Musings on Perimenopause and Menopause: Identity, Experience, Transition.

By Demeter Press

A woman muses about buying lovely new panties; another sets out on the trip of a lifetime; a blogger offers information, support, and community to perimenopausal women; researchers uncover myths and misconceptions about migrant and refugee women's experiences of menopause; a gerontology scholar extrapolates for menopause the meanings of cultural representations of childbirth; a sociologist and intersex advocate challenges her medically constructed menopause; young women's stories inform an inquiry into the health and social repercussions of primary ovarian insufficiency—all in a collection of research papers and personal narratives that moves far beyond the idea of menopause as a mere biological marker. While biomedical and feminist researchers agree that menopause is a time of transition and border crossing, they offer diverse viewpoints about whether perimenopause and menopause signal deficiency and burden, or growth and freedom, or both. So too, contributors to this collection—influenced by factors of age, cultural background, societal context, and physical and psychological experience—vary significantly in their perspectives of this process. Research, analysis, narrative, poetry, and art intermingle to create a multi-textured montage that challenges stereotypes, probes relationships, and defies categorization. Musings on Perimenopause and Menopause: Identity, Experience, Transition provides insight into how women think about and experience the transition to menopause in contemporary times.

• Language: English
• Publisher: Demeter Press
• Release date: Apr 23, 2021
• ISBN: 9781772583243

Book preview

Musings on Perimenopause and Menopause

Identity, Experience, Transition

Edited by Heather Dillaway and Laura Wershler

Copyright © 2021 Demeter Press

Individual copyright to their work is retained by the authors. All rights reserved. No part of this book may be reproduced or transmitted in any form by any means without permission in writing from the publisher.

Demeter Press

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Printed and Bound in Canada

Cover photograph: Cleve Wershler

Cover design and typesetting: Michelle Pirovich

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Library and Archives Canada Cataloguing in Publication

Title: Musings on perimenopause and menopause: identity, experience, transition / edited by Heather Dillaway and Laura Wershler.

Names: Dillaway, Heather, editor. | Wershler, Laura, 1953- editor.

Description: Includes bibliographical references.

Identifiers: Canadiana 20200375555 | ISBN 9781772582857 (softcover)

Subjects: LCSH: Menopause. | LCSH: Perimenopause. | LCSH: Menopause —Social aspects. | LCSH: Perimenopause—Social aspects. | LCSH: Menopause—Psychological aspects. | LCSH: Perimenopause— Psychological aspects.

Classification: LCC RG186 .M87 2021 | DDC 612.6/65—dc23

Acknowledgements

Heather Dillaway thanks Joani Mortenson for helping to initiate this book and Laura Wershler for making sure we finished it. She also thanks Jason, Aurora, and Teague for putting up with her need to work during family time.

Laura Wershler thanks Heather Dillaway for the invitation to be her co-editor and all the contributing authors for making the editing of this volume a journey of discovery and possibility.

Both editors thank Andrea O’Reilly and Demeter Press for assistance in preparing and publishing this manuscript and the authors for their patience and hard work as we compiled this volume.

Contents

Acknowledgments

Introduction

A Reading Guide to Musings

Laura Wershler (with Heather Dillaway)

Section One

MENO-TYPICAL

1.

The Anatomy of a Hot Flash

Beth Osnes

2.

Gone Girl: The Menopause in Popular Culture

Mary Jane Lupton

3.

Myths and Misconceptions: Migrant and Refugee Women’s Constructions and Experiences of Menopause

Jane Ussher, Alexandra Hawkey, and Janette Perz

4.

The SWAN Study: Gender, Race, Identity, and Menopause

Mindy Fried

5.

Slouching towards Menopause

Joanne Gilbert

Section Two

OUT OF STEP

6.

Before Your Time: When Menopause Comes Too Soon

Evelina W. Sterling, Christine Eads, Starr Vuchetich, and Catherine M. Gordon

7.

Shadow Story

Yolanda Kauffman

8.

Just before Menopause

Donna J. Gelagotis Lee

9.

Patches Not Pads: An Intersex Experience with Postsurgical (Pseudo) Menopause

Georgiann Davis and Koyel Khan

Section Three

BLOOD RELATIONS

10.

Waiting for Seventeen Days

Heather Dillaway

11.

