure to get enough sleep (as much as my anti-cylic night owl rhythm allows), drink lots of water, and find ways to manage stress that don’t involve food rules.

I also remind myself that every woman’s journey through menopause is unique. What works for Sara doesn’t have to work for me. And what works for me might not be the best choice for someone else.

Share

Intermittent fasting might be a game-changer for some women, but I’ve made peace with the fact that it’s not for me. And that’s okay.

I’ve reached a point in my life where I trust my instincts. When my body asks for food, I try to listen. I’m focusing on what makes me feel good rather than trying the latest hype.

So, while I’m really happy for Sara and all the women who’ve found relief through intermittent fasting, I’ll be over here enjoying my morning eggs and toast at whichever time I get up and feel like it - far from the tyranny of the clock. Because if menopause has taught me anything, it’s that I deserve to do what works for me.

This will not be the usual personal essay or information on menopause blog. To kick off the month, I’m sharing a state-of-the-nation summary for the publication and a little insight into what’s happening with the publication on Medium.

As you probably know, I run “My Menopause Brain,” both here on Substack and over on Medium. Some of my excellent writers are on both platforms, and some write only on Medium. Some are only here on Substack. Either way, making money from writing is tough.

For many writers, January on Medium.com was a lousy month. Spam and AI writing have been taking over the site for a while now. Earnings started dropping in December, but in January, it finally got so out of hand that it completely obliterated a lot of writers' income and visibility, making it hard to justify writing on Medium any longer.

As far as we know, Medium is working hard behind the scenes to rectify the problem, but we’ve yet to see if the situation has genuinely improved. If you write for a living, sudden drops in income can become an existential problem. And I mean drop: cents per article.

My Menopause Brain has been in the Medium Boost program since October, and we have some excellent writers here. If you’re unfamiliar with this program: Medium has a team of curators who decide which stories are shown to a broader audience.

Editors like myself who are in the Boost Nomination program can make suggestions on which stories should be boosted. Supposedly, we were chosen for the program due to our expertise on the topic and because we publish good stories in our publications,

The theory is that we are the experts on the topics we publish and nominate. In practice, however, not one of the stories and experiences we shared on Medium was chosen for a boost in the last two months. Depressing, right?

Since there is no feedback from the anonymous curators, it feels like the stories we write are given to people who can’t relate to the topics that are important to us and don’t care for “old lady stories.” Menopause has become a no-no topic here.

The problem with this system is that stories that are not boosted have little chance of being seen by more than a handful of people. At the moment, excellent writing goes to Medium to die if it isn’t artificially propped up by a boost.

Some of the stories I published last month are outstanding, even if I say so myself, so I’m glad I get to share a lot of them here as well, where we consistently get more views - even if the pub doesn’t make any real money yet. (Full disclosure: We have four paying subscribers at the moment. Thank you so much for your support!)

Both and are writers in my publication on Substack and Medium. I nominated their stories on Medium this month, but they were ignored. You can find some of their stories here on Substack. Go see the quality of their writing yourself.

Overall, this is a sad development on Medium. It’s not just about the money. We’re trying to spread menopause awareness and uplift the voices of women who are deemed invisible to the world because of their age.

So why do we continue writing and editing in these situations?

The simple answer is that we do it for love. For the love of writing and words strung together to create riveting stories.

We love writing about our experiences, describing the world as we experience it and giving others a window into our worlds.

And I keep running my publication because I love uplifting these amazing voices as much as I possibly can.

Yes, we need money and want to be paid for our writing. In this world, our income reflects how much our work is appreciated. I know saying this is frowned upon by purists. But honestly, we can’t eat our words, can we? Even if we write because we love the beauty we create, we need food, clothes and shelter.

So, I’ll keep trying to ensure my writers get a chance to keep on writing, be seen and make some money while they do it.

February Writing Challenge

I’ve been thinking about how to best support my writers on Medium this month.

It’s still unclear if the spam and AI issue is resolved (I’ve noticed a new increase in AI comments on my posts lately) or if we’ll continue to be shadowbanned from the boost for writing about icky women’s health topics. It remains to be seen.

I have a full-time job in the tech industry, so I don’t rely on the income I make through my writing to survive, but for my creative satisfaction, I do rely on writers publishing great stories in the pub.

My idea for February is to provide a small motivation to keep writing. I will put some money on the table to reward the stories I publish on Medium.

The (unboosted) story that is read the most in February will receive €100. The second most read €50 and the next five €20 each.

At the end of the month, I’ll post screenshots of the Medium stats and pay the winners to their PayPal, Ko-fi or buy-me-coffee accounts. If you’re in the EU, I can send the money to your bank account. Venmo doesn’t exist in Europe, so that’s out.

If I manage to get your story boosted on Medium despite all odds, it no longer qualifies because that is your ticket to getting paid by Medium for a change.

I know this isn’t a lot of money, but seeing that some writers have earned cents on their stories, I hope this incentive encourages you to write something for My Menopause Brain this month.

If you’re not a writer on Medium yet but feel motivated to write for me there, please apply here.

If you’re a reader, I hope you’ll check out some of the fantastic stories we published there this month.

You’ll find us here: My Menopause Brain on Medium.

Send me a message if you’re not a Medium member and can’t read the stories, I have “Friend links” I can share.

My Menopause Brain is looking for writers and collaborators who want to share their experiences and create more menopause awareness. If you’re interested, leave a comment, send me a message or apply here.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness and create visibility for women at their best age. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.

Everyone say hi to our new writer . Heather is a writer who lives the life of my (secret) dreams, sailing the world with her Kiwi Boyfriend on their sailboat, the Gypsea Explorer. She’s also a writer in our pub on Medium, and I’m so stoked to have her here on Substack. I know you all are going to love her essays. Giver Heather a warm welcome and follow her on her socials LinkTree: https://linktr.ee/writerjacks

I blame W. Axl Rose — Guns & Roses — Welcome to the Jungle.

It was the only song being played on any radio, anywhere, anytime, all the time.

It was 1987.

“Do you know where you are, baby?”

Heavy breathing.

“Oh God, that feels good.”

His name was Ben. He was a line cook at Denny’s Restaurant, the most opulent dining establishment around. The restaurant was located in a small Oregon town named after a tractor or some other piece of heavy farm equipment.

The Denny’s of the ’80s was when employees still wore brown polyester skirts and short-sleeved shirts with the word Denny’s marching up and down rainbow fabric like a parade of ants.​​

It was my first real-paying job at $2.50 an hour. I had started as a dishwasher, and two short years later, due to my unrelenting ability to scrape hardened eggs off plates and bleach drains, I was elevated to the status of waitress. We were still waitresses in the eighties who had not yet become servers.

I don’t know if it was the tall paper hat perched on top of his head or the way his mustache laced across his upper lip like a lopsided caterpillar, but Ben was to be my first, the man who would shake the proverbial cherry loose from the tree and make me a woman.

I didn’t become a woman in the traditional way, whatever that might be: dark parking lot, the backseat of a Buick, full moon overhead, Barry White crooning in the background, or trying to bust a cherry in the afternoon before mom and dad came home from the supermarket.

I became a woman inside a walk-in freezer on the graveyard shift at a Denny’s Restaurant, the voice of Axl Rose filling my ears.

Subscribe now

I was 18. Ben was 20-something.

Walking down the private alleyway of the cook’s area, past the line, French fries dropping into vats of sizzling lard, chicken fried steaks being tossed on the grill, grease-covered ghetto blaster piercing the air with the 80’s anthem, Welcome to the Jungle.

Like an anointed priestess, I followed to the Forbidden City, a place reserved only for The Tall Hat Clan, aka The Cooks ‘walk-in’ refrigerator.

The chill hit my skin, turning it to goose flesh instantly.

“Are you sure about this?”

The truth is, I hadn’t been sure about this myself until a few days previously. I had spent my teenage years in terror of sex, and in this case, I really can blame my mother. Some kids have parents who sit down and give them the fabled ‘birds and bees’ chat. I wasn’t one of those kids.

I was ten years old when I inadvertently discovered sex. It was in a horse trailer with my very worldly friend, Helen. Helen had come from California to the country, and so she knew about many things, including sex.

She described it and then suggested that my own mother had committed such an act, which explained why I was here in the first place. I did not receive the information well, so I popped her in the nose.

She wailed. My mother arrived and surveyed the chaos. Her calm green eyes landed squarely on my own. Her only comment was, “How can you not know about sex? Haven’t you seen the cows?”

That image kept me away from boys and sex for years to come.

But Ben was different. In the wake of my misguidance, he had committed himself to educating me. He had sent flowers, love notes, love songs, pages from Playboy, and anatomical drawings illustrating the difference between cow sex and human sex.

Even if I wasn’t entirely convinced, the drawings made it seem possible, the songs made it seem plausible, and the Playboy bunnies made it seem pleasurable. I was curious.

“Don’t worry baby….it’s alright….”

“But, what if we get caught? We’d get fired. My mother would kill me.”

“Don’t worry baby, Ralph’s watchin’ the front door.”

Ralph was Ben’s brother and the lead cook, although his hat wasn’t any taller.

“I’m leaving for college in three months and can’t afford to lose this job now.”

“Baby, shhh, don’t worry. No one’s here. You’re not gonna lose this job. And I gotta make love to you before you go…because you know I love you, baby, don’t you?”

Breath came in short gasps, fingers fumbling over my zipper.

My pink cotton briefs announced to the world that it was Sunday. Funny, I thought. I don’t usually work on Sundays, but the proof was there on my Days of the Week Underpants; it had to be Sunday, which meant that I needed to clean the salt and pepper shakers.

My mother bought me thematically decorated underwear for every occasion, including these most practical Days of the Week underpants.

There are two Underpants teams.

The A-Team is brought into play for very special occasions. These are your sexy woman panties: black lace, see-through eyelets, and red hearts with rhinestones. Thongs and String Bikinis are the Quarterbacks and Wide Receivers of The A-Team; in other words, your Joe Montana/Jerry Rice combination that only happens during the last few seconds of a Super Bowl.

The B-Team is your everyday wear, tastefully feminine yet simpler and more practical.

Finally, the “Special Teams” only called into play once a month. They are your granny panties.

Days of The Week underpants play for Team B, and I was confused as I thought about Sunday. Had they gotten out of order? Was I missing a day? Was it really Sunday?

Feeling Ben against me, and Sunday was temporarily forgotten.

I glanced down.

OH MY GOD!! My eyes snapped shut, trying to erase the image. Quick, say something — anything.

“What if I get pregnant?”

“Baby, don’t worry….you can’t get pregnant in here…it’s too cold for the sperm. Trust me.”

Years later, that same logic would be repeated to me in a hot tub.

I closed my eyes and imagined that it was Axl’s breath beating on my neck, wiry, lean body covered in tattoos and long hair spilling down his shoulders. It was Axl, minus the Denny’s hat, minus the brown polyester pants, minus the caterpillar mustache and marching ant parade.

My eyes wandered over Ben’s shoulder, where towers of gray pallets neatly lined the wall, each filled with dozens of perfect, porcelain white eggs and boxes of Chicken Fried Steaks.

“Oh baby, you feel so good.”

Then it was over. Ben rested his head on my shoulder; he looked relaxed, even content. My arms wrapped around his neck. I thought about the Chicken Fried Steaks and what part of the chicken they would come from. I thought of customers who were wondering where that damn waitress was to refill their coffee; I thought of the bus tubs that would be overflowing with dirty dishes, and I thought of my Days of the Week underpants and hoped that Sunday was not ruined forever.

“I gotta get back,” smoothing out his checkerboard pants, readjusting his hat.

“That was fun. We’ll have to do it again before you leave.”

He opened the door, slid out, and the door closed silently behind him. I was left in a sea of darkness and chicken fried steaks.

It wasn’t as bad as the cows, but I was pretty sure I didn’t look like one of Heffner’s women.

Had he liked it?

Was it good?

Maybe I had done it wrong.

