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IN SEARCH OF A LOST MENOPAUSE
Janice Stensrude
February, 1995

My search began when I saw women in my age group going through or completing menopause. I hadn't given it much thought before. I wasn't even certain when menopause was supposed to happen; I knew it was sooner for some and later for others. But now I was distinctly at that age—the age where I would be in my menopause, if that were possible.

I was 31 years old when I had my hysterectomy. I had been bleeding for many months, and nothing the doctor tried seemed to work. One ovary was horribly infected, swollen to the size of a grapefruit. Large doses of birth control pills didn't stop the bleeding, and antibiotics did not seem to help the infection. I accepted the hysterectomy with relief. The months of weakness, blood loss, and anxiety were finally over.

I was 52 when I began to think about my menopause—the menopause that would never happen, I thought, because of losing my reproductive organs at such an early age. I felt cheated, left out. I began to ponder my lot with increasing frequency. I wanted to know what I had missed. I wanted to know what menopause was all about. And so I began the search for my lost menopause.


Words and Their Meanings

I had heard menopause called by many names—the change, change of life, climacteric. I considered them all polite words for the same thing, "climacteric" being the polite word used by medical professionals, and "the change" being the polite word used in low, muffled tones in women's private conversations. What I learned is that, though change of life and climacteric have essentially the same meaning, menopause has a much more limited definition.

Menopause, a term that most people accept as reference to the years of a woman's midlife change, is actually a single event—the final menstrual bleeding. If a woman has not had menstrual bleeding for at least a year, say the medical experts, she may consider herself to have crossed the menopausal threshold. This time of waiting to see if there will be another menstrual period led feminist writer Germaine "Take No Prisoners" Greer to label menopause a non-event—the bleed that never happens (Greer 1992, p. 23).

Climacteric, from the Greek klimacter, meaning critical period (Greer 1992, p. 22–23), is the 10- to 15-year period preceding menopause during which a woman's body begins the changes leading to cessation of menses (Perry & O'Hanlan 1992, p. 2; Sheehy 1991, p. 223; van Keep, et al. 1976, p. 1; West 1994, p. 193). Changes in a woman's body begin as early as 35, manifesting as changes in mood and menstrual cycle, which are harbingers of the last bleed. For most women, however, these changes are first noticed during the early to mid forties.

Postmenopause is the term which appropriately refers to the time following menopause, and perimenopause refers to the few years preceding menopause when the signs of change are most evident. Thus, a woman's change of life, or climacteric, that may begin as early as 35, is divided into four phases: early climacteric, perimenopause, menopause, and postmenopause.

Adopting the reasoning of Paula Doress-Worters and Diana Laskin Siegal (1994) writing in Ourselves, Growing Older, I choose the word "sign," rather than "symptom" deliberately. Symptoms imply a medical condition, and signs infer the natural process that is the climacteric (pp. 119–120).


Navigating the Climacteric

The ovaries gradually begin producing less estrogen in the mid thirties, and some women notice changes in their periods between the ages of 35 and 40 (Sheehy 1991, p. 223; van Keep, et al. 1976, p. 2). By the mid to late forties, menstrual bleeding is either considerably less or considerably more than it has been, and the cycle becomes erratic. During this time, some women may have a menstrual period every two or three weeks, others every two or three months, and many experience a mixture of frequent and infrequent cycles. Though the median age at menopause is 51 (average is 48), radical changes in menses and onset of noticeable mood swings are relatively common in women in their early 40s. When these signs become evident, a woman is said to be in her perimenopause. The climacteric includes a period of about four years following menopause until the ovaries settle into the new pattern and the body adjusts to the lower levels of estrogen.

What is popularly thought of as "menopause," then, is more precisely the "climacteric"—precise only in name. A multitude of signs are associated with this time in a woman's life. Heading the pack are hot flashes, vaginal atrophy, perspiration, and unpredictable, profuse bleeding.