Dear Magnolia… Nobody Really Understands… What Can I Do?: Reflections on a Perimenopausal Blog as Social Support

Gillian Anderson

12.

Finding Bedrock

Marie Maccagno

13.

Menopause Claimed

Laura Wershler

Section Four

UNLEASHED

14.

Harsh Blessings: On Finding Poetry at Fifty

Magali Roy-Féquière

15.

Uninhabitable Lives: Narrative Strategies of Menopause Experience in Notes on a Scandal and Carol

Sylvie Teillay-Gambaudo

16.

Perimenopause: The Body, Mind, and Spirit in Transition

Victoria Team

17.

From the Crowning to the Crone: Extrapolating Judy Chicago’s Birth Project to Older Women

Anne Barrett

18.

All New Panties

Cayo Gamber

Conclusion

Advancing Our Perspectives on the Menopausal Experience

Heather Dillaway (with Laura Wershler)

Contributor Notes

Introduction

A Reading Guide to Musings

Laura Wershler

(with Heather Dillaway)

Where are all the books about menopause? So asks the title of an article by Sarah Manguso that appeared in The New Yorker in June 2019. Here, in 2021, is one such book that we believe affirms the subhead below that title: For women, aging is framed as a series of losses—of fertility, of sexuality, of beauty. But it can be a liberation, too. Aging, specifically women’s reproductive aging, is the impetus behind the contributions to this diverse collection about perimenopause and menopause. In these pages, researchers, scholars, poets, artists, and narrative writers explore and expand on the experience and meaning of the menopausal transition. If, as Manguso writes, we are culturally prepared to perceive women’s natural aging as uninteresting at best, pathological at worst—deserving of dismissal or disgust or both, then it is our hope that Musings on Perimenopause and Menopause: Identity, Experience, Transition makes clear that women’s aging is anything but uninteresting and more than deserving of atten-tion, curiosity, and respect.

What makes this collection unique is the variation in approaches to the subject and the range in emotional tone of the personal experiences conveyed. Between the hot flash cartoon at the beginning and a woman’s musings about all new panties at the end, readers will find a stunning array of quantitative, qualitative, analytical, and introspective detail. What might strike one reader as positive, may be perceived by another as negative. What makes one reader laugh, may make another cringe. This variability in how women think about the menopausal transition when they actually go through the experience—how it becomes richer and more complicated, messy, or eye-opening in both positive and negative ways—is the defining characteristic of Musings.

Although the established clinical definitions of perimenopause and menopause permeate the pieces in this volume, they do not dictate the course of these narratives, scholarly or otherwise. Most women are now familiar with the distinction between the two. Perimenopause refers to the period of time leading up to menopause, when signs or symptoms—such as irregular bleeding, hot flashes/flushes, insomnia, and others—may begin, often lasting several years before the end of menstruation. Menopause is reached once twelve consecutive months have passed without menstrual flow. The median age at natural menopause for White women in industrialized nations is between fifty and fifty-two.¹ Post-menopause is used by many² to refer to the phase following the point at which menopause is reached, whereas others³ suggest the words postmenopausal and postmenopause are redundant—that to reach menopause is also the start of living in menopause.

Feminist researchers and writers have long proposed that how women recognize, define, and cope with their own experience of perimenopause, menopause, and postmenopause is just as important, if not more so, than how their experiences intersect with these tidy clinical definitions. Individual women recognize reproductive aging as an important life-stage transition, not just as a retrospective moment in time or as a clinical diagnosis. Furthermore, although biomedical and feminist researchers agree that reproductive aging is a time of transition and border crossing, they offer differing perspectives about whether menopause signals deficiency and burden, or growth and freedom, or both. Contributors to this volume address both and also something more entirely. Research, analysis, inquiry, narrative, poetry, and art intermingle to create a multitextured montage that challenges stereotypes, probes relationships, and reframes traditional touchstones of the peri- to postmenopausal experience.

At first glance, the collection defied categorization. But as we worked through the editing process, unifying ideas emerged that crossed format boundaries and suggested how best to present this assorted anthology. The volume is divided into four parts, titled by theme.