As I walked back to the front of the restaurant, I wondered if I looked different.

Was I changed?

Was I a woman now?

I still have a soft spot for long-haired rocker boys, especially Axl Rose. But at that precise moment, my life changed. I didn’t know what it was then as I began to clear plates of half-eaten pancakes off of Formica tables, wipe down plastic-coated menus, and refill ketchup bottles.

Now, as I near my sixth decade of life, I look back at that younger version of myself, and although I don’t recognize her — I remember parts of her, and I love her.

I have finally figured out a few things my ‘walk-in fridge deflowering’ taught me.

It taught me that:

Sex doesn’t have to mean ‘nothing’, but it doesn’t have to mean ‘everything,’

Joy must be in the journey. You will suffer if you are attached to a result and only do something because you want a thing (love, acceptance, popularity, boyfriend, money, insert adjective here). The result we seek comes when we show up unattached.

Keep your eyes on your vision, and don’t waver. Walk willingly into the unknown. Courage is not the absence of fear but feeling the fear and doing it anyway. Magic happens on the OTHER side of fear — not on this side.

Set yourself up for success. You wouldn’t ask yourself to walk into an exam without having studied the material…so why do life like that? Have a plan. The plan might go off track (probably it will), but start with one.

The next morning, I packed all my young, girlie things into my baby blue Pinto and put it into gear. He growled into life, and I began to drive down Route 140, leaving that small Oregon tractor town in my rearview.

I didn’t know where I would go, but I knew I wouldn’t be going back — not because I was embarrassed or ashamed, but because I was changed. I had grown up a little bit on that graveyard shift in that walk-in fridge at Denny’s Restaurant.

And — I have never eaten a Grand Slam since.

Subscribe now

My Menopause Brain is looking for writers and collaborators who want to share their experiences and create more menopause awareness. If you’re interested, leave a comment, send me a message or apply here.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness and create visibility for women at their best age. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.

Thank you for reading My Menopause Brain — your support allows us to keep creating menopause awareness.

If you enjoy the stories and information we share, it would mean the world to us if you invited friends to subscribe and read with us. If you refer friends, you will receive benefits that give you special access to My Menopause Brain.

How to participate

1. Share My Menopause Brain. When you use the referral link below, or the “Share” button on any post, you'll get credit for any new subscribers. Simply send the link in a text, email, or share it on social media with friends.

Refer a friend

2. Earn benefits. When more friends use your referral link to subscribe (free or paid), you’ll receive special benefits.

• Get a 1 month comp for 5 referrals

• Get a 3 month comp for 15 referrals

• Get a 6 month comp for 25 referrals

Visit the leaderboard

To learn more, check out Substack’s FAQ.

Thank you for helping get the word out about My Menopause Brain!

I was nine the day I came face to face with a naked Burt Reynolds. I don’t remember what I was looking for, but I was being thorough because I closed my mom’s always-open closet door to look behind it. That’s where Burt was waiting. The poster tacked to the cobwebbed wall showed the erstwhile Bandit lying on his side, propped upon elbow. He lay on an animal pelt of unknown species with a strategic arm covering his genitalia but not his pubic hair, which was resplendent in its 1980s business.

His face was mischievous and mustachioed but friendly; he appeared to be having a great time. I immediately swung the door back in place to cover the image. Then paused. Then swung it again to have another look. Lather. Rinse. Repeat.

Over the next couple years, I would think of and physically visit this image regularly; it had more to do with knowing it was taboo—that I wasn’t supposed to see it—and less to do with the sexuality of it all, although that would register eventually.

I’ll turn 49 this coming year, and as my hormones perform gold-medal-worthy, Simone Biles-style floor routines in my loins—just as my child prepares to enter puberty, experiencing some pretty special hormonal gymnastics of his own—I find myself reflecting on my earliest exposures and understandings of my sexuality. Enter Burt and the veritable tunnel of sexual awakening that lay behind that poster.

Maybe the reflection comes from the way my sexuality is being seemingly taken away from me by age just as we’re in a bit of a new women’s revolution where we’re supposed to own it, or take it back, or be girl-bosses of it then tuck it into our purses next to our reading glasses and carry it around. Maybe it’s in how I’m starting to feel so invisible right when I finally feel so pretty and have so much to say.

Maybe it’s a faded memory of the version of my mother who hung that poster; I picture her tacking it up there half to admire and half as a joke because she thought most things were at least a little bit funny (and if you’ve seen the famous image, you know it has major cheek, so much pun intended) It’s almost unfathomable to me how very young she would have been then.

As I’m approaching the age my mother was when she died, it occurs to me that she had to keep her desires hidden, whether because of the societal expectations of that time or to minimize distractions while raising two little girls on her own.

Meanwhile my friends and I choose sexy reads for book club then discuss them over social media without shame. We talk about vibrators and how intimacy is changing for us. We’re candid with one another about our horniness, or lack of horniness, or fluctuation of horniness.

My mother had a single contraband naked man poster in the literal closet (plus one very questionable Tom Selleck coffee mug; don’t tell me she didn’t have a type), and my friends and I tag each other on Jason Momoa’s Instagram posts or casually say ‘horniness’ three times in one sentence. What a time to be alive.

People will tell you that your late forties are when you quit caring about what anyone thinks, when you embrace your body—even that substantially lower left breast,—remove the toxic people from your life, and let your freak flag fly; this is when things are supposed to get really good. For the most part, I agree, and I’m here for it, here for the revolution and for the free lube or whatever the savvy marketers are handing out to us modern peri-meno ladies as we exit our mammograms or local Tori Amos concert (the ‘menopause market’ is worth over $6B, according to The Guardian).

It’s a new kind of sexual revolution that has as much to do with actual sex as it does with understanding and owning the processes our bodies go through instead of just standing by while they happen to us.

There are online peri-menopause sex influencers now. There are seminars where women gather and bond and learn to embrace their clitorises (the entire organ, not just the tiny external part we learned about in health class). Jane Fonda and Lily Tomlin made a very watchable show where they sell special vibrators for elderly women whose vulvas and vaginas are more delicate. I repeat, what a time to be alive.

I’m glad it’s so much more acceptable to experience our lives and bodies in the open now.

While I promise not to talk to grocery store cashiers and restaurant servers about my night sweats and grey hair, I do feel lucky to have a circle of close friends I can talk about anything with and a husband with enough feminist clout to truly listen. Hell, I’m even thankful for that one lady on Instagram who does all the sex dances and vibrator reviews with zero irony (you go, girl).

I guess I just wish that our moms had the same support network and, sure, that I had a mom to commiserate with now. The span of sexuality throughout a woman’s life used to be so shameful, and now it seems so… interesting. We’re like walking science experiments, but we actually get to try to hypothesize together over racy book club selections and the accompanying hilarious, sex-themed appetizers.

So, as I embark on this next adventure in my sexual being, I’d like to extend a thank you to the hirsute man who kicked it all off for me and the mom who taught me to be comfortable in my own desires, even when hers were so carefully hidden. Rest in peace, both of you.

My Menopause Brain is looking for writers and collaborators who want to share their experiences and create more menopause awareness. If you’re interested, leave a comment, send me a message or apply here.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.

I love reading other women’s stories about how they navigate the madness that is menopause. Why? Because I keep learning new things about the world and myself. In this piece talks about how “Shadow Work” helped her address mental health issues. This is a new concept to me, and I can’t wait to read the books she recommends. Let me know if you’re familiar with it and how it helped you in the comments.

Leave a comment

A gap year in Playa del Carmen, Mexico, sounded like a great idea to everyone I told. I was 49, turning 50, and I desperately wanted the work break to be a cure-all.

Publicly, I didn’t frame it that way, of course. The years leading up to my late 40s featured a psychological deterioration that was difficult to explain, much less garner sympathy for, especially since our life in Dubai seemed sparkling.

For a decade, I’d unsuccessfully powered through a laundry list of symptoms that I could not shake, and that threatened to consume me.

Apathy and numbness.

All-consuming anxiety.

Relentless dread.

Unbridled rage.

A sense of collapse.

Unquenchable exhaustion.

There were other clues like weight gain, chronic insomnia, and hair loss, but if my symptoms were a competition, the dread, numbness, and rage tied for worst.

Though the emotional blunting froze everything, buffering the bad parts meant joy was inaccessible, too.

Dread had slowly encroached, then quickened, blanketing life with an inexplicable feeling of doom.

Rage erupted at the slightest provocation and, once triggered, could not be tamed or retracted.

As an example, one sunny afternoon, I had a meltdown at a busy intersection. Within seconds, I went from peacefully crossing the road to screaming venom at a man for whistling at me. Left to my own devices, I’d have extracted that man’s beating heart with a butter knife and stuffed it down his throat.

An oversized reaction, to say the least.

My onyx moods, though frightening, presented a sliver of opportunity. The darkness and rage were so pervasive that I’d try anything to dial down the intensity.

That’s how I found myself quitting my job and moving to Mexico in 2024.

Subscribe now

Depression, Dread, and Dark Nights of the Soul

I arrived in Mexico, hoping the change in scenery would help. There was a degree of relief, yes, but the old feelings festered.

When you are intimate with them, you learn that dread and depression are very different beasts.

If depression is a match, dread is the ash washed over the forest after it burns. It’s post-apocalyptic. Once you meet dread, you bow down, kneel, and beg for your life.

Read (2009) defines dread as an “extreme aversive emotion…far stronger than fear or sadness or grief and stranger even than ‘merely neurotic’ anxiety of depression.”

Though I spoke to a few close friends about what was happening, I kept it mostly private. Honestly, I did not want people to know how unhinged I was.

Peripherally, I was functioning, but inside, I was in a state of paralysis. It felt like someone else was inhabiting my body, and I could no longer trust what I might say or do.

I suspected my dread might be connected to a dark night of the soul or what Buddhism calls “falling into the pit of the void.”

Eckhart Tolle states:

“The dark night of the soul is a kind of death that you die. What dies is the egoic sense of self…Often, it is part of the awakening process, the death of the old self and the birth of the true self.”

Was it a dark night of the soul, a mid-life crisis, or was I going stark-raving mad?

Perfectionist and achievement-driven, I couldn’t bear the rage-filled, dread-filled, meaner me. My usual tactics — powering through, compartmentalizing, fixing — were failing.

Though I wanted to drown those snarling, unyielding parts in the murky waters of my subconscious, they wouldn’t relent.

In desperation, I reached out to a therapist.

Shadow Work: Facing the Parts We’d Rather Ignore

My therapist suggested shadow work, and I was initially miffed and suspicious.

Shadow work involves exploring and integrating your shadow self, including repressed emotions, fears, and desires, to foster personal growth and healing. By addressing these aspects, you connect with your unconscious mind to uncover insights and embrace self-acceptance.

Betterup

Then, two books transformed my perspective:

Meeting the Madwoman (Leonard, 1994) showed me how suppression of dark energies leads to self-destruction. The author, trained as a Jungian analyst, identifies eight ‘madwoman’ energies and explains how to transform their destructive patterns into creative forces.

Another book, Opening to Darkness: Eight Gateways for Being with the Absence of Light in Unsettling Times (Manuel, 2023), offers a Zen Buddhist perspective on darkness, exploring it as a sacred doorway to awakening rather than something to run from.

Through journaling and reflection, I began to engage with my repressed parts. My mind became a town council, and everyone got their turn to speak. Each voice had a distinctive tone and age that I could relate to.

The snarky, sarcastic one was me at 15.

The scared one, me at five, needed assurance.

The furious parts were irate for being muzzled all those years. So many words had been stuffed down to play nice when a boundary should have been expressed. This was the version of me who’d nearly caused a blood bath at that sunny intersection.

By listening, I came to appreciate that they were me, and I was them. Acknowledging them quieted them down, and the soundtrack of conflicting thoughts dissipated.

The Critical Link Between Hormones and Mental Health

Though shadow work helped a lot, something still felt off-kilter. I wondered if hormones might be to blame.