Postmenopause: The Change Realized

It is common, during the reflective time just following menopause, for women to grieve the passing of childbearing ability. Though to many women there is no logic in mourning the passing of an option that they had no intention of exercising, there is nonetheless a common experience of deep sadness associated with the withering of the womb. States Greer (1992):

Grief at the death of the womb is, in Iris Murdoch's phrase, an "august and terrible pain" unlike anything a woman can have experienced before, but she comes through it stronger and calmer, aware that death having brushed her with its wing has retreated to its accustomed place, and all will be well. (p. 8)

Among the hot flashes, perspiration, and other body changes, other things are changing for a woman, things that do not appear to have anything to do with her body. Throughout their writings on menopause, both Greer (1992) and Sheehy (1991) refer to the postmenopausal period as a time of renewed and new activity. A woman begins to take more interest in herself as the primary actor in her life. Long neglected dreams and goals demand attention.

Greer (1994) proposed that the postmenopausal woman returns to the dreams and ambitions of childhood, the prepuberty ambitions of accomplishments beyond motherhood. She is returning to a life plan interrupted by nature's demand to fulfill a biological role. Margaret Mead, resuming her career at 51, named this time "postmenopausal zest" (Sheehy 1992, p. 252).


The Final Passage

I propose another passage, another change in women's lives beyond menopause—the Wisewoman phase, I call it—that begins around age 75 when the ovaries of an intact woman (a woman who has all of her sexual organs intact) cease functioning altogether (van Keep, et al. 1976, p. 26). It is a time when a woman's experience is complete, the children that were a part of her young adult life are now becoming grandparents, and she has tasted every stage of human experience short of old age and death.

Greer (1992) also recognized another phase of change past menopause. She wrote of the seven ages of a woman's life, each heralded by a change which she labels a climacteric, true to the Greek definition of "critical passage." Greer's first climacteric is birth; the second, adolescence; the third, defloration; the fourth, childbirth; the fifth, menopause; the sixth, a time of the spirit, a preparation for death; and the seventh, the most powerful of critical passages: death (p. 49).

Sheehy (1991), too, posited a passage following menopause. She called it "maturescence," and described it as "the passage to full maturity in the seventies" (p. 252).

Our growing body of knowledge about the experience of climacteric and menopause has come about through the writings of women who have completed this passage. Our feminist heroines have come of age. Friedan, Greer, Sheehy, Shinoda—these are some of the names of the women who have influenced our lives since Friedan took the lead with her "feminine mystique." Friedan will be the first to reach 75. Perhaps then there will be another book, we will know more about maturescence, the sixth climacteric, the Wisewoman. The voice of women began with the voices of young women, and now those voices are aging. Our first generation of liberated women are coming of age.

In claiming menopause as a rite of passage, Greer (1992) quotes Mankowitz:

Rites of passage usually take place in three parts: first the stage of isolation, withdrawal of the individual from society and into close contact with, and dependence upon, nature; second, the ordeal of severance, an event sometimes painful, involving physical or symbolic renunciation and confrontation with loss and death; and third, a ceremony of rebirth and renewal—the return of a changed being into society and the world. (p. 36)


Lost or Just Misplaced?

I have learned that I have missed nothing of the menopause or the climacteric. At 54, I am right on schedule. At 31, I was a bit ahead of schedule.

My last bleed, which lasted more than four months, resulted in a hysterectomy—rightly labeled "surgical menopause." The estrogen therapy that began with injections at surgery held at bay the signs of estrogen deficiency that accompany loss of ovarian function. Therefore, though having achieved menopause, I did not experience the physical signs that accompany natural menopause. I experienced the inexplicable sense of terrible loss at losing my ability to give birth, even though I had the family I wanted and had made monumental efforts to avoid pregnancy. I grieved my uterine euthanasia, just as intact women grieve the natural death of their wombs.

