Chapter 1: Excerpted from Menopocalypse: How I Learned to Thrive During Menopause and How You Can Too, by Amanda Thebe. Available October 2020 from Greystone Books.
The Chinese call it “a woman’s second spring.” Westerners call it “The Change.” I call it “menopocalypse.” Yes, I am talking about menopause.
My journey into the unknown started with perimenopause and culminated in my current postmenopausal state. And what a journey it has been! I consider it one of the toughest ordeals of my life, especially since I have always been so healthy and physically fit.
As a child, I started doing karate at age eleven and have been motivated to exercise and eat well ever since. As I got older, fitness remained a passion, and I spent my time outside of my job at IBM working to become a personal trainer. After meeting my husband and immigrating to North America, I embarked on a new career in graphic design but maintained my passion for fitness, coaching friends at the local YMCA or training mums in the schoolyard. In 2013, I finally decided to leave my design business to start my own fitness company, Fit n’ Chips, and have not looked back since.
My business thrived. I had the most amazing clients, and they inspired me to be a better coach and person. I am embarrassed to recall how dismissive I used to be of older women who complained about menopause and its symptoms. I encouraged them to just push through their discomfort and work harder. I mean, how awful could “The Change” be? There was little to no information available for a personal trainer working with menopausal women, and having not yet experienced menopause myself, I just could not relate. Today I eat humble pie. As soon as the shit hit the fan for me, everything they had told me made sense, and those early discussions have helped me immensely with my research. (P.S. I’m sorry!)
Entering my forties felt like a breeze. I was fit and healthy and in better condition both physically and mentally than I had been in my twenties. I felt awesome and thought I looked awesome, too. I was clearly doing something right, and I could see that it was inspiring other women to get strong, look after themselves, and thrive in their forties as well. Life was good. I was living the dream!
Then I turned forty-three.
Something happened that changed everything I knew about my body and my health. It started after one of my bi-weekly boxing classes, where I worked exceptionally hard, punching a huge heavy bag with all my might. I loved that class (it reminded me of my old karate days), but that afternoon I had to go home and lie down. I assumed I had just pushed a little too hard in the class. You know that feeling when you’re on a high after an epic workout but afterward are so spent that all you want to do is sleep? That was me.
But after I lay down, I couldn’t get back up again. It felt like my bed was spinning. I began to feel nauseous, and my whole equilibrium shifted. I realized I was experiencing some kind of vertigo, and I was literally seeing stars.
This condition lasted for two days and was completely debilitating. After it subsided I just assumed it had been some sort of virus. I quickly got back to normal, but a few days later it hit me again, and then again, and again.
I had no idea what was happening to me. My head would feel like it was being squeezed in a vise, and then I’d experience extreme nausea and vomiting. I couldn’t walk without falling over, so I crawled around on my hands and knees. It was just horrid.
Each of these episodes would last three to five days, and they happened almost every week, leaving me utterly exhausted. It was a hellish time for me, as my new business had just started to flourish and I was eager to invest time and energy in it. Yet most of the time I felt so unwell I could barely even make myself a cup of tea. I remember reading a bedtime story to my six-year-old, just wishing it to be over so I could hit the sack—at seven o’clock! I don’t remember ever feeling that tired before or since, even when the children were newborns.
I eventually went to see my doctor, leading to many visits to neurologists and ENTs (ear, nose, and throat specialists). I underwent dozens of tests, including an MRI, a CT scan, balance testing in which vertigo was induced, and many more. For more than eighteen months I went back and forth to the hospital. One time I landed in the emergency room because I felt so unwell. All of the tests came back inconclusive. Without any answers, I spiraled into despair. The doctors recognized that something was clearly wrong with me: I felt like shit and I looked like shit, but none of them—none of them—could help me. What was happening to me?
After almost two years of struggling with these symptoms, I couldn’t remember what it was like to feel good. I consider myself to be a hardy person; I very rarely get sick, and when I do, I tend to handle it quite well. Even that ability was compromised now.
Inevitably this had an impact on my emotional well-being. I started to withdraw from social events, which was completely out of character for me—I love a good party. Some days, after coaching my clients, I would drive straight home, collapse onto the sofa, and just stare into space, unable to move and unable to care. The only thing that stopped me from sitting there into the night was that I had to collect my children from school.
On the other side of this despair was a side to my character that really scared me. It was like a switch would flip, and I would suddenly fly into a hysterical rage. I would shout, scream, and cry like a wild banshee. I didn’t even recognize myself, my head spinning like something out of The Exorcist. I still get tears in my eyes thinking of how scared my own kids were of me, wondering if I was going to be nice Mum or crazy-bitch-from-hell Mum that day. No mother wants her children to be scared of her; mine were walking around on eggshells.