Research confirms the link between perimenopause and depression. A meta-analysis spanning 55 studies and nearly 77,000 participants found global depression rates among perimenopausal women at 33.9%, rising to 35.6% during menopause.

A year before, I’d started synthetic hormone replacement therapy (HRT), which, like shadow work, helped, but the doom would not relent.

Was this new depressed baseline the best I could expect, even with HRT?

After seeing a functional medicine doctor in Mexico, I learned the missing link might be my thyroid. Years earlier, I had been diagnosed with subclinical hypothyroidism and prescribed Levothyroxine (T4 support). Three years ago, I weaned myself off, thinking I didn’t need it.

Big mistake.

Thyroid disturbances can worsen during perimenopause due to declining estrogen. Symptoms overlap with menopause — fatigue, mood swings, and brain fog — making diagnosis tricky.

My doctor suggested desiccated thyroid hormone, which supports both T3 and T4. Within days, I felt like myself again. I later learned that many people respond better to this type of thyroid hormone.

A Tailored Approach to Hormone Therapy

Encouraged by the mood improvement, I decided to switch from synthetic HRT to bio-identical hormone replacement therapy (BHRT). While research is mixed on which is more effective, I like the flexibility of BHRT.

Though I don’t use compounded BHRT, my functional doctor can tweak my dosage based on symptoms and regular lab work, a level of customization that synthetic HRT didn’t provide.

The tailored approach is working. My mood is better, my energy is returning, but best of all, the dread has lifted.

Finding Balance Is a Continuous Effort

Mexico didn’t fix me, and neither did quitting my job.

However, having more time and space allowed me to address my symptoms. I was able to work through my shadows and balance my hormones. The work was painful, messy, and non-linear — but worth the effort.

These days, I’m more at ease. I’m no longer at war with myself.

I’m also giving myself grace for the long road and detours. Perimenopause is complicated. Symptoms wax and wane, and the interconnection between hormones, thyroid, and mood is difficult to tease out, even by medical experts.

The only way to find what works is to attune closely to your experience. Finding supportive health practitioners who will listen and have experience working with women going through the menopause transition is also essential.

Mid-life is a dark night of the soul. But through darkness, there is a chance to find a deeper, more authentic version of yourself. By embracing both our light and dark aspects, we emerge stronger.

Subscribe now

No trees it is said can grow to heaven unless its roots reach down to hell.

Carl Jung

My Menopause Brain is looking for writers and collaborators who want to share their experiences and create more menopause awareness. If you’re interested, leave a comment, send me a message or apply here.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.

I always had too much hair. It was very curly and unruly, and there was loads of it. So much that I felt bad for my hairdresser when I went in to have it braided. I never thought hair thinning would be an issue; I thought it would be a relief.

Until it happened. Instead of evenly thinning out, it started to recede—gradually. At first, I didn’t notice it myself. But then I had some studio photographs taken that I loved - one of them is in my bio, by the way - and my mum showed them to one of her friends.

Instead of complimenting the pictures, she asked if I was losing my hair.

This started my daily obsession with studying my hairline. Because it turns out she was right. My hairline has receded. It is now at least 1.5 cm (0.6 in) further back than it used to be.

My first suspicion was that it was traction alopecia. I’ve been wearing braided hairstyles for most of my adult life, so this was definitely a possible culprit. And part of it might be. But then I noticed my hair was coming out in what felt like large clumps while washing, and I realized it had to be something else.

I went into research mode, and lo and behold, another wonderful possible side effect of menopause is a receding hairline. Well thank you, Mother Nature.

Hot flashes, mood disorders and weight gain aren’t enough it seems. Let’s throw in some baldness to make you feel really down on yourself.

I also learned that I’m not alone in this predicament. By the age of 70 around 38% of women will have experienced hair loss. 50% of women will be impacted in some way. Starting in perimenopause, they’ll experience symptoms due to the drop in hormones: hair thinning, loss of volume, or a difference in hair texture. Why? Because, the change in hormone levels impacts the growth and structure of our hair.

Research by Fabio Rinaldi et al. published in Biomedicines in November 2023 found:

During menopause, hormonal fluctuations and aging can impact the HF, leading to phenomena such as thinning, loss of volume, and changes in hair texture. These changes are primarily attributed to a decrease in estrogen levels.

I don’t know why I was so surprised this was happening. I’m already a veteran of hormone-related hair loss, after all.

When I was 40, I had a hysterectomy, and as a result, I lost my eyebrows. Again, it was gradual. I didn’t notice until my brother, who hadn’t seen me in a while, asked me what was “wrong” with my eyebrows. Charming. But unfortunately accurate. Something was wrong; a few months later, I had lost all my eyebrows.

They never grew back. Doctors were no help. They had no clue what was “wrong” and told me I had to live with it as they couldn’t do anything. No doctor mentioned that this could be hormonal. And I never suspected hormones either.

Subscribe now

Knowing what I know now, I’m pretty furious about the lack of knowledge in the medical community. Looking back, not one of my doctors bothered even to mention that having a hysterectomy could come with side effects due to hormonal changes. If it hadn’t been for the site hystersisters.com, I would have been completely at a loss during the aftermath of that operation.

So here I was years later, again losing hair in a place where I would have preferred to keep it, and I had no clue why my hairline was continuously creeping up my head. I tried changing hairstyles, I started taking HRT (hormone replacement therapy), hoping this might reverse the process and trying to tell myself it wasn’t as bad as I thought it was.

And it probably isn’t, but you know how we exaggerate our shortcomings in our heads.

But neither HRT nor new hairstyles managed to improve the situation. My hair kept thinning, and my hairline remained further north than it should have been.

I started using topical Minoxidil (Regaine© 0.2%) but stopped after less than a month because I didn’t believe it would change anything. At that point, I had resigned myself to a life with less and less hair and contemplated just shaving my head and wearing wigs. Unfortunately, I have a big head, and hot flashes and wigs aren’t the best combination, so I nixed that idea.

Last November, I decided to give it another (more consistent) try and added folic acid to my supplements (if it helps during pregnancy, why not during menopause?).

So far, I’ve been seeing some slight improvement. Single new hairs below what is now my new hairline. Not a resounding success, but enough to keep me going.

I’ve done some further modern research (aka googling) and learned that there is a condition called Frontal Fibrosing Alopecia that can cause hair loss along the hairline and on eyebrows, eyelashes and other body parts.

According to the Cleveland Clinic: Frontal fibrosing alopecia usually affects women and people assigned female at birth (AFAB) after menopause, most often after age 50. But women as young as age 21 can have FFA, too. Women of African descent also tend to show symptoms earlier, sometimes in their early 40s.

The skin on my forehead doesn’t look pale, scarred or shiny, so I’m keeping my fingers crossed that I don’t suffer from this condition. But I guess a visit to a dermatologist is pending.

If you’re wondering why I haven’t seen a doctor instead of scouring the internet, well, my experiences with doctors (except my gynecologist) have been so frustrating I have a hard time shaking the feeling that going isn’t pointless. But yes, I should go.

I wish I had had better experiences with doctors and menopause symptoms. But I realize that many doctors simply don’t have the training necessary to help women in this phase of life. Things are finally changing, I think, thanks to more women being vocal about their experiences, but we still have a way to go. I don’t have the numbers for Austria, but according to this article in Flow Space the situation in the US is just as dire:

In fact, of the 99 U.S. obstetrics and gynecology residency program directors surveyed for the study, nearly all participants (92.9%) strongly agreed that residents nationwide should have access to a standardized menopause curriculum, yet only 31.3% reported having a menopause curriculum in their residency program.

So, despite all its negative sides, I’m very thankful for the internet and the communities of women willing to share and discuss their symptoms and possibly remedies.

Subscribe now

A few days ago, I stumbled across this thread on Reddit and realized that despite feeling bad about my receding hairline, I’m in good company. User hellno_ahole (love the handle) reports that she has lost three-quarters of her hair and is now struggling with increased facial and body hair due to oral Minoxidil. 

From the comments on this post, oral Minoxidil comes with these side effects for quite a lot of women. Many of them are willing to tolerate them to keep their hair growing back. And I get it. Hair loss in women is a very emotional topic. It is so deeply linked to our perception of beauty. Still, for now, I’m staying with topical Minoxidil, just upping the dose to 0.5% and switching to a cheaper brand that doesn’t cost an arm and a leg. Being a woman is just so expensive, isn’t it?

She ends her post with:

I can see why suicide rates increase during menopause. Nothing is right with my body and it feels like it all happened overnight. Thanks for reading.

And yes, I relate to that very much. For years now, nothing has seemed right. And it doesn’t seem to end. The thread is full of women sharing both their experiences with hair loss and the remedies they have tried.

For a long time, I tried to pretend my hair loss wasn’t happening because I felt ashamed of losing it. Now, I realize there’s nothing to be ashamed of. It’s a natural process. And we need to talk about it so other women know they’re not struggling alone.

Have you struggled with hair thinning and hair loss? If you have found a way to combat it, let me know. I’m happy to try other solutions.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber so we can keep on doing the work.

You can also buy us a coffee instead.

My Menopause Brain is looking for writers to collaborate with who want to share their experiences and create more menopause awareness. We’re happy to cross-post your stories or publish your menopause experiences directly.

If you’re interested, apply here.

The last day of the year is always a moment for reflection. The media is full of retrospectives of important news events or, more depressingly, homages to celebrities who have passed away during the last 12 months.

It’s a moment to look back on all the things that happened, the fleeting moments of joy or sadness. And, of course, the things that impressed or changed us.

The written word has always played a central role in my life. From the moment I learned to read, I could never get enough of stories. I’ve traveled the world through them. I’ve lived a thousand different lives through books. Every word I’ve read has changed me.

The stories submitted to My Menopause Brain by our fantastic writers are part of that never-ending change.

My Menopause Brain is active on Substack and Medium. Some of our writers are active on both platforms, but many are not.

I want to highlight some of the stories that impacted me the most. There isn’t enough space for all the great pieces I read, but I’ve curated a list of my top 10 stories on Medium, and I’m linking them below with paywall-free friends links, and I hope you’ll enjoy them.

A journey to yourself

A story I’ve read multiple times and keep coming back to is “A Traveler’s Guide to Menopause” by Sharmila Voorakkara. Her deeply touching story reminded me that it is never too late to leave a life that no longer suits you and move to a place that is more welcoming to your whole “you.”

You’ll be scared, and you will grieve the things you lost. But when you embrace the change, you can make a new beginning for yourself.

I am an explorer. I have arrived in the awful-beautiful, beautiful-awful terrain of a country I discover every day. I put one foot in front of the other.

Subscribe now

Unexpected symptoms

Menopause comes with a lot of changes. Many of them are unwelcome, and many are unexpected. The symptoms most of us are familiar with are hot flashes and weight gain. Brain fog is one of the unexpected ones. You rarely hear about it until it hits you.

For me, this one was very scary. One of my closest friends suffers from early-onset dementia. For a while, I wondered if I was following her down that path. It was “only” menopause, but it took a while to figure that out.

In her story “Being Over 40 Means Constantly Asking Myself This Question,” Alice Cutler describes this phase beautifully. All these moments when you realize you’ve forgotten the most obvious things. That feeling of suddenly glitching and not knowing why. Is it perimenopause, or am I just going crazy?

The brain fog sneaks up on you. We can all relate to forgetting what we went into a room for, so when it happens, it doesn’t always translate to a perimenopause symptom. But when it happens all the time, there must be a change, right?

Samantha Jones touches on the same theme in her piece “I Was Going To Write an Article About Menopause — But I Forgot What I Was Gonna Write About.” I feel this so much. I have all these ideas I want to write about, but until I get to it, I’ve forgotten them, and my brain feels like this deep, empty void. So once again, I write nothing.

The other day, I had what I thought was a brilliant idea for an article on menopause. I was in the shower, where I had my most amazing thoughts and ideas. I could practically see the article and the title. By the time I got out of the shower, I couldn’t even remember the blog idea.