It was nine years after my surgery when my first physical signs appeared—oddly enough, as a reaction to the estrogen that was to have held them at bay indefinitely. I suffered the most extreme night sweats, waking to an icy cold body lying in pools of water on soggy bed linens. These nightly wet nightmares immediately ceased when I discontinued estrogen. Shortly thereafter I began to have hot flashes, which I enjoyed for two years before I resumed estrogen—this time as a pellet surgically implanted in my hip. Though artificially induced, these signs were only a bit early at age 40. My body was catching up to nature's cycle.

At 51, when most women are experiencing their last menstrual bleeding, I again stopped using estrogen. I was not then aware that it was a natural time to cease the hormones. Unknowingly I reconnected with my natural cycle by simply failing to make a doctor's appointment, eventually feeling intuitively that it was exactly the right thing to do.

With medical intervention, the signs of menopause become "symptoms." "The climacteric is called climacteric syndrome only when associated with symptomatology," declared the report of the First International Congress on the Menopause (van Keep, et al. 1976, p. 3). In releasing estrogen, I unconsciously released a syndrome and embraced a passage.


To Dye Or Not To Dye

It was at this time that I looked in the mirror and asked, "Who are you?" I was determined to find out and began by letting the streaked blonde coloring grow out of my hair. Discovering me would not be all that easy, but I needed visible evidence of the effort.

There was another dimension, too, to the exercise of owning my natural hair color (whatever it would turn out to be). There was an element of defiance: "I am going to be me, and now when a man (or anyone else for that matter) becomes interested, it will have been through the effort to know me and the time and attention entailed in such an effort." It was interesting to me, then, when I read that I was not alone in using such a device to explore my Self and present my Self to the world.

Carolyn Heilbrun (1991), addressing an audience of Smith College alumnae, spurned what she called imitating youth. "Only youth has the talent to turn men's heads," said Heilbrun (1991). "I will not live in drag for your sake," she stated defiantly to the phantom men from her past that demand something of her that she cannot and will not give. "Neither the gaze of men, nor her former need for them to gaze, will any longer define the life of a woman who has undertaken this rite of passage," she declared (p. 27).

Greer (1992) quotes from Doris Lessing's midlife novel The Summer Before the Dark:

Her experiences of the last months—her discoveries, her self-definition; what she hoped were now strengths, were concentrated here—that she would walk into her home with her hair undressed, with her hair tied straight back for utility; rough and streaky, and the widening grey band showing like a statement of intent. It was as if the rest of her—body, feet, even face, which was aging but amenable—belonged to everyone else. But her hair—no! No one was going to lay hands on that. (pp. 37–38)

Again the defiance. Having spent our lives doing what we thought was wanted by others, we now dare them to not accept what we timidly, then forcefully have come to accept in ourselves. "Love me, love my hair," we say—and my aging body, and my maturing intellect, and my hot flashes—all of it! Many women find that the people around them from whom they so carefully attempted to hide these mystifying and alarming changes were far more willing and accepting than they themselves (Sheehy 1991, p. 256). We look into the mirror of the other's face and say to ourselves, "This is who I am. Love me!"

Greer (1992) quoted a 1973 interview that Doris Lessing gave to Harper's:

you only begin to discover the difference between what you really are, your real self, and your appearance, when you get a bit older. . . . A whole dimension of life suddenly slides away and you realize that what in fact you've been using to get attention has been what you look like. . . . It's a biological thing. It's totally and absolutely impersonal. It really is a most salutary and fascinating thing to go through, shedding it all. Growing old is really extraordinarily interesting. (p. 52)

It is not really an issue of to dye or not to dye. Said Heilbrun (1991):

My own statistical sample suggests that many women will stop dyeing their hair after a few years, but a few will persist even to their death beds. It doesn't really matter. So long as we don't think we can successfully impersonate youth, we should do with hair dye and makeup what offers us the chance to take our bodies for granted. For as one enters upon this new life, this time when one becomes an explorer of a new landscape, one should not underestimate the importance of camouflage. (p. 27)