They say you get to a certain point along the road where you have no choice but to take action. One night, when I was feeling particularly low, I attacked my husband out of the blue with a list of all the things I didn’t like about him. It was horrible. I was horrible. He didn’t stand a chance against the angry volley of verbal abuse I was throwing at him. Exhausted and worried for our marriage, he asked if we were going to be okay. He didn’t want the marriage to break down and would do anything to help me, to help us.
The realization hit me then. All of the wretched things I had just told him I hated were actually things I admired about him (my hubby was born without tact, yet one of the things I love about him most is that he cannot lie. If you want to know the harsh truth, he’ll give it to you! I wish I could be more like that). I had a moment of intense clarity where I saw that my marriage was (and still is) a good, strong marriage. I loved my husband and children, we were financially secure, my business was thriving, I had lots of amazing friends and a good support network— so why was I so unhappy? I knew in that moment that I needed to get help and to start getting answers.
In the end it was a routine appointment with my gynecologist that saved my soul and my marriage, and definitely my sanity. After two years of visits to other specialists, I went in for my regular well-woman examination. I usually hate those appointments, where the doctor rushes through the fifteen minutes allotted to you with little empathy and makes it seem almost impossible to ask the questions that are bothering you. I always feel like a bloody nuisance and then struggle to find the right words to describe exactly how I’m feeling.
This time, though, was different. As the appointment was ending, my doctor stopped, looked me straight in the eye, and saw that something wasn’t right.
“Are you okay?” he asked.
“No, I’m not!”
The tears started and wouldn’t stop. All it took was for him to ask me if I was okay and then to actually listen to me. Of course he’d seen this all before, but I had no idea what was happening to my mind or my body, who I was becoming, and where the real me had gone.
He immediately recognized what I was experiencing: perimenopause. All of the symptoms that had been dragging me down were very real perimenopausal symptoms. I was suffering from chronic depression, caused in part by my reduced estrogen levels, which was something he could help me with. My vertigo, nausea, and balance issues were all the result of migraine with aura, another known and treatable symptom of perimenopause.
I am not one of those people who head to Google to fill themselves with fear about all the dreadful things that could be wrong with them; in fact, I tend to use Google as a way to rule out illnesses. But I had been starting to think that something was seriously wrong with me, so when I finally found out what was really happening, I was flooded with relief. Even though my symptoms were horrible and life-altering, it was reassuring to know that they were part of a normal process that my body had to go through and was well-equipped for—though it might need some assistance. My doctor told me of treatments and protocols I could follow to start gaining control again. At last I had an answer. At last I could start the process of feeling better.
Now I just needed to understand what the hell perimenopause was! My symptoms over those past two years had included depression, erratic mood swings, migraines with aura, fatigue, short-term memory loss, loss of motor skills, and incontinence (yep, that too!), and they could all be explained by my fluctuating hormones. I’m not going to lie, I was pissed off that I had endured over a year and a half of tests and visits to ENTs and neurologists, and for some reason they couldn’t see the bloody obvious staring them in the face. Yet it took just five minutes with my gynecologist to identify what was happening. What a relief it was to finally know that I wasn’t going crazy, that this was an actual thing that had a name. And so began my journey to peel back the layers of what perimenopause really is and to share that information with other women out there.
The biggest lesson was that I had to advocate for myself and my health. I had to keep asking questions and pushing for answers, despite constantly being told there was no conclusive reason that I felt the way I did. I was living in Canada, a country where I had easy access to a medical team—and yet I felt that team had failed me.
I can’t highlight this enough: women are still experiencing dismissive medical care, leaving us feeling all sorts of crazy, simply because our symptoms aren’t readily recognized. Had I known that these were symptoms of perimenopause, I could have gone to my appointments armed with this information and asked for help. In hindsight, I realized that I had in fact started feeling perimenopausal not long after the birth of my second child. Around the age of thirty-eight, my periods had started to change, and so did my PMS. I’d often been hit with really bad fatigue, and my immunity to colds and bugs was compromised, so I often felt rundown.
Why didn’t I have this information? It seems so obvious to me now that had I known, I could have coped with my situation much better.
Women are given very little information about menopause. It isn’t taught in schools, GPs don’t get training in menopause management, it’s not discussed in the workplace, and even among friends it’s rarely discussed openly.