One: Meno-Typical

In this section, the contributors approach, in both conventional and nonconventional ways, the typical talking points and issues of concern around the menopausal transition. By typical, we refer to the biomedical discourse that has become a master narrative (Lyons and Griffin) of sorts, constructed by the information we receive from family, friends, healthcare providers, and lay culture. No one can deny that menopause and reproductive aging have been medicalized and pathologized such that most women have internalized ideas about negative symptoms and absorbed information about safe and/or effective treatments. As we discuss again in the conclusion of this volume, the focus on bodily symptoms and markers of this change as well as the reliance on doctors and researchers as experts (rather than women themselves) can potentially lead to initial negativity and uncertainty. But as the pieces in this section attest, women also come up with their own ways of negotiating bodily symptoms and reinter-preting what these experiences mean for them.

Take one of menopause’s most prevalent and enduring tropes. In the opening piece, The Anatomy of a Hot Flash, Beth Osnes uses cartoon images and expository captions to interpret a personal yet almost universal experience, one she perceives to be both disruptive and liberating. The duality of her perception is a recurring theme in most of the chapters of this book.

In investigating both the biomedical and psychological factors related to the menopausal transition, Mary Jane Lupton provides a sort of postscript to the seminal work she co-authored over forty years ago. Her intention for the chapter in this book is to review, rethink, and update what we wrote about menopause in The Curse: A Cultural History of Menstruation. Riffing off popular culture throughout the piece, she uses gone girl imagery and metaphor to both inform and satirize the cultural history of menopause: Among the contemporary middle class, the postmenopausal woman is the gone girl veiled in the cloak of invisibility and past her prime.

The master narrative about menopause can affect not only how we experience it but also how we anticipate this life-stage transition. In Myths and Misconceptions, Jane Ussher, Alexandra Hawkey, and Janette Perz present research into how migrant and refugee women construct and experience menopause. Although most women were premenopausal at the time of their interviews, they foresaw as negative the most expected bodily changes associated with the menopausal transition. Yet across cultural groups, some women challenged negative constructions of menopause. Access to accurate information following migration was one factor that led to more positive outlooks. As one woman said: I used to hear about menopause. When the menstruation stops, the woman feels that her age is now come to an end, and she suffered depression, but here in Canada, they don’t think [this] about menopause. After menopause, life starts. Others described menopause as a natural process or just another stage of life. This, too, can be considered a typical perspective on menopause.

Mindy Fried’s personal essay, The SWAN Study: Gender, Race, Identity, and Menopause, broadens the frame as she intertwines her experience as a participant in the longitudinal Study of Women’s Health Across the Nation (SWAN) with data on race, culture, and identity drawn from the study’s findings. A sociologist and experienced researcher herself, she is struck by how SWAN gave her a regular opportunity to reflect on the process of growing older. It also alerted her to information about her own health, including issues associated with the menopausal transition. To these personal benefits, Fried adds the potential for the study’s data, collected from a diverse population of participants, to improve the lives of aging women.

It is a poet’s voice that ends this section. In Slouching towards Menopause, Joanne Gilbert personifies the unwelcome visitor that shows up just when she thinks the endpoint is near:

I wasn’t glad to see you

after almost a year of

living without you.

Your return, unbidden, unwanted

unhinged me

With sustained metaphor, Gilbert poignantly captures the uncertainty many women typically experience during perimenopause.

Meno-Typical establishes the master narrative as a foundational reference point. From here, the collection branches out to extend the reach of menopause discourse.

Two: Out of Step

Out of Step shifts direction with stories that fall outside normative experience, where the transition to menopause does not happen at the age or in the way it is expected to happen. These pieces challenge our top-of-mind ideas about menopause, about aging women. We learn about a medical condition, primary ovarian insufficiency (POI), from both clinical and personal perspectives. In Before Your Time: When Menopause Comes Too Soon, the voices of young women pierce the narrative that perimenopause and menopause are experiences reserved for women in midlife. Co-authored by medical sociologist Evelina Sterling, an adolescent health physician, and two patient advocates, this chapter weaves together facts, figures, and health issues with the words of young women experiencing POI. One woman, age thirty-seven, said the following about her experience with POI:

My diagnosis was unexpected and unwelcome. Nevertheless, my POI had a strange, uplifting effect on my life. I now recognize the importance of life and what a gift it truly is…. Don’t get me wrong, like probably all women with POI, every day that goes by, I continue to wish that my diagnosis could be reversed. Yes, I still long and wish for my fertility back. Yes, I worry about my hormone levels, my bone loss, my early aging, and all the other things that come along with POI. But now, I see every day as a learning day.

