“I know exactly how you feel” someone shared with me the other day, “but I’ve been on hormones for the past year and I finally feel like my old self again.”
I’ve had many interactions like this over the past months and each one offers another opportunity to pause for a moment and question my choice of meeting the challenges of being a woman in midlife, without HRT.
The response in that conversation took place after explaining that I had come back a week early from my travels due to the challenges of my current peri-menopausal reality. Hot flushes and poor sleep do not match well with the tropics, and being in a permanent state of hyper-sensitivity, agitation and navigating a pre-menstrual-feeling underworld, being anywhere is hard work at the moment. I’d just had enough and wanted the familiarity of home.
This week it will be six months since my last menstruation. As well as the physical challenges, since then I’ve experienced low energy, little interest in creativity, work or the outside world, limited social capacity and am (often comically) annoyed by everything. Enthusiastic people feel like a different species to me. From what I’ve heard this state could continue for years to come, so why would I not take something to make it better?
Doesn’t the empowered woman not settle for suffering? Why choose to struggle when we don’t need to, isn't life hard enough?
These are definitely thoughts I’ve had and seemingly the dominant narrative that’s being spread. Here in Germany, current bestselling author Dr. Sheila de Liz recommends taking hormones as a precaution, before you even have any symptoms (after all it also ‘reduces the risk’ of osteoporosis, joint pain, colon cancer and diabetes). The number of prescription items in England related to HRT have doubled over the last seven years and the global market size was valued at USD 21.28 billion in 2022 and has an expected growth rate of 6.6% from 2023 to 2030.
Before I continue, I want to state that nobody gets to decide what is empowering for you other than you yourself.
I am not claiming that the path of HRT is bad and that no one should do it, as it’s clearly the best option sometimes. It’s not black or white. Choosing to deal with additional challenges to life is a privilege that not everyone can afford. I might also change my mind in the future and decide it’s a good option for me, and I definitely don’t want to shame anyone. In writing the following around what I’m discovering in my choice not to go down the medical route, I just want to add a different perspective to the dialogue, that I think is needed. It raises important questions around the underlying narratives behind the conversations we’re having around women’s bodies, the journey through midlife and into elderhood.
Anyways….
Approaching 45, I don’t think I want to feel like my old self or go back to business as usual.
Despite her best intentions, my old self normalised things that were really not ok. Like pushing against myself rather than going with my body’s natural flow. Living with levels of stress that were too high, spending too much time in survival mode and feeling chronically unsafe. Like having less than great boundaries and over-giving in relationships. Relying on dysfunctional coping strategies and addictions to sugar and caffeine.
Despite the discomfort of being confronted with my body’s discovery that it’s unable to cope with this as the status quo, I am grateful for the humbling wake up call and the invitation to grow.
Experiencing who I am without my usual drive and forward momentum is an (at times sublime) disorientation and disentangling from the parts of me that always experienced my identity and self-esteem from my work and sense of being a ‘someone.’
Having no choice but to slow down is opening portals to buried feelings that the constant business and fullness of life didn’t allow for. My sensitivity towards caffeine requires me to meet some very tender and fearful parts of me that have always felt like they needed to armour and brace themselves from the world.
It’s been uncomfortable to see how intolerant and impatient I can be with myself when I’m not functioning as I’d like to or feel like I should. It’s a massive invitation to learn how to be kind and patient to myself, and to upgrade my software to prioritise my own wellbeing above my giving to the world.
Just like the challenging days or phases of our menstrual cycle work us, the menopause journey works us too.
And as uncomfortable as all of this is, at the moment it feels like if I made the cries of my body and psyche go away through taking hormones, I would miss out on these learnings and the fullness of the rites of passage that the menopause journey actually is.
We need rites of passage in life.
All the oldest, earth based cultures understood that these initiatory experiences (that always include challenge) support our evolution of consciousness, our maturation and journey into elderhood - something we have tragically lost in our dominant contemporary culture.