Unexpected symptoms of the change

Unexpected symptoms of the change we’re going through feature prominently in many of the pieces I read this year. And as scary as they are, I enjoy a humorous take on them. I love the writers who are good at lightening the mood when discussing serious topics.

There’s so much uncomfortable stuff happening at the same time it’s hard not to have beef with Mother Nature. Trinity Ellis, Author, summed up how scary this can feel in “Hot Flashes and Cold Truths: My Take on this “New Chapter” of My Life.” And still managed to sprinkle in gems of humor:

What’s new is that my insides are shriveling up and going to shit. That I’m changing into a decrepit chrysalis from a once beautiful butterfly. I am steadily headed more towards moth-hood and swiftly away from motherhood.

I recently read that I need to keep my vagina in tip-top shape lest it just close up. I think a man wrote that.

Talking about shriveling and drying up. These are topics that are often discussed only behind closed doors. But are a reality for many of us. Vaginal atrophy and dryness can make sexuality in menopause not only uncomfortable but outright impossible.

In “Welcome to Nether-Netherland, Where Everything Grows Old, Including Your Vagina,” Barbara Whitfield does an excellent job of tackling this sensitive topic.

Like too many women experiencing unexpected symptoms, she landed on her diagnosis by researching herself. Her story saves us from that hard journey.

By training and inclination, I’m a researcher. Research not only distracts my mind but furnishes me with the right language to speak calmly. I certainly didn’t want to confront the GP with little more than a crazed, ‘Apparently, my fanny looks like a snooty housekeeper from a gothic novel.’

Menopause comes with a lot of surprises.

Many you can embrace and move on, but some are harsher.

In “Menopause Delivered Me a Surprise,” Debra G. Harman reminded me of the importance of listening to your body. If you feel something is off, advocate for yourself. We all know that it is sometimes hard to get doctors to take us seriously.

Uterine cancer most often occurs when a woman is over the age of 45. The average age for women to get uterine cancer is sixty. I was sixty-one when I got my diagnosis of endometrial adenocarcinoma (the most common type of cancer). Within eight weeks, I knew a lot about the disease.

As hard as menopause can be, having another chronic disease can make the experience so much worse.

In “Why I Couldn’t Wait for Menopause,” Christine Schoenwald writes about her experience of having her doctors root around for a treatment of her endometriosis. One of these was having her go through a chemically induced menopause at 30. And then she had to do it all again naturally at 57.

I enjoyed menopause so much — I went through it twice. Well, that’s not entirely true. The first time I had menopause, I had what’s known as medical or chemical menopause.

Exercise improves my mood

One of the most important changes I embraced this year was going back to the gym. I had forgotten how much exercise improves my mood and underestimated the impact it would have on many of the mood disorders I was experiencing, thanks to the hormonal shifts.

Two pieces about the topic of exercise I particularly loved were Tracy Collins’ “If Perimenopause Didn’t Already Kick Your Butt, Pre-Diabetes Might,” and Ali Hall’s “How I’m Staying Fit and Strong During Perimenopause.”

If you’re on the ledge about going to the gym, reading Tracy’s reminder that (peri)menopause is a risk factor for diabetes might give you that last push you need.

You can imagine my surprise when I found out that peri-menopause and the associated metabolic changes are risk factors for insulin resistance and pre-diabetes.

If you never stopped training but suddenly feel you’re no longer as athletically capable as you used to be. Ali’s piece helps you understand how training and exercise have to be approached differently as a woman, especially when you go into perimenopause. Because well, we’re not men. Our bodies need different things.

I am a qualified ultra-running coach, and yet nowhere in my training was I taught to differentiate between the genders for training programmes. Nor was I taught to adapt training sessions for different life stages, such as working with a woman’s menstrual cycle or being cognisant of perimenopause and menopause.

The change feels liberating in so many ways

But the change is not all hot flashes, shriveling and mood disorders. There’s also a lot of positive change. And it feels liberating in so many ways. You stop caring so much about other people’s opinions and start focusing more on yourself and what you need.

Barbara Powell wrote about this so beautifully in her piece “My Triumphant Escape from Bikinis, Birth Control and Slut Shaming.” We hardly ever notice how much our actions are shaped by caring about other people’s opinions. Until we no longer care.

Society and The Larger World are of the strong opinion that they have some measure of custodial rights to fertile women’s bodies: organs, pregnancies, embryos, zygotes, fetuses and babies. This was clear now. It had always been there, lurking — creeping me out on some level — but I couldn’t have described this phenomenon until now, in its absence.

I completely agree. I also wrote about this in September; it is one of the best feelings to come with the change.

Men also have their burdens to bear?

Of course, we mustn’t forget that men also have their burdens to bear. And I don’t mean dealing with the erratic menopausal wrath of their loved ones. No, In “Is the Male Menopause Really a Thing?” CarolF reminds us that men can suffer from a form of menopause, too. No, it’s not like the male flu, and it’s not just the midlife crisis.

some men have physical problems that could be classified as menopausal/andropausal. They might not have the same severity or range of potential problems as women, but they can have some.

This semi-serious and entertaining piece is a good way to end my list of favorite 2024 reads.

Which stories did you like best? Do let me know and see you all in the new year.

Subscribe now

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.

My Menopause Brain is looking for writers who want to share their experiences and create more menopause awareness. If you’re interested, apply here.

As the year comes to a close, time seems to have sped up once more. I’ve had this sensation of time racing for the entire year. But November passed like a flash.

So here we are, it’s December. I’ve opened the first two doors of my Advent calendar and baked the first batch of Christmas cookies with my friends, the fabulous four. The smell of Vanillekipferl and Spitzbuben fresh out of the oven made me think about Christmas past and Christmas traditions.

Every country has its own set of traditions. In Austria, we decorate the Christmas tree on December 24th and celebrate Christmas Eve. The Christkind (the Christ child), not Santa, is in charge of bringing the gifts.

I remember how we would be ushered out of the apartment in the afternoon. Taken on outings in the crisp winter air to give my parents time to decorate the tree and arrange the presents. Snow on the ground. The feeling of anticipation.

Then it was time; a tinny bell was rung to call us into the living room, where the Christmas tree sparkled. Hazardously lit with real candles, the smell of tree sap and burning sparklers in the air. How we never burnt down the house is a mystery to me.

I remember the delight I felt at the sight of the tree and the taste of the Christmas cookies. I remember singing Christmas songs— in later years, accompanied by one of us children playing “Holy night” or “Come all ye children” squeakingly on a recorder or a harmonica.

For the life of me, I can’t remember a single present. We got toys, books, and clothes, but those memories have faded. What remains is the feeling of joy and happy anticipation. The warmth and the secureness amid my family.

Subscribe now

What traditions do you remember? How have they changed over the years? Have you kept the same traditions your parents passed down to you? Did you create new ones?

This month, I’d love to hear how celebrating traditional holidays has changed for you over the years. Not only Christmas. Maybe you celebrated Hannuka, Diwali, Eid El Fitr, or another holiday important to you as a child.

Let me know how you celebrated then and how you celebrate now. Now that you are going through change, are you changing how you celebrate?

Share

Maybe, like me, you are revigorating old traditions? My partner and I never had a Christmas tree, but I realized I missed that part of Christmas a few years ago. So, for the last three years, we’ve bought a tree and decorated it together on the 24th of December, just as my parents used to do.

We don’t have live candles and sparklers. We’re not that brave. But having the decorated tree in my living room from Christmas Eve on the 24th of December to Epiphany on the 6th of January still gives me joy, much like when I was a kid.

And one thing I have learned as I grow older is that we should do what brings us joy. Very often, those are the things that aren’t strictly necessary. Like having a Christmas tree just for yourself. Or, baking Christmas cookies with your friends, even if you could go out and buy some at the store.

What gives us joy isn’t necessarily the things themselves. The tree or the cookies (even though they are fantastic). It’s the memories we create, decorating and baking together. Chatting and laughing.

It’s the new traditions we build. An annual Christmas cookie-baking date that has become a new fixture in our lives and now includes a new member — my friend's 6-month-old daughter, who will grow up with the memory of her mother's friends baking, chatting and laughing. Making delicious cookies as the smell of Vanillekipferl and Spitzbuben fresh out of the oven wafts through the house.

TLDR: This month, I’d love to hear your stories about your holiday traditions and how they changed. Let us share your memories, good and bad — your insights, feelings and learnings.

Subscribe now

My Menopause Brain is looking for writers both here on Substack and on Medium. Details on how to apply here.

If you’ve enjoyed this piece and want to support us, buy us a cup of coffee or subscribe and helps us to create more Menopause Awareness by sharing this story. Thank you!

It’s been a while, a long while, it’s been a month and what a month it was. I feel like we all needed a moment to breathe and recuperate. But now we’re back with a bang. A banger of a story by . Menopause is the gift that keeps on giving. This piece is about a gift I hadn’t heard of. But it explains a lot. Thank you, Barbara, for educating us (and regaling us with your humorous approach to a sensitive topic.

Three years ago, I got my first UTI. Having never had one before, I assumed I could wash it away with a combination of cranberry juice, barley water and Uva Ursi drops (recommended by a friend in a storytelling circle).

Nothing worked.

Two different types of antibiotics later and a couple of canceled storytelling circles (no one wants to have cystitis in a field with only a compost loo), it finally went away.

I was relieved, as the pun would have it.

Not long after, I was in the shower. Back then our shower ran like a menopausal woman, boiling one second, freezing the next, so while I flannel-washed daily like Kelly McGillis in Witness, I didn’t shower every day. This is important to know so you don’t think me a fool for not noticing sooner that all was not well in the netherlands.

Back to the shower: I was washing my (insert your favoured name for it, but for now, let’s call it what it is) vulva. Except I wasn’t. Like a dreadful Second World War film, it was flaps away. My labia had taken flight.

At first, I thought I was imagining it. I’d once had my bike stolen from outside college. I kept returning to where it wasn’t because I couldn’t believe it wouldn’t be there. This was like that.

Eventually, I asked my husband to look.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber! 

Subscribe now

You can also buy us a coffee instead.

My Menopause Brain is looking for writers who want to share their experiences and create more menopause awareness. If you’re interested, apply here.

‘Well, they’re there,’ he said, ‘just neater and more angry than normal.’ An image of Daphne du Maurier’s Mrs Danvers came to mind. I remained tight-lipped.

Like many facing medical panic, I took to Google before calling the GP on the basis that knowledge is power as well as solace.

After a straightforward, ‘Why do labia shrink?’ Dr. Google assured me that it was quite normal and there were things that could be done about it. Google exhausted, I made an appointment with the GP.

In the meantime, I needed something to read that would give me a greater understanding of what I was facing.

By training and inclination, I’m a researcher. Research not only distracts my mind but furnishes me with the right language to speak calmly. I certainly didn’t want to confront the GP with little more than a crazed, ‘Apparently, my fanny looks like a snooty housekeeper from a gothic novel.’

Research took me to a wonderful book called Me & My Menopausal Vagina* by Jane Lewis. Lewis is not a doctor or a scientist; in fact, she’s a retired florist, but through painful experience and study, she has become the expert on Vaginal Atrophy, which is what I discovered I had.

By the by, I hate that term so much, I’ve taken to calling it my withered vagina; withered meaning weathered, and I’m certainly that.

Lewis’s book is the only resource you’ll need if facing the same diagnosis. It’s funny, personal and (excuse the pun) no holes barred.

She talks about her symptoms, the treatments (some straightforward, some alarming) and the importance of talking frankly about VA. It’s only an ageing body part, after all, and we should be able to be open about it just as we are about failing eyesight, insomnia, brain fog, and grey hair.

A word of caution, Lewis has an extreme case of VA, so don’t be daunted. You may not suffer the same severe symptoms as she does, just as most mothers won’t suffer the horror-story births that friends are quick to regale them with. But forewarned is forearmed.

As Lewis asks:

Why don’t we know vital and, ultimately, life-changing information about our own bodies? About what to expect, how to manage it and how long it will last?

