The first hot flash that hit me in public was while shopping at Target, trying on cute tank tops in an ironic attempt to stay cool for the rest of summer. I’ve suffered panic attacks for the past decade, but this was different; the store was fairly empty except for a few moms with toddlers in tow, and I was enjoying the cool air conditioning blowing through my new short haircut.
For the past two years, hot flashes regularly hit me at night, during both summer and winter. I was prone to not only throwing the sheets off but also stripping down to nude while still partially asleep. Since my symptoms began after I was married and I wasn’t used to sharing a bed, I chalked it up to the living, breathing furnace in bed with me.
Initial symptoms of menopause
It wasn’t until we divorced that I realized I was just as unbearably hot when I slept alone. When I woke up, I took cold showers and began to stand in front of the open fridge just for the hell of it, which confused both me and my new roommates. What was wrong with me? I wasn’t ready to face the fact that I was experiencing a substantial drop in my estrogen, and that my bottomless box of tampons was symptomatic of what doctors don’t want to tell a 32-year-old: I was experiencing the early stages of menopause.
The hot flashes I started experiencing in public were only one of the embarrassing impacts of menopause at 32 years old. As a journalist, my office is typically a coffee shop, which is Seattle’s thing. That said, air conditioning is not, especially at a local cafe. When it’s hot outside, it’s hotter inside, and with menopause, the last thing my body can do is cool down on its own. A recent hot flash left me snapping at a barista after desperately searching for a place to crank out an article on deadline yet feeling like I was going to pass out because no one had air conditioning. The cute young baristas behind the counter at every cafe waved off the heat as sweat beaded up on their foreheads, which was actually slightly sexy.
As I panted for air after running across the street from another cafe, I was anything but sexy, using choice four-letter words and coming across like a total bitch with no patience or tolerance. No one would ever assume my crazy hormones were behind the rage.
No one would expect a 32-year-old to be menopausal.
Before the diagnosis
Yet, my doctors knew I would likely end up here after I was diagnosed with premature ovarian failure a year ago. I had stopped ovulating and my periods were both irregular and light. It was too late, even then, to freeze my eggs or consider IVF. In terms of fertility, my only option to become pregnant is to use a donor egg, but I still keep up some hope that menopause hasn’t fully kicked in yet and that I’ll ovulate one more time, even though the symptoms I experience suggest otherwise.
For those who battle infertility, getting to know our cycles can feel incredibly clinical; my bathroom often looks like a lab with all of the ovulation test strips. I detest cutesy period tracker iPhone apps, instead opting for a dedicated paper planner to note when I bleed, how often, how much, and every mood I experience. I order my own labs online to draw the blood to measure my estrogen levels. When my PCP laughs off my symptoms and refuses the tests, I go back anyway, hoping she’ll be amenable to doing it at the clinic so insurance will cover the cost. Instead, my own research and clinical savvy are what brought me there after being told I was “too young” for fertility problems when I had a hunch there were issues.
If and when I get my period every few months, I’ll visit a lab to run tests to confirm my estrogen is dropping, as is my egg count and quality.
Feeling the urgency of time
Every test reminds me there’s no time left; I’ll never have a family of my own, and as someone now single, that’s terrifying. Will anyone want to marry me if I can’t have kids? Will they pressure me into using a donated egg or embryo—into giving birth to a child that is not mine—just so I can become pregnant? I fear I’ll end up pushing my boyfriend away with my irritability, my occasional rage, and my downright bitchiness to others when I have a hot flash.
For those reasons, I fear I’ll push everyone away. I don’t exactly feel like I owe an apology for what my body is doing, yet it’s nearly impossible to control the hormones. As I’ve told some close friends, it’s like going through puberty, except not as easy to recognize. With teenagers, it’s easy to blame emotional and chaotic behavior on their ever-changing hormones. At 32, unless a woman is pregnant, emotional and chaotic behavior is more likely to be noted as erratic, rather than understood.
To talk about the hormonal changes I’m going through only leads to shock or disbelief. Often, I get asked if there’s a way to “fix” it. I rarely even get so much as pity, which would be a welcomed gesture of comfort and empathy. As my best friends from high school and college get married and start families, forming cliques to exchange babies for playdates, I’ve slowly lost touch with them for lack of similar interests. At best, I see my girlfriends for lunch or a happy hour, only able to squeeze time from them when they’re already at work, away from their families for a few hours.
It’s not that I actually ever wanted kids; my ache for a child of my own—with my own genetics—developed immediately after discovering I couldn’t have one. I cried daily for months after my initial diagnosis, my then-husband confused about why I even cared. I always thought I’d have the choice to have kids when I was ready, but then a strong wave of jealousy swept over me; jealousy that I couldn’t even pursue IVF or freeze my eggs for a later date. Not only was I jealous of my friends who had babies, I was jealous of those who had triumphant and gorgeous stories of successful IVF. Hell, I was jealous when Amal Clooney and Beyonce announced their pregnancies at such a late age. How could they both be so incredibly lucky with their careers, their relationships, and their ovaries?
It’s this feeling that my life isn’t going to be what it should that kills me and, in the meantime, I suffer from physical and emotional symptoms that I can’t explain to a total stranger in a coffee shop. While I’m biting a barista’s head off, I really just want to burst into tears because I can’t stop; all I want is to ask if I can walk behind the counter and into their fridge for a minute, passing by the bagels because even if I look at the carbs, I’ll gain five pounds.
I’m tired from the sleepless nights, exhausted from lack of energy, crabby from the hormones, and I count calories by the decimal point for fear of judgment of my changing body. And the weight I already have doesn’t come off like my friends who simply walk their newborns in a stroller around the lake while sipping on a latte. Suffice to say, the struggle is real and, at 32, I have so much else I should be enjoying.
One good thing is that I have a gynecologist who recognizes my symptoms for what they are, while some doctors might otherwise argue about the state I’m in; many of my symptoms occur with premature ovarian failure itself, but the drastic drop in my estrogen levels, combined with the fact I haven’t ovulated in over a year, is one clinical definition of menopause. (Other doctors like to wait until there hasn’t been a period for one year, but not treating the symptoms can obviously wreak havoc on the woman’s life.)
Hormone replacement therapy
I began hormone replacement therapy (HRT) a few months ago, which looks like a pack of birth control pills and is a combination of conjugated estrogens and medroxyprogesterone. The goal of HRT is to increase the levels of estrogen to reduce most of the symptoms I’ve been experiencing. It’s also critical to help prevent osteoporosis, which unfortunately is another reason all of this sucks—my entire body thinks it’s about 20 years older than it is, so I could break a bone much more easily. With treatment, I don’t have to stop my normal activities and the hormones have dramatically boosted my energy levels. Now, I can actually wake up before noon and not feel exhausted by 8pm.
Of course, a hormone replacement pill can’t fix everything and it has risks of its own. I’m still isolated from my friends with families. I’ve yet to respond appropriately when someone asks when I’m having kids (or just assumes I will). I have yet to find a good way to handle bolting from a store because a hot flash or mood swing strikes. I am 32, trying to live the life a 32-year-old should be living. When my body wants to act otherwise, I can only follow its lead and hope for the best. And sometimes, that just sucks.