Yolanda Kauffman, a social worker and contemplative photographer, intermingles images with words to offer an individual perspective on too-early menopause. In the preface to her chapter titled Shadow Story, she notes how her creative practice helped transform a devastating and painful thirteen-year event into a mystical and powerful experience of growth and learning.

Award-winning poet Donna J. Gelagotis Lee begins her transition story, at age forty-one, with a medical pronouncement—the kind that probably has given many women false ideas about how and when most of us reach menopause. Not suddenly, at some predetermined age in the early fifties, but through a series of bodily and other changes over a progression of years:

Forty-one

Too young for menopause, the doctor says

as I look at a picture of his wife, almost

my age, and wonder what he’ll be telling her

if she wakes up in a sweat one night

In stanzas titled by age, year by year up to fifty, Just before Meno-pause takes the reader through a perimenopausal tour of curiosity and uncertainty. Lee’s poetic exploration questions and discovers, ponders and reflects, in ways that will resonate with many.

What about an early menopause that isn’t really menopause? Georgiann Davis, a woman with complete androgen insensitivity syndrome, recounts her psuedo-menopause experience in a compelling story that begins as follows: Menopause often marks a transition in a woman’s life, as it did for me … only I was a teenager when doctors surgically shaped my body leaving me in what they labelled ‘postsurgical menopause.’ I was born intersex, but like other intersex people, I wasn’t told the truth when I was diagnosed. In Patches Not Pads: An Intersex Experience with Postsurgical (Pseudo) Menopause, sociologists Davis and Koyel Khan draw on Georgiann’s intersex experience to make the case for holding doctors accountable for their constructions of both intersex and menopause status. The authors touch briefly on voices missing from this volume by asking questions about how the lived experiences of trans men and women might add to the discussion of socially constructed menopause.

The pieces in this section see beyond the master narrative of meno-pause to a broader narrative framework that includes these seemingly out-of-step experiences. If we reconceptualize meno-typical to include the atypical, we can grasp the range of identity and experience possible during the menopausal transition.

Three: Blood Relations

When thinking about our own reproductive experiences, we use our connections with others as both a guide and sounding board to help us interpret and negotiate these experiences. Relationships matter, and connections with others shape how we see ourselves. The pieces in Blood Relations explore how relationships of various kinds—mother and daughter, woman and partner, women helping women—influence perception, decision making, identity, and sense of community thr-oughout the transition to menopause. 

Our contributions to this volume, which open and close this section, explore the mother-daughter connection from different directions. In Waiting for Seventeen Days, Heather Dillaway shows us the intimate bodily knowledge that may exist between mothers and daughters. When she and her daughter download an app to chart their menstrual cycles together, an unexpected perimenopausal event catches her off guard: The most jarring part of the lateness was that I had been looking forward to using the period-tracking app with my daughter. I was almost ashamed to tell her I had nothing to track. Being seventeen days late that month meant being unlike her, when I thought we now were moving in parallel. Finding the coincidence of her daughter’s menarche and her peri-menopausal event clarifying, Dillaway discovers another point of commonality: adjusting to their respective evolving life stages together.

In Menopause Claimed, Laura Wershler explores how a workshop experience revealed previously hidden significance in the reproductive connections between herself and her mother. She describes how her mother’s loving presence seeped into each memory that surfaced in a guided visualization through the blood rites, from menarche to menopause, sparking this insight:

What stuck in my mind was the recent loss of my mother…. I was still recovering from the physical and emotional exhaustion of being her primary family care provider, of watching my beloved mother struggle with advancing frailty. I realized at that moment that only when she was gone, when I was sixty years old, did I feel as if I had finally reached menopause.

Wershler comes to appreciate the interconnectedness between all women (not just between blood relatives), whatever our experiences with the blood rites might be.

Evolving relationships with her partner and adult children form the backdrop to Marie Maccagno’s quest to transform her relationship with herself. In Finding Bedrock she travels both inwards and outwards, seeking a foundation on which she can ground her life. She starts from a place of deep vulnerability: For many weeks, I felt as if I was living behind plexiglass, a see-through barrier keeping me apart from the life going on around me. My nerve-endings felt numb, my thought processes like thick mud sliding slowly down a shallow slope. Questions about my future circled endlessly in my brain. Disoriented by an unexpected diagnosis and a major relocation, Maccagno leans into her rich connection with nature. Walking—through forests and mountains, over roads and trails, on the Camino de Santiago—and writing become pathways to a new way of being with her family and herself.