When I frantically tried to find information online, it quickly became apparent that the pickings were slim. Information on websites felt dumbed down to include only hot flashes and a few mood swings. The reality can be so very different. Historically, women have been hugely underrepresented in research; it appears we are too difficult to study, you know, because we have periods and complicated hormones.
In her 2018 book Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick, Maya Dusenbery discusses a study from the early sixties. “Observing that women tended to have lower rates of heart disease until their estrogen levels dropped after menopause, researchers conducted the first trial to look at whether supplementation with the hormone was an effective preventive treatment. The study enrolled 8,341 men and no women.” Today women may be getting more of the attention they deserve: As recently as 2016, the National Institutes of Health deemed that any research it funds must include female animals, removing the male bias in scientific studies. Despite this, there is still much more research needed for women in menopause.
What else did I learn? That I was not taking the fight lying down, that I was taking charge of my life again by being proactive and recognizing that nutrition, exercise, recovery, relaxation, and stress reduction were key to making this period of my life manageable. A strength and metabolically challenging fitness program that focused on building lean muscle and keeping my metabolism revved up was imperative. On the flip side, prioritizing recovery and relaxation was also critical, so that my body could heal. Avoiding shitty foods laden with added sugar and refined within an inch of their lives helped keep my migraines at bay and my moods lifted—bingeing on overly processed foods with ingredients I couldn’t pronounce (which I seemed to crave more than ever in my life) made me hit rock bottom. Alcohol became my enemy (and trust me—taking away a gin and tonic from a northern lass is not a pretty sight); I simply could not tolerate it without dire side effects. (Side note: I’m really hoping to get that resilience back, as I can’t wait to get a little tipsy again!)
As well as all of the above, I found that for the first time in my life, I needed to take time each day for me. That was something I had never done, but finding the time each day to read, nap, knit, go for a walk, or do anything that pressed my reset button became vitally important.
And finally, I started talking—talking about my symptoms to anybody and everybody. And I haven’t stopped. I don’t care if it makes them roll their eyes in boredom. I know that women want and deserve to be heard. We’re tired of being ignored, misunderstood, and belittled. We’re sick of feeling invisible. If I can do anything with this book, I want to change that whole dynamic. I am happy to put my vagina on the line for this cause.
My experience is what led me to write this book. Most people don’t realize that perimenopause (or menopause transition) can start affecting women in their late thirties or early forties. Perimenopause is the phase when most symptoms appear, and they can last up to ten years. Women are considered menopausal for only twelve months to the day after their last period ends. And that’s just the beginning, baby! After that day, a woman is postmenopausal, and we are in fact postmenopausal till death do us part. A woman can spend one-third of her life in menopause—from perimenopause to post-menopause—and with women’s average life expectancy hovering around eighty-one in North America, that’s a bloody long time.
Whether you are a woman heading toward menopause, the husband/partner or son/daughter of a woman, or a trainer, counselor, teacher, coach, or employer who has female clients, students, or employees in their late thirties or beyond, you should get familiar with the impact that menopause can have on a woman. It’s not fun, it’s not sexy, and it usually makes people roll their eyes and want to walk in the other direction. But it’s essential that we all become less embarrassed to talk about it and remove the shame and taboo that is associated with the unmentionable M-word.
I am now in the stage called post-menopause, as I haven’t had a period for more than a year. I feel now that I have clarity about what has passed and what to expect next, yet one of the most frustrating things that I hear from women is that they have no idea what the hell is happening. Our mothers either told us nothing or minimized their experiences; it’s just the way it was done in their generation.
Women basically just got on with it and suffered in silence. But that’s not me. I have a very loud voice, and I don’t mind using it. I am ready to clear up confusion, dispel a few myths, and throw some truth bombs your way.
Using my experience and knowledge, as well as expert advice, I was eventually able to manage my symptoms and regain a normal life. This had a positive effect on my marriage and my family because, yeah, nice Mammy is back again!
What this book is and what it is not:
- This is a book to help you manage the things you can control so that you can cope with the ups and downs of menopause.
›› Part 1 of the book might seem full of doom and gloom; it’s where I lay out all the shitty stuff happening. Persevere until Part 2.
›› Part 2 is where we get deep and dirty into solution-driven actions you can take today.
- This book is not a medical text. I have written it using the knowledge I have gained as a personal trainer and nutrition coach and from interviews with medical experts in the field of menopause management.
- This book is not a replacement for your chosen medical therapy.
Use this book as a companion to your work with your medical team. Any time you’re having menopausal symptoms, I want you to reach for this book for guidance and support. I hope this book will be your new best friend.
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