… I was not prepared to deal with this much pain in my later years. And according to my support groups, I wasn’t the only one. It seems that the words vaginal atrophy have somehow escaped our vocabulary, and even when they do eventually find their way to our lips we seem able only to whisper them in embarrassment, shame or confusion.

Looking back, my symptoms had started a few months before the UTI, and UTIs are often an indication of VA. I had begun to feel a burning when I used soap, and loo paper felt like sandpaper. I lost my pubic hair, which sounds like a good thing, but I’m a fan of a lush bush. Shouldn’t that rhyme?

And I also fell victim to ‘formication’ (not what you may be thinking), which is a severe itching of the outer labia that feels as though you’ve sat on a termite mound. I mistook mine for thrush, so I wasted time and pots of natural yoghurt on useless treatment.

By the time I realised something was wrong, nearly every part of my vulva had beaten a retreat. The pain was like an exposed nerve in a tooth but in a part of my body that rubbed on everything — knickers, seats, itself. On top of that, for me, at least, I had to deal with PGAD.

To save my blushes, I’ll let Lewis explain what that is.

Like a wizard’s robe, the clitoris has a hood over it, aptly named the clitoral hood, which should slide-n-glide nicely, protecting the clitoral gland. But, with menopause, this too can atrophy, exposing the extremely sensitive gland below. For a while, I even suffered from something called permanent genital arousal disorder (PGAD).

Happily, all my symptoms were vulvic (is that a word?) and not vaginal, so I’ve had no problem with sex, although, by necessity, it’s of the lusty, roll-in-the-hay variety rather than fiddlings and fondlings.

Once I made it to the doctor, she was attentive and supportive. She was prepared to listen and, more importantly, trusted I knew what I was talking about. She even took notes so she could help other women in the same situation.

Having spoken to her, I was prescribed topical oestrogen cream. She assured me — my mum had died of breast cancer — that the dosage for a whole year’s worth of cream would be less than one dose of HRT. We’re talking minuscule amounts, so if you’re resistant to full-on HRT, don’t worry.

Within a week my labia were plumping up, the itching had stopped, and my bush had become a shrubbery.

Longer lasting was the worry that every time I urgently needed to pee, I might have a UTI — I never want another one of those. I started to time myself between pees and then count how many seconds I was in full flow to make sure that each pee was normal. Three years on, I still do this, but it’s the only hangover.

Now three years down the line and having accepted I will always need oestrogen cream to lead a normal life, I can honestly say, as medical problems go, I’ve got off lightly.

My routine is straightforward: oestrogen cream every three days and moisturisers twice a day. And that’s it. No more onerous than putting in my contact lenses.

But, as with all things in life, there’ve been upsides and downsides.

One downside is that the two moisturisers I use, though not costly, are a regular expense I could do without.

Another issue, and only because I’ve never had to think of this before not being a ‘products’ person, is travelling. The oestrogen cream comes in a tiny tube, so no bother with customs, but the moisturisers need to be decanted into pots, having calculated how little I can get away for the amount of time I’m travelling.

Not having enough is unthinkable.

On the upside, I treated myself to expensive pure cotton underwear and spent never-to-be-disclosed amounts of money on 100% organic linen bedding. It’s worth it to keep the netherlands temperate.

As an unexpected bonus, I’ve lost all embarrassment about my menopausal body. I’ve learnt to love every nook and cranny, every wrinkle and pimple (yup, still getting those). It’s like the clock on Salisbury Cathedral that’s been working steadily since 1386. With a bit of tinkering, my body is still ticking along and to be marvelled at.

To those of you who have any of the symptoms of VA or have had a recent diagnosis, I would say, don’t panic, don’t be embarrassed, buy Jane Lewis’s book, and find a routine that suits you. All will be well.

Subscribe now

Thank you for reading, you can find out more about me here.

If you’re feeling generous and would like to buy me a coffee (or, in my case, a pot of Marmite), you’ll find me here. I would be hugely grateful.

In this piece discusses the lack of data and research on autistic menopause. Lack of research on menopause is already a big problem, autistic menopause is even less researched which makes it even harder for autistic women who enter menopause to get the care and support they need.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber! You can also buy us a coffee instead.

Dr Jen Gunter of The Vajenda recently wrote this post about the need to be aware of data voids when researching information online, particularly where our health is concerned:

“A data void exists when there is no or very little reliable information on a topic. Data voids are easy to find in so-called alternative health care because when a procedure isn’t recommended or is even downright ridiculous … people don’t write research papers on the subject, and hence, there are few, if any, legitimate news articles. This means there is nothing accurate, or at least very little, for people to find when they search.”

Until recently, there has been a lack, or void, of credible data and research evidence detailing the health/life span and reproductive, hormonal, physical and mental health of autistic women. We continue to lack evidence based support strategies, models for optimising our healthcare, and methods to promote and increase our mental health regarding our menopausal transition.

Looking into this topic via an internet search engine brings up varying results in the overlapping information between “autistic” and “perimenopause”, yet there are only a handful of studies that are academic in nature. There are also podcast episodes, blogposts, videos and anecdotal information, of which I would classify my own writing here at The Autistic Perimenopause: A Temporary Regression.

Subscribe now

There are so many unknowns, not often discussed, because “autism” and “menopause” are quite the social taboos. Until we have sufficient research data and conclusive evidence detailing out the ideal formula for late diagnosed autistics stages of unmasking and mental health elevation, there will always be spurious pseudoscientists attempting to fill the void. They will try and sell us their snake oils, their supplements and their diet plans. They will make claims that we can be free of our autistic traits, if only we would buy into their schemes and programmes.

As we come to our late diagnoses, trying to make sense of the shitstorm that often precedes a later-in-life diagnosis of autism, this leaves us vulnerable and exposed to believing almost anything we read online, whether it is backed by science or not.

The late diagnosed autistic women of today are The Lost Generation of Autism. We are the ones who flew under the radar, fell between the cracks, obscured ourselves from scrutiny by morphing into inauthentic versions of our true selves. When our masks slipped, our quirks and differences were attributed to character flaws. We have been subjected to intimidation, exploitation and humiliation, many of us relentlessly and for decades. Chronically misunderstood, isolated, and forever on the fringes of society.

Our lives have been spent bracing ourselves against the harsh world and its overwhelming demands and stimulation. Our minds have been consumed second guessing our own intuition and pleasing others, doing whatever it takes to be accepted. Our masks are so convincing that even we do not know who we are without them, and trying to find out is truly frightening and overwhelming.

We need to be represented and supported through research that develops strategies that enable us to know how to process and progress in our unmasking. Conventional strategies and mainstream life do not provide us the psychological safety we need. So how can we unmask safely and with confidence? I wish I knew. I don’t think anyone really knows. Sure, there are great theories such as radical self-acceptance and “just being yourself”, but they don’t work out well in every social situation. If you do know, please tell us all in the comments, because I for one need all the help I can get right now.

In the absence of hard science, we need to discuss these issues with our neurokin, share the highs and the lows. Thank goodness for the community we have here on Substack. It can be so hard to reach out to others for advice, after decades of being unable to share our vulnerabilities. But when we reach out we can receive some excellent advice as well as feeling validated, reassured and supported.

Autistic women have a lifetime of medical gaslighting and medical misogny, but it is important that we discuss our needs with our doctors to get appropriate midlife medical treatment. If you feel there is something not quite right, and you notice it occurs in line with your menstrual cycle, and/or feels hormonal to you, trust your own instinct.

What so for the midlife autistics who are still unable to trust their gut instinct? Or don’t even feel their instincts, as a lifetime of cries for help have gone unheard and unmet. What about those of us with alexithymia, interoception challenges or cognitive information processing differences that make it harder to obtain, understand and/or rationalise information presented online? This is what makes the urgency all the greater, for research to be conducted, disseminated and become part of the autistic menopausal transition plan.

The findings from what is probably the main study on autistic perimenopause to date, published earlier in 2024 still only highlights the issues many autistics are facing in midlife. We still need to find best practice for optimising our health, or at least optimising our survival rates at this emotionally volatile time.

Key takeaways from ‘A Perfect Storm’ Autistic experiences of menopause and midlife:

• The importance of person-centred, autism-informed healthcare that considers intersectionality and accessibility needs. We encourage healthcare professionals to recognize autistic communication styles and the various symptoms of menopause, including those that are less widely discussed, and to be receptive to the fact that menopause may start earlier than is commonly expected.

• The impact of autism awareness on menopausal experience is a crucial research question, and one which will necessarily become easier to address as time goes on, and as more diverse populations are diagnosed in early life.

• Further research is needed to better compare autistic and non-autistic experiences of menopause and to contextualize particular socio-demographic impacts on experiences.

• Regardless of its limitations, this study draws attention to the similarities in menopausal experience across international contexts and adds to the growing evidence that menopause may present particular difficulties for autistic people, suggesting the need for greater attention to healthcare, knowledge, connection and support.

This research is a monumental early step in what needs to become a rapidly developing highway of data, for the sake of our own psychological, physical, emotional and mental health as autistic women navigating midlife.

Subscribe now

My Menopause Brain is looking for writers who want to share their experiences and create more menopause awareness. If you’re interested, apply here. If you’d like to support our writing, buy us a coffee.

Happy Menopause Awareness Month! Today, Tracy Collins shares her experience with tackling Pre-Diabetes caused by perimenopausal changes. Hormonal changes in the perimenopause can affect your blood sugar levels. This can cause perimenopausal women to develop pre-diabetes or make it harder for women with diabetes to manage it.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber! You can also buy us a coffee to support us.

Peri-menopause is a real ass-kick. Hair loss, brain fog, mood swings, depression, anxiety, panic attacks, weight gain, and heart palpitations are the symptoms I struggle with. There’s a list of 34 others, and they all suck.

If you’d asked me last year, I would have said my two-year battle with severe depression was enough, thank you very much. Hormone Replacement Therapy (HRT), thyroid medication, and therapy helped get my volatile mood swings under control.

Though peri-menopause is a ruthless teacher, it has empowered me to attune closely to my inner state. As my mood improved, I felt a new challenge festering.

Why am I always ravenous?

This question baffled me for 24 months. No matter what I ate, I was hungry within the hour.

Fixated on stabilizing my mood, I didn’t have time to investigate my voracious appetite. In June, I got updated blood work done, and the doctor called me for a follow-up.

Not only were my blood sugar and cholesterol elevated, but my kidney function was off. Nothing major, she said, but we need to keep an eye on this.

Her words gnawed at me.

Not only was my fasting glucose high, but my A1C, a marker for diabetes, was 5.7. In Canada, this is technically classified as ‘at risk’, but according to the CDC, it’s considered pre-diabetes.

Though I’d struggled with middle-aged weight gain, I always exercised and had a healthy diet.

You can imagine my surprise when I found out that peri-menopause and the associated metabolic changes are risk factors for insulin resistance and pre-diabetes.

Add that to the symptom shit list, ladies!

Why pre-diabetes terrifies me and should terrify you too

According to the CDC, pre-diabetes unchecked will develop into diabetes in about five years.

Diabetes is a gateway to other health conditions like heart disease, stroke, and kidney failure. But those aren’t the ones that make me shudder.

What terrifies me is the link between diabetes and Alzheimer’s disease. These days, Alzheimer’s disease is commonly referred to as Type 3 diabetes. A 2022 meta-analysis shows that Type 2 diabetes is a risk factor for Alzheimer’s disease. High blood sugar is the common denominator for both.

My grandmother had Alzheimer’s disease. She moved in with us when my parents divorced, so I am intimate with its horrors.

Her life took on a sick twist of the movie The Curious Case of Benjamin Button as her memory regressed backward. In the early days, she knew who I was. Within a few years, I was my mother as a child. After that, she was searching for her dead husband and then her deceased brother and parents.

On a few occasions, our neighbors found her wandering naked in the fields, looking ‘for home.’

Nobody deserves to go like that. No thanks.