Beyond familial relationships, friends and peers also serve as a benchmark. The identities and experiences of others can help us interpret our own, as we see in Dear Magnolia, Gillian Anderson’s in-depth analysis of The Perimenopause Blog:

A central and organizing narrative evident in Dear Magnolia is perimenopausal women’s desire to connect with other women at this stage in their lives. They want someone to talk to, to listen, to relate to, and confide in. Someone they can share their feelings and experiences with. Women want support and are online actively creating or searching for a sense of community.

Anderson recognizes the online support community developed by Magnolia Miller as part of the larger historical record of how women use their relationship and community-building skills to support one another during transitional times. 

The personal and collective narratives in Blood Relations illustrate how our social-emotional relationships influence, contribute to, and help us make sense of our transitional experiences.

Four: Unleashed

The last section explores how women unleash themselves from expectations, societal norms, and assumptions about the aging re-productive body. These pieces are about seizing the freedom to be, to create, to push boundaries. Through both ordinary means, like needlework, and transgressive actions, like an illicit affair, we see how women can reimagine their lives, challenge what is expected of them, and take risks that may or may not pay off.

In Harsh Blessings: On Finding Poetry at Fifty, Magali Roy-Féquière explores how the fresh perceptions that menopause thrust upon her unleashed her poetic soul. This gender and women’s studies professor writes: Before menopause, I had no idea I could create with words. Distilling impressions and experiences from a period of dis-orientation she calls both exciting and sad, Roy-Féquière expresses her newly accessed creativity in a series of poems forged with vivid imagery and visceral language.

Philosopher Sylvie Teillay-Gambaudo digs into issues of gender, phallogocentrism, and dominant medical discourse in Uninhabitable Lives, making a case for why we need female-centred narratives on what menopause actually feels like. Her in-depth analysis of two films examines what are considered to be transgressive behaviours and the consequences unleashed for the characters involved:

While seeking cinematographic narratives of menopause ex-perience, I was struck by how frequently aging experience was depicted alongside, or enmeshed with, other experiences that could be categorized as uninhabitable…. I will discuss how the aging narratives in Notes on a Scandal and Carol are presented in a dynamic of mutual support with other narratives: criminality and aging on the one hand and homosexuality and aging on the other.

Women’s experience, she concludes, has the transformational power to render visible those experiences that social conventions conceal.

Victoria Team’s chapter, Perimenopause: The Body, Mind, and Spirit in Transition, conceals nothing, providing the reader with a first-person, real-time account of one woman’s topsy-turvy journey through the stages of perimenopause. Team invokes the diversity of her life experience to tell a story full of wonder, dismay, confusion, family, and spirituality. She unleashes vulnerability to share embarrassing incidents: Once at a social gathering in a café, I had a hot flush and dizzy spell, felt a massive uterine wave, and noticed a stream of blood running through the mesh chair to the floor. She unleashes honesty to disclose actions at odds with her strongly held Christian beliefs: I appreciated and sought compliments. This desire was so strong that I actively tried to attract people to whom I was not attracted myself. She unleashes her desire, at age forty-eight, to prove she has not lost her reproductive ability: Something powerful compelled me to try to get pregnant again. As a doctor, she unleashes her medical training to seek answers and solutions to confusing physical symptoms but to no avail: I am a health professional, yet I misinterpreted perimenopausal symptoms that I experienced, attributing them to an unknown serious illness. By conveying the complexity of her own perimenopausal transition, Team assures those who may have similar experiences that they are not alone.

One of the most well-known feminist works of art is the subject of Anne Barrett’s essay "From the Crowning to the Crone: Extrapolating Judy Chicago’s Birth Project to Older Women. Her essay examines the broader implications of the Birth Project for revisioning women’s lives beyond their youth and outside of their reproductive lifecycles." Barrett explains that Chicago herself hinted at a more expansive understanding in her writings about the project, pushing beyond the conceptual confines of women’s reproductive capacity. In addition, excerpts from the