In his book “Come of Age” Stephen Jenkinson describes elders as ‘the axis mundi of our mutual life’ and argues that elderhood is not something we simply all become by ageing but that:
Elder really first and foremost should be a verb and not a noun or an adjective, which is to say, it’s something that’s done.
Being an elder or ‘eldering’ is to play a vital role in service to our communities. Going deeper into the role of this as a woman, Sharon Blackie writes:
Perhaps more than anything, to become elder is to be comfortable with your place in the world, finally to have understood where all of your various journeys have been leading you, to understand your gifts as well as your limitations, and to tightly focus those gifts on service to the earth and to community. To become the elder who can express her wrath rather than her rage and warn of the direct consequences of ignoring it is to have stepped fully into your own power as a woman. To become elder is to have found the courage to reclaim the moral authority which we once lost. That reclaiming takes courage because women have always been trained so very well to be afraid, and it isn’t always our impotence which makes us most afraid. Sometimes it’s our power. We’re not accustomed to it and so we fear its consequences.
To step into your power means to trust yourself, your instincts, and your intuition. To let the fear go and the shame and tell the stories which need to be told.
By drawing parallel between menopause and the transition into elderhood (something I am obviously many years away from!) I am not saying that by being on HRT we thereby sacrifice our wisdom or will never become elders! Again: we are blessed to live in an age where we have options and choosing this form of support can most definitely be our best option.
And yet, I believe there is a relationship between the two: maturing towards elderhood and trusting in ourselves. Not running away from discomfort or hiding from our pain as a habit but letting life really work us. And seeing through and beyond the narratives of our current systems, especially the health system and how disempowering it is to women.
In our current narrative and world of ‘anti-aging’, menopause is largely characterised by a ‘deficiency in estrogen’ that needs to corrected and something we need to fight against. The underlying subtext here seems to be that women got the short end of the stick and by default, our bodies need to be rescued from their own natural process, which is inherently not ok as it is.
This needs a major reframing. Rather than something to avoid or bypass, we can trust that there is an intelligence taking place: a journey of correction, where our bodies are asking for our listening and our responding to.
It was heartening this week to see that the prestigious medical journal the Lancet, in their series of four essays on Time for a balanced conversation about menopause write:
“For most women, menopause is a natural phase of life that they transition as part of biological ageing. However, as highlighted in a Series of four papers in today's Lancet—published ahead of International Women's Day on March 8—commercial companies and individuals with vested interests have over-medicalised menopause. The framing of this natural period of transition as a disease of oestrogen deficiency that can be eased only by replacing the missing hormones fuels negative attitudes to menopause and exacerbates stigma. Furthermore, appropriation of feminist narratives by commercial organisations, which position use of menopausal hormonal therapy (MHT) as a way to empower women to regain control of their bodies, while downplaying risks, further endorses the framing of menopause as a disease.
and later:
… interpreting menopause more broadly as a disability risks further fuelling the ageism and stigma that older women already face. Menopausal women can be strong, healthy, and happy….Menopause can also be a time for women to reassess their identities, to embrace this next phase in their lives and the freedom from menstruation and menstrual pain, and to challenge negative perceptions of older women, which are prevalent in some societies. We need to send a realistic, balanced message to women and to society: menopause does not herald the start of a period of decay and decline but is a developmental life stage that can be negotiated successfully with access to evidence-based information as well as appropriate social and medical support. Women deserve nothing less."
In Chinese, the word for menopause means ‘second spring’.
When we remember the wisdom of cycles that live within and all around us, we can trust that after each descent there is always expansion and new growth.
I keep the words “second spring” in my pocket like an amulet.
On bad days I keep coming back to it, and try and remember to tend to the basics: fresh air, sunlight, nature, good food, exercise and no stress. I look to the female elders in my life whose presence I am so grateful for, and come back to the skill of meeting and surrendering to life right were it is. These are my healing balms right now.
Lovely piece Ruby… so good to see you here, I only joined Substack a month ago.
Sam
( elders group in the Hive)❤️
another cracker of an article .
i liked how your point was clear without rubbishing the alternative .
in a world quick to hide from their own challenging feelings , facing the music is a revolutionary act indeed .