Middle-aged women often complain about brain fog, and I am no stranger to this. Even with a detailed grocery list, I forget important items. One weekend, I planned a roast chicken dinner with vegetables, mashed potatoes, and gravy. Guess what I forgot?

The chicken.

Twice in the last year, I woke up with no idea where or who I was. It takes a moment to rouse out of that horrifying reality. That must have been what it was like for my grandmother.

Witnessing her degradation will haunt me forever, and I will do anything to avoid it.

I’m taking back control

Pre-diabetes or insulin resistance is generally reversible with lifestyle. Globally, the rates of insulin resistance are skyrocketing, ranging from 16% to 47%. In the US, about 40% of the US population is insulin resistant.

Mainstream doctors will put you on medication without telling you that changing your diet can change your lab results in 90 days.

Once I saw my lab report, I started reading voraciously and listening to podcasts. Next, I hired a dietician.

It’s been a month, and I’m seeing positive changes. I’ll have my labs re-run in a couple of months, but for now, I’m focussing on the cornerstones of lowering my glucose.

What you eat matters, but so does when you eat

Instead of focusing solely on what you eat, intermittent fasting focuses on when you eat. Fasting overnight is easy and gives your body time to use fat storage for energy. The fasting windows vary, but for me, I try not to eat between 6:30 pm and 9:30 am.

In The Diabetes Code, Dr. Fung, author, nephrologist, and diabetes expert, argues that overcoming insulin resistance through fasting is critical for the reversal of both pre-diabetes and Type 2 diabetes.

But is fasting recommended for peri-menopausal women?

Dr. Mary Clarie Haver, a menopause expert and creator of the Galveston Diet, advocates for the 16:8 model. In her model, you eat during an eight-hour window and fast for 16 hours.

Mid-life protein needs were a shock

My dietician recommends I aim for 110+ grams of protein per day.

Though it sounds like a lot (and it is), research shows that women in peri-menopause need to increase their protein to offset dips in estrogen and the corresponding muscle loss and bone density. Aiming for 1–2 g of protein per kg of body weight is the general range you’ll find online.

Breakfast is key, and I’ve learned that 40 grams of protein keeps me going until lunch. For lunch and dinner, I plan for 30+ grams per meal.

40 grams of protein equates to 3 eggs, ½ cup of egg whites, 1/4 cup of cottage cheese, veggies, and avocado — a far cry from what I used to eat. No wonder I was hungry!

A tasty hack to reduce blood sugar spikes

I started following the Glucose Goddess and listened to her audiobook. One of the hacks to stabilize your blood sugar is to drink a tablespoon of apple cider vinegar mixed in a glass of water 15 minutes before you eat carbs.

In my case, I usually limit starches to dinner, and the vinegar helps prevent glucose spikes.

Though some people don’t like the taste of it in water, I truly enjoy it. I especially enjoy it added to flavoured sparkling water which tastes a bit like a shrub, a popular vinegar-based drink. If you hate the idea of drinking vinegar, you can make a green salad and use the vinegar in your dressing.

A 10-minute activity to bring down glucose

The research is pretty clear that peri-menopausal women need to include strength training to offset muscle loss. I work out from home and aim for three days of weights per week. I also have cardio and stretching days.

To support lowered glucose, I go for a walk after dinner. Research shows that a 10-minute walk within 90 minutes of eating prevents glucose spikes.

The road ahead

It’s been one month so far, but the roller coaster of hunger and blood sugar spikes is subsiding. Since A1C is based on an average over three months, I won’t see the impact in my blood work for another 60 days.

Last week, I saw my doctor to pre-order the bloodwork. She was pleasantly surprised to hear I’d hired a dietician and made lifestyle changes to reduce my blood sugar.

Most of her patients, I learned, wait until a type 2 diabetes diagnosis and go on medication. Since I’m terrified of type 3 diabetes, or Alzheimer’s, that’s not an option for me.

On my way out the door, my doctor said that when she was my age, she’d nearly quit medicine because of her poor health and diet. She’d make radical changes that saved her life.

If you want memorable tomorrows, focus on building your health today, was her parting message.

Let’s hope it works, I thought. Let’s hope.

Subscribe now

If you liked this story, feel free to buy me a hot coffee!

My Menopause Brain is looking for writers who want to share their experiences and create more menopause awareness. If you’re interested, apply here.

Happy Menopause Awareness Month! Today, Cinda Serianni shares her experience with tackling Menopause insomnia. Having issues sleeping well is a very common menopause symptom. Studies show that 35% to 60% of us suffer from sleep disturbances during (peri)menopause. Learning what helps and what remedies you can try will help you bring back restful sleep, energy and joy into your life.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber! You can also buy us a coffee to support us.

Subscribe now

After months of waking up at 2 am on the dot and struggling to fall back asleep until 5, I was desperate to get a full night's sleep and understand what was standing in the way.  I learned that sleep problems can start during perimenopause and continue into menopause and after.  Indeed, sleep issues seem to peak in late perimenopause and continue into post-menopause.

I was 53 and perimenopausal.  I didn’t know I was perimenopausal at the time because I was young, feeling fit and alive.  Perimenopause was for old ladies, and that was not me!  Except, it was.

A good night’s sleep typically involves seven to eight hours of quality, uninterrupted rest each night. Some women may need less, while others might need more.

During perimenopause and menopause, women’s sleep patterns change due to our changing reproductive hormones as well as several other factors, which can include low Vitamin D, low iron, and even low calcium intake.

Like many women in perimenopause or menopause, I was able to fall asleep without issue, only to find myself waking up in the early hours of the morning overheated.  Interestingly, the hot flash is not what wakes us up but the changes in our brains which lead to the hot flashes trigger our awakening.

Share

There are two major stages of sleep: REM (rapid eye movement) sleep or dreaming sleep; and non-REM or quiet, healing sleep. In REM sleep your brain is active.  It is the stage of sleep where you dream.  Thinking and most bodily functions slow down, but movement can still occur, and a person often shifts position while sinking into deeper stages of sleep. REM sleep makes up about 25% of your total sleep time.

After REM sleep comes deeper sleep or non-REM sleep. Deep sleep is characterized by slow brain waves called delta waves. When our brain slows down, our body enters deep healing sleep.  Our blood pressure falls, and our pulse slows down.  The brain is less responsive to external stimuli, making it difficult to wake up.  This deep sleep aids in the repair of injuries and reinforces our immune system.

Just as deep sleep restores our bodies, it also restores our minds, perhaps in part by helping clear out irrelevant information.  Deep sleep also helps cool our brains.  Blood flow is less directed toward our brain, and in deep sleep, the pituitary gland releases a pulse of growth hormones, stimulating tissue growth and muscle repair.

It is during this deep sleep that many women wake up to hot flushes and are unable to go back to sleep, spending hours counting sheep or, worse yet, fiddling with their smartphones.

Losing deep sleep means losing that restorative time for our bodies and minds.  It also means that our growth hormone will likely be lower than usual, and insulin and cortisol will remain high.  This is troubling as the high insulin and high cortisol competes with melatonin, the sleep hormone, which is already low because of the change in estrogen levels in perimenopausal and menopausal women.

It’s no wonder that women often experience daily fatigue, exhaustion, and irritability. On top of that, disrupted insulin levels overnight can lead to weight gain, particularly around the belly.

Not every woman in perimenopause and menopause will get the 2 am wake-up call. But there are other sleep disruptors lurking in the shadows.  Women can also develop sleep apnea, which may develop from a loss of estrogen and progesterone.   Many times, women don’t recognize the symptoms of sleep apnea, like daytime drowsiness, difficulty concentrating and irritability, because they just chalk it up to the symptoms of perimenopause or menopause itself.

Experts note that postmenopausal women are two to three times more likely to have sleep apnea compared with premenopausal women. Before menopause, people are fairly protected, but the protective effect of hormones seems to be lost with menopause.  Also, women going through menopause are more likely to have a drop in oxygen levels.

Women with sleep problems may benefit from a referral to a sleep center for diagnosis and treatment options.

The decline in estrogen can disrupt sleep by causing anxiety and depression. This creates a catch-22 situation, as poor sleep is known to increase depression, anxiety, and stress, which in turn further disrupt sleep.

WHAT CAN YOU DO TO BE MORE RESTED?

Some tips for good sleep include:

Get up at the same time every morning - Maintaining a regular sleep pattern will help stabilise your body clock. Sunday morning lie-ins, although wonderful, are not a great idea as they may delay the production of melatonin, leading to lighter sleep. Many people rely on lazy mornings, but despite what you’ve been told, this is not a quick fix for catching up on sleep debt!

Increase daytime bright light exposure - Exposure to natural light during the day helps regulate your circadian rhythm, which can improve sleep quality. Try to spend at least 30 minutes outside each day, especially in the morning. If natural light is limited, consider using a light therapy box.

Exercise regularly - Regular physical activity can help you fall asleep faster and enjoy deeper sleep. Aim for at least 30 minutes of moderate exercise, such as walking or swimming, most days of the week. However, avoid vigorous exercise close to bedtime as it may interfere with your sleep.

Set aside a “worry time,” including journaling or writing down thoughts and feelings -  Designate a specific time during the day to write down your worries and thoughts. This practice can help clear your mind before bed. Journaling about your day or your feelings can also be therapeutic and reduce anxiety.

Establish a comfortable sleep environment - Create a sleep-friendly environment by keeping your bedroom cool, dark, and quiet. Invest in a comfortable mattress and pillows. Consider using blackout curtains, earplugs, or a white noise machine to minimize disturbances.

Do something relaxing before bedtime - Engage in relaxing activities before bed to signal to your body that it’s time to wind down. This could include reading a book, taking a warm bath, practicing gentle yoga, or listening to calming music. Avoid screens and bright lights as they can interfere with melatonin production.

Share

Sleep hygiene is important.  However, it may not address the underlying causes of sleep disturbances associated with menopause.

Some studies suggest that certain antidepressant medications, such as selective serotonin reuptake inhibitors, also known as SSRIs, can improve sleep quality in menopausal individuals. Antidepressants have sedative effects and may provide benefits in women with night hot flashes or depression. However, there currently are no antidepressant medications specifically approved for the treatment of sleeplessness.

Hormone replacement therapy (HRT) may also be an option. Recent research indicates that HRT can be beneficial for sleep, especially in controlling night sweats.

Melatonin hormone regulates our sleep-wake cycle. As we age, melatonin levels decline, leading to sleep disturbances. Taking melatonin supplements can be helpful in the short term, but be cautious as it may suppress your body’s natural production, potentially worsening sleep over time.

Another promising approach is Cognitive Behavioral Therapy for Insomnia (CBTi). Recommended by experts, CBTi helps address underlying factors like stress that contribute to poor sleep. Consider it as a long-term solution rather than a quick fix. CBTi is recommended as a first-line treatment by the National Institute for Care and Excellence (NICE), as well as the British Menopause Society and the National Institute for Health.

Consult your doctor to determine what treatment could be right for you.

Menopause and perimenopause-related sleep disturbances greatly affect women’s quality of life and long-term well-being.  This, in turn, reduces workplace productivity, strains personal and social relationships, and increases the risk of poor physical, cognitive, and mental health.

It’s time to prioritize women’s health by addressing menopause-related sleep disturbances. If you or someone you know is struggling with these issues, seek professional help and explore treatment options. Together, we can improve the quality of life for countless women. Let’s take action now for a healthier, more productive future.

Subscribe now

is the host of the podcast Simply Cinda, dedicated to women over 50, where she explores topics such as perimenopause and menopause. She is passionate about raising awareness and providing support for women navigating this important phase of life.

Follow Cinda on Instagram at @Simply_Cinda1 and subscribe to her podcast at https://pca.st/znf7pxdl.

My Menopause Brain is looking for writers who want to share their experiences and create more menopause awareness. Apply here if you’re interested.

If you’re a mother, you have one day a year dedicated to you — in Austria, that is the second Sunday in May.