Changes in the Erotic Palate

Shortly after my 54th birthday, I drifted into celibacy as I ended a long-term relationship. As the pain of the breakup eased, I was amazed that I suffered no longing for sexual intimacy. I was more amazed when I read:

Not everyone does, but by about age 54, whether or not they have had pelvic surgery, 75 percent of women no longer have the same level of interest in sex that they once had. . . . The loss of libido is generally more sudden than gradual—rather like walking through a door and finding oneself in a completely different room. (Cutler 1988, p. 227)

I remember the best of my sexually active years with great fondness and no small degree of relish. I do not view my celibacy as permanent (though it may very well be). It seems only that sexual gratification is no longer a matter of urgency and that, as Greer (1992) said, "No sex is better than bad sex" (Greer 1992, p. 9).

Feminist Gloria Steinem, a beautiful woman who had worked as a model and struggled to be recognized in journalism at a time when men would rather have been looking at her legs than her prose, told Sheehy (1991):

Sex and sensuality—going to bed for two entire days and sending out for Chinese food—was such an important part of my life, and it just isn't anymore. It's still there, but it's less important. I don't know how much of it is hormonal and how much of it is outgrowing it. (p. 256)


Postmenopausal Zest

I suffer the flagging immune system typical of the early postmenopausal years, and my energy vacillates from none to incredible. Phyllis Kernoff Mansfield, a researcher of female cycles at Penn State told Sheehy (1991):

I'll have a really long period of magnificent energy and acute mental functioning, even brilliance, when I'm never tired, always very up, producing like crazy. At first I thought, Oh! So this is going to be part of my new personality. Then just as suddenly I fell into a period of intense anxiety—and that lasted for a month. (p. 223)

As women's bodies become acclimated to the new levels of hormones in their postmenopausal bodies, these energy cycles level off, and then, if we love ourselves enough to be healthy, a new energy is discovered—Mead's postmenopausal zest kicks in.

The Change That Ends Changes

"It is the change that ends changes," wrote Greer (1992) of the menopause. "It is the beginning of the long gradual change from body into soul. . . . The fifth [climacteric] is exceeded in significance only by the grand climacteric of dying. The climacteric is not a rite of passage, but the passage itself" (p. 49).

"The fifth climacteric is the time when a woman plans the rest of her life," wrote Greer (1992), "if she has not the financial resources, the education or the energy, it is not too late to acquire them" (p. 6). Now involved in intense study to complete my long-postponed college education, I have also done work in exploring my childhood, looking for self-defeating patterns, exploring the meaning of my life passage. I am getting to know me. I am becoming important to me.

Greer (1992) called it "the difficult transition from reproductive animal to reflective animal" (p. 24). Sounds like menopause to me! And I find it extraordinarily interesting.


References

Cutler, W. B. (1988). Hysterectomy: Before & after. New York: Harper & Row.

Doress-Worters, P. D., & Siegal, D. L. (1994). Chapter 10: Experiencing our change of life: Menopause. In P. B. Doress-Worters & D. L. Siegal (Eds.), The new ourselves, growing older: Women aging with knowledge and power (pp. 118–132). New York: Simon & Schuster.

Greer, G. (1992). The change: Women, aging and the menopause. New York: Alfred A. Knopf.

Heilbrun, C. (1991, Summer). Naming a new rite of passage. Smith Alumnae Quarterly, pp. 26–28.

van Keep, P. A., Greenblatt R. B., & Abeaux-Fernet, M. (Eds.). (1976). Consensus on menopause research: A summary of international opinion. Baltimore: University Park Press.

Perry, S., & O'Hanlan, K. (1992). Natural menopause: The complete guide to a woman's most misunderstood passage. Reading, MA: Addison-Wesley Publishing Company, Inc.

Sheehy, G. (October, 1991) The silent passage: Menopause. Vanity Fair, pp. 222–263.

West, S. (1994). The hysterectomy hoax. New York: Doubleday.

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