A day my mother hates for unclear reasons. She refuses to be wined and dined. In her opinion, this is the day solicitous children drag their mothers to fancy food places to “air them out.”

So we don’t, but we still call her and wish her a happy Mother's Day. My elder brother likes to send her flowers, but since I know she doesn’t like those either, I send her chocolate—very specific chocolate by Zotter, an organic, fair trade, artisan, Austrian chocolate manufacturer.

So that’s what you get for being a mother: a day of being aired out by your kids and/or chocolate. Doesn’t feel adequate for the amount of work it was raising your children.

Subscribe now

Imagine my surprise that there’s an entire month to celebrate losing your reproductive capacities.

Since 2009, the International Menopause Society (IMS) and the World Health Organization (WHO) have designated October as World Menopause Awareness Month. October 18th is celebrated as World Menopause Awareness Day.

The theme of this year's World Menopause Day 2024 is Menopause Hormone Therapy.

Did you know this? I only learned about it a couple of months ago.

But then I learned so much about Menopause in the last 12 months. It feels like a brand new world has opened up to me.

Can I say it feels so on point to celebrate Menopause in autumn? You know autumn — leaves falling, things dying, but so beautiful — as we approach the autumn of our lives. Poetic really.

Many things that feel hard or sad are poetic if you look at them from a fresh angle. Aging is one of them. It’s hard if you focus on how your body changes in ways society tells you are undesirable and try to force it to stop the process. Wrinkles, grey hairs, saggy skin — old.

Or it can feel liberating when you hold space for the new person you’re becoming. Wiser, more confident, and less easily moved by the desires of others — strong and free.

Before I realized that I was suffering from menopause-related symptoms, I was convinced that I had developed mental health issues. Everything felt wrong and very hard.

Understanding that estrogen influences how your brain works and your mood was an epiphany. It paved the way out of the dark hole to an HRT regimen that helped me out of my anxiety and depression and my feeling like a functional human once more.

I still have so many epiphanies nearly every day reading the stories about menopause submitted to my publication here and on Medium. Just last week, I learned about menopause acne from Victoria Corindi 🌻 and finally stopped wondering why my complexion has gone down the drain.

From Debra G. Harman, MEd. I learned that the average age for women to get uterine cancer is sixty.

Sharmila Voorakkara reminded me that menopause, like all of life, is a journey. One that is very individual and isn’t over until we reach the end. And that every journey is equally valid. Be kind to your fellow travelers.

From all the fantastic writers who submitted their stories to My Menopause Brain during this first month in the Boost Program, I learned that we must advocate strongly for what we want and need.

For this month, dedicated to our transition journey, I’d love to hear what you learned when you went into menopause. What epiphany did you have?

Subscribe now

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.

My Menopause Brain is looking for writers. Details on how to apply here.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

Subscribe now

Last year, life hit me like a truck.

I used to run over trails and hills like a gazelle, but suddenly, my spring was replaced with a clunkiness, and I felt like an old rusty tractor. My body was betraying me.

There were other things at play, too. I endured fatigue, teariness, irritation, anxiety, low mood and a sense of hopelessness.

My body seemed to be changing shape before my eyes, yet my training routine and nutrition were the same.

I couldn’t figure out if there was something physical going on, which was also dragging me down mentally. Or whether the root of my issues was more mental but with a vice grip on my physical well-being.

And so I did what every self-respecting human would do — I turned to Dr. Google.

The contenders were seasonal affective disorder (I’ve never wintered well), low iron or even B12, stress, cPTSD, low testosterone, or even the start of perimenopause.

I trotted off to my doctor for blood tests and had my hormone levels, including testosterone, checked, as well as my vital blood markers.

Everything came back normal. And yet, I felt far from normal.

Run like a girl

Despite the lack of confirmation, everything was pointing toward perimenopause.

On the one hand, I look forward to being post-menopausal. No more periods and no more fear of an unwanted pregnancy. On the other hand, I was a competitive runner at this time. I knew only too well the impact of perimenopause on women athletes with its steep decline in performance.

I needed to reevaluate my training and do it fast because everything that had worked for me before was suddenly failing me.

The thing is, for too long, women have been treated like small men.

The pink-it and shrink-it approach shoehorns male-centred research onto women, and as Caroline Criado Pérez outlines in her book Invisible Women, gender biases have been applied across the board, from medical research through to the use of crash test dummies. So, it is hardly a surprise that we see this pattern of gender bias in the fitness industry.

Heck, I’m surprised that menopause studies aren’t based on men.

I am a qualified ultra-running coach, and yet nowhere in my training was I taught to differentiate between the genders for training programmes. Nor was I taught to adapt training sessions for different life stages, such as working with a woman’s menstrual cycle or being cognisant of perimenopause and menopause.

Sounds ludicrous, right?

So, for the sake of myself and my fellow women running clients, I took matters into my own hands.

I adapted my training programmes to work with perimenopause as opposed to allowing myself to be guided by what works best for guys.

I completed the Well-HQ course about training the menopausal body. I also devoured Dr. Stacy Sims’ book Next Level which is all about “kicking ass, feeling great and crushing goals through menopause and beyond.”

If I were to sum up my new-found knowledge into an easy-to-apply package, it is this: Don’t deprive yourself of calories, ensure you get adequate rest, introduce intervals into your runs and in the words of Dr. Stacy Sims, “lift heavy shit.”

Here’s why.

Share My Menopause Brain

Fuel your body appropriately for what you are asking it to do

It may seem counterintuitive, but if we don’t eat enough calories, we risk putting on weight. You see, we send our body into a panic that food is scarce, and so instead of losing weight due to a calorie deficit, our bodies store it. When we deprive our bodies, we send them into fat-storing mode and slow our metabolism down.

Make sure you fuel your body adequately for exercise both before and after. This means no exercising in a fasted state, which can increase the stress hormone cortisol, and result in weight gain and other issues such as chronic fatigue and susceptibility to injury.

If you are unsure whether you have eaten enough before exercise, eat a snack. A banana and a handful of nuts may be enough.

And now more than ever, make sure you consume adequate protein for your size and exercise level. Protein is needed to repair and grow your muscles after exercise, allowing them to perform optimally at your training session.

Sarcopenia is the loss of muscle mass. Women can lose up to eight percent of muscle mass each decade after their thirtieth birthday. According to Dr. Sims, one way to counter this loss is to “lift heavy shit,” which we will come on to. In short, for the muscle to be able to grow and repair, we must feed it. And this is where protein comes in.

When I was training for ultra marathons, I sat about 57kg and aimed for 120 grams of protein a day. This is consistent with recommendations suggesting active people need 1.2–2 grams of protein per kg of body weight per day. Although that said, Dr. Sims recommends consuming upwards of 2 grams for endurance and strength athletes.

Put your feet up, take it easy, your body is slower to recover

If there’s one thing I learned as a running coach, it is the power of rest. Rest is an instrumental part of training. In fact, it’s when we rest that all the good adaptations occur in our body, which leads to an increase in fitness.

But try to get any committed athlete to rest, and you’ll have a tough negotiation on your hands.

I was the same. Rest feels counterproductive. In days gone by I would rather do a double training session than take extra rest. And yet rest is where the magic happens, especially for those of us in midlife.

The truth is that our bodies take longer to recover than the male body. In her first book, Roar, which is all about optimising training and nutrition for women and serves as a prequel to Next Level, Dr. Stacy Sims talks about how the female fat-burning system returns to normal levels post-exercise after 3 hours, while for men, this stage lasts for up to 21 hours.

Sure, it’s not fair, but we just have to work with it.

Sleep is when our bodies repair and regenerate. Sometimes, it’s a toss-up between sleep and training. For instance, our only window to train may result in us getting up early. But a consistent lack of sleep may compromise our fitness long term and deprive our body of that essential repair time.

It’s all about balance.

I trained six days a week with one rest day, during which I incorporated a gentle yoga session. Now, I find my body feels much better after five training sessions a week.

While it feels like I’m not doing enough, ultimately, my body needs this rest to stay energised and functioning optimally while also avoiding fatigue and burnout.

Share

Enough of the slow ploddy runs, mix in some speed and fly

Dr. Sims talks about the importance of sprint interval training (SIT), where we have a burst of hard and fast running followed by a recovery period.

So why incorporate SIT into our fitness regime? Science has proven that it improves our body composition. It increases lean muscle mass while reducing fat—music to our menopausal ears, right?

SIT boosts the number and function of mitochondria, our energy-producing cells. Think of them as generators in your body. Mitochondria also improve our sensitivity to insulin and lower our blood sugar levels. Their number and function are essential for our cardiovascular and metabolic health.

But that’s not the only benefit. Belly fat is an unwanted guest of menopause, but SIT is particularly good at burning belly fat.

A good example of a SIT session is running hard for 30 seconds, then at recovery pace for 30 seconds, repeating this six times, then taking a four-minute extended recovery, ready to repeat the set another one or two times. Remember to make sure you are adequately warmed up. There are some more examples you can use in this article by RunRepeat.

So, if you run several times a week, why not mix it up a little, add some SIT to your sessions, and see how you go?

Time to get strong

Ahhh, yes, the whole “lift heavy shit” strapline that Dr Sims is famous for.

With the drop of oestrogen during perimenopause and into menopause, we no longer have oestrogen’s help for power, strength and lean muscle development. So, we need to train smarter. Note I didn’t say harder — smarter.

This is why we need to “lift heavy shit,” as it stimulates the central nervous system to replicate the same benefits that we used to get from oestrogen.

Ultimately, lifting heavy shit supports our whole body by increasing our metabolic rate, improving stability and posture, producing stronger bones, and resulting in healthier blood pressure.

They say if you don’t use it, you’ll lose it right? If we don’t use our muscles, we will lose them. We will become the doddery and frail women that we fear turning into.

I’m no fan of strength work if I’m honest, but I’m aspiring to do three sessions a week. Right now, I’m using my weighted vest and free weights through a series of squats, lunges and heel raisers. I hate to admit this, but strength work does much more for my tone than running ever did.

The key point when it comes to strength is this: if there’s no other motivation to lift heavy shit, surely to be able to live an active and independent life for as long as possible is incentive enough.

I recently had a lady named Mary comment on one of my running stories. She told me she had run all her life and kept herself fit, strong, and healthy. She was 70 years old and about to do a half marathon. While some folk aspire to be like celebrities, not me, I aspire to be like Mary.

Truthfully, I still feel like a bit of a tractor, but I’m working on it. I may not return to my bouncing gazelle legs, but I’m not ready to swap out my gym kit for knitting needles just yet.

I will accept my performance deterioration with grace, but I refuse to allow perimenopause to take the best of me.

Remember, it’s all about training smarter, not harder.

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

Subscribe now

You can also buy us a coffee instead.

My Menopause Brain is looking for writers. Details on how to apply here.

My Menopause Brain is an entirely reader-supported publication and I would like to keep it accessible to all. However, if you read it regularly and appreciate the content, please consider becoming a paid subscriber. Or, you can buy me a coffee to support my writing instead. And please consider sharing this article. It helps spread the word.

Subscribe now

I’m traveling down the Nile, contemplating temples and ruins built thousands of years ago. As I stand in awe in front of these monuments left behind by people gone so many centuries ago, I can’t help but think about the fleetingness of time.

This piece on aging, time and loss was written before our Nile Princess cruise set out but it feels timely to release it now.

When disaster strikes, it robs us of words. We stand stunned in the face of the catastrophe without the means to utter our surprise, our anguish, and our pain. The words we are left with are inadequate and banal — unable to convey the immensity of our feelings.

I’ve been looking for words for weeks now. Three, to be precise. Three weeks ago, a friend had a devastating heart attack. I missed a message on that Saturday evening because I was watching Adele sing her heart out in the sold-out Munich stadium.

Only hours before I finally read the message on Sunday, I liked a picture on his Instagram. It showed him and his friend about to set out on the golf course where the heart attack would strike him down.

As I watched Adele sing, he was fighting for his life in intensive care. When I found the message, they had put him in an artificial coma to help him heal.

For three weeks, we’ve been holding our breath, hoping for news that he’s improving. Suspended between having to keep moving forward and not wanting to leave him behind. Waiting for him to come back to us. And tell us everything is alright. So, we can stop pretending we know that everything will be alright.

We all know we are going to die, don’t we? But do we understand we will die? Do we truly appreciate the fact that one day, from one moment to the other, we will be gone? And so will everyone else we know.

We know that it is inevitable. There is an end to our road. Our road, everyone’s road. And when our road ends, the world will continue as if nothing has happened. Nothing of significance. Just another person who has disappeared into nothingness.

A scary thought. So, we joke about our mortality. Laughing in the face of death is a common way to deal with the terror we feel when we dive into that place where we understand that we will end.

And yes, aging brings us closer to that moment every day. This we know.

But what we fail to grasp is that every day also brings us closer to the death of our loved ones. Our parents, friends, brothers, sisters, and everyone we know. Every day we age, the likelihood that they will leave us behind grows.

While our death, our transition into nothingness may be scary when contemplated. In the end — pun intended — it is the end. Once we’re dead, we will not suffer. We’re over.

Those who suffer will be the ones who love us and are left behind. As we will suffer when they go. Death is harder on the survivors. They have to live with the loss.

The death of others is harrowing; it leaves a permanent hole in the fabric of our lives. A hole that we might get accustomed to but that remains. And can’t be filled.

The older we get, the more holes there will be. People shaped holes that accompany us until we create our own hole in the lives of others.

Aging is living with more and more loss.

While we openly talk about the loss of our youthful features and bodies, we rarely spend time speaking about the actual loss we will experience.

Share

Over the last few years, I’ve seen the specters of the holes that are to come looming ever closer. And I’m having a hard time coming to terms with it.

My father is slowly descending into dementia. His body is failing, along with his mind. He still recognizes us when we Facetime but has forgotten most of his life. The edges of the hole he will leave become more visible every day. I have recurring dreams of hopping on a plane and rushing across continents, only to be too late to talk to him one last time.

My mother feels smaller every time I hug her. I keep wondering how much longer until there’s nothing left in my arms. I resent having to work and so little time to spend with her.

My brain understands the concept of life and death: this circle that has to be fulfilled, but my heart rebels against it. I feel my emotions twisting and turning inside me to escape this truth.

I don’t yet know how to cope with this knowledge of inevitable loss.

Should I try not to worry about it? Or should I think about it a lot so I will be prepared? Can we be prepared?

The Buddhists seem to think we can be. From the “Tibetan Book of the Dead,” I learned that we must prepare for death to rescue ourselves from the cycle of rebirth we’re caught in.

But then Buddhists believe that being reborn is bad. I don’t. Neither that we will be reborn nor that it would be bad if we could. I’d welcome it. I’d be soothed by the knowledge that after death, my loved ones would go for another spin. I’d love that for them — and me.

“I don’t believe in God, but I miss Him.”

I don’t believe in the afterlife — unfortunately. I’m sure it would make things easier. Incidentally, I think that the afterlife was invented to make the idea of death more palatable.

The thought of death not being “The End” is soothing. Despite being an atheist for a long time, I did believe in some prolonged existence. Rebirth, universal energy. Some way to alleviate the terror of non-existence.

But then a friend gave me Julian Barnes's Nothing to be Frightened Of and forever cured me from hoping there might be a life after death.

If you want to keep believing that there is more to death than “nothing” and don’t want to spend months paralyzed in terror because you’ve lost all that upheld that belief, don’t read this book.

I wish I had been warned. But I made peace with nothing and the terror left at some point. I no longer worry about my end.

Now, like Julian Barnes, “I don’t believe in God, but I miss Him.”

I don’t know how to make peace with the terror of knowing that with aging, I’ll lose all the people who are important to me. And the emptiness they’ll leave behind.

My friend is not dead. He is still in intensive care, still struggling for his life.

I visited him today because I’m going away for two weeks. I couldn’t go without seeing him before I left, and I hoped seeing him would reassure me that he would still be there when I returned. It didn’t.

Seeing him kept alive by machines, tubes going in and out of his body, sedated, unable to speak, just made the hole he has left in the fabric of my life bigger. And increased my fear that this hole would become permanent.

With aging, we will experience loss. Death is inevitable, but somehow, our society has relegated death so far from life that we barely acknowledge it exists. It is carefully hidden from view.

Death has been separated from life. It takes place in its own space, carefully hidden from the living. There are no more wakes at home, no old people cared for and dying among the living.

Hospitals, hospices, and institutions hide the end — the slide into nothingness — from view. We don’t have to think about it, so we can pretend that the worst thing that will happen to us as we age is a few wrinkles on our face.

Subscribe now

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here, please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.

My Menopause Brain is looking for writers. Details on how to apply here.

This was the first post I made on my Substack; at the time, I had maybe five subscribers. Now that so many new readers have joined, I feel it is the right time to post it again as a reminder of why I started this publication. To spread as much menopause awareness as possible!

When I went into menopause and suddenly started sweating profusely at the most inopportune moments, I wasn’t surprised.

Embarrassed? Yes - often - but not surprised. Sure, I know it’s natural, but if you haven’t gone through airport security with rivers of sweat dripping down your face and back, I’m not that interested in your take on this.

I wasn’t surprised because the sweats felt like something that was supposed to happen. Everyone knows about them. They’re just one of the downfalls of having a female body and hormones.

I had little idea what else would come. Knowing what I know now, I’m convinced that learning about the details of menopause should be mandatory for everyone — starting in high school.

I know menopause or perimenopause are finally talked about more these days; thanks, J.D. Vance, you did us a solid there. Unintentional, sure, but we’ll take it.

But it’s still not enough. Why don’t we learn about it in school, in biology or sex-ed?

Women’s magazines rarely talk about it in more than a superficial way. I guess they don’t want to distract you from buying new make-up and clothes with detailed descriptions of aging, new and unfamiliar body odors or impending physical dysfunction.

Not even my mother talked about it with me.

I was left reeling by a new feeling of deep, uncontrollable rage. And by the anxiety and the depression.

Over the last couple of years, I’ve experienced a plethora of unwelcome negative emotions. The experience has left me angry — justified angry, not menopausal angry — that nobody ever educated me about this side of menopause.

Sure, we know that menopause exists. 

Menopausal hot flashes are the subject of comedies. Sketches that make light of women getting older. But you don’t understand what it means until it happens to you.

Tell me, what do you think of when you hear menopause?

Are you worried about menopause because you’ve been told it’s a sign that you’re old? Unwanted and soon to be invisible? Have you been told that menopause means it’s game over? That you’re no longer young and fertile when it occurs?

Even though we should know better —  50 is the new 40, as my mom keeps telling me — we all think about old age. We see a grandma rocking her grandchildren and knitting socks.

But that’s not us yet, is it?

Share

You’ve likely heard you can expect weight gain or hair loss. But do you also know about mood swings, tinnitus, forgetfulness, brain fog, insomnia, sadness, anxiety or depressive episodes?

And itchy ears? Apparently, this is a common thing.

No? Well, buckle up. 85% of women experience symptoms of varying severity. Chances are high you’ll be in for a bumpy ride.

Because you’re not a granny, you probably have a full-time job and a family. And you have to navigate your career and responsibilities while suddenly feeling like a complete stranger to yourself. 

I had no idea that menopause would intermittently turn me into a raging ball of anger. My husband can confirm that I’m scary when angry.

Under normal circumstances, I’m pretty patient and chill. Suddenly, I lost all my chill. Every day, I woke up anxious, feeling overwhelmed by every single thing I had to do that day and wondering what the point of getting up was.

I used to be someone who woke up happy; now, everything felt like a chore, and people drove me nuts.

All the people, even the ones I love.

I picked fights and stopped talking to people — some of them for good reason — but before menopause, I would have been more diplomatic.

And, of course, I had no idea what was going on. I felt like a dark cloud was hovering over me, that life was no longer fun, but I couldn’t pinpoint why.

Sure, the hot flashes and sweats told me I was menopausal, but I didn’t make the connection between the dark cloud and my hormones for a long time.

If I had, I wouldn’t have wasted time trying to combat my menopause symptoms with a mix of yam extract and black cohosh. 

I would have gone straight to hormone replacement therapy (HRT).

Subscribe now

Hormone replacement therapy got a bad reputation in the early 2000s when a study seemed to show that the side effects of HRT were worse than the benefits it brought to women. 

I still remember the sensational magazine headlines about the increased risk of breast cancer with HRT. Women immediately stopped taking hormone replacement. 

Even now that studies have shown the overwhelming benefits of HRT has for the cardiovascular system, reducing coronary disease and all-cause mortality, HRT hasn’t recovered from the bad reputation it acquired.

My grandmother died of breast cancer so, like many women, I shied away from taking hormones. 

I tried to go the ”natural” route. I ate more soy products, took natural hormone supplements and continued to sweat like a pig. 

It wasn’t sustainable; sooner or later, airport security would stick me in a solitary cell and start probing me. So I talked to my gynecologist. A kind and well-educated woman I trust. 

She finally made the connection for me. She explained that the sweating, the mood swings and all the other symptoms were connected and recommended I start using estrogen.

And it helped. Not being bathed in sweat 24/7 helped me focus on battling all the other symptoms. Estrogen alone hasn’t been able to get rid of all of the mood disorders, unfortunately.

A combination of more sleep, physical activity, Ashwagandha, St. John’s Wort, passionflower and taking care of my microbiome with fiber-rich food, kefir and fermented vegetables has helped immensely.

Now, I finally have days when I wake up and feel like myself again. Full of energy and motivation to get up and do something.

I cherish these days and try to savor them because it’s still a fragile balance.

Share

Most of us don’t know that menopause can make it extremely hard to be a functional adult both at work and at home. Until we’re in the middle of it.

And while we struggle, the people around us have no idea what’s going on either. Why they’re suddenly in a remake of Body Snatchers? Where their beloved partner was suddenly replaced by a constantly irritated, snappy body double. One that is constantly tired and no longer enjoys the activities they used to love. And has no sex drive.

Our boss doesn’t understand why we suddenly forget tasks, meetings, deadlines, or papers we were supposed to bring. If he’s a younger man, he might have heard of pregnancy brain. But menopause brain is a thing, too. Brain fog is real.

Companies rarely make accommodations for menopausal women. Even as we now thankfully have prayer rooms for religious employees, there are no cold rooms for women experiencing hot flashes. Wouldn’t you love one of those?

There is no way to take more time off or rest more. Even though we might desperately need it. Because it’s just women getting old, not a big thing, right?

But it is. It can be considered a disability if the symptoms are severe.

According to the Equality and Human Rights Commission (EHRC), employers should be forced to make adjustments for women who are going through menopause.

New guidance issued by the Equality and Human Rights Commission says menopause symptoms with a long term and substantial impact on women’s day-to-day activities may be considered a disability …

Employers could be sued for disability discrimination if they fail to make “reasonable adjustments” for women going through menopause under new guidance issued by the Equality and Human Rights Commission (EHRC) on Thursday, amid concern over the number of women leaving their jobs due to symptoms.

And believe me, there have been many days where I’ve considered quitting my job.

Even though menopause is called the change, it isn’t seen as the monumental change in your body it is. 

It can be brutal and debilitating. 

Everyone needs to be aware of that — your husband, boss, colleagues, kids, and friends. 

They should have learned about it in school. In detail. Menopause doesn’t just affect women. It affects society as a whole. It affects our relationships and our productivity.

You shouldn’t have to have individual awkward conversations about it. And you should have the space to go through it with support and dignity.

So you don’t have to turn into an angry ball of fire to get some space and time for yourself.

Subscribe now

My Menopause Brain is an entirely reader-supported publication that wants to spread Menopause Awareness to as many women as possible. If you read our blog regularly and value the information you get here.
Please consider sharing this article or becoming a paid subscriber!

You can also buy us a coffee instead.