This is Real Women, Real Bodies: Your destination for trusted health and wellness advice, reflecting the untold experiences of people like you.

By Amber Sparks
Apr 09, 2020 @ 3:30 pm
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Julian Birchman

I’m a baby Gen Xer, born in the last year of the generation, so I grew up worshipping my friends’ older sisters and brothers, the bands they were into, the movies they loved. As a preteen, I’d tag along to Jane’s Addiction concerts, sneak downstairs at slumber parties to watch Singles and Slackers, and wear slip dresses and fishnets and Docs like the cool kids. And I’ve been watching with increasing interest as my idols — the disaffected slackers, the latchkey kids — have moved into middle age with exactly the same sense of toughness and cynicism you might expect from the generation that popularized grunge.

I’ve been hoping, to be honest, that they’d do menopause differently than previous generations. I remember women my mom’s age talking about menopause, Suzanne Somers hawking hormone replacement therapy, and the cheery emphasis on femininity. As an aspirant Xer, that earnest, Earth Mother stuff made me cringe. Many other women, including my otherwise very feminist mother, found their answer in not talking about it at all (or silently tinkering with the thermostat when no one was looking). Now that I’m closer to the change, I want to know what to expect, and I’m more interested in the science than the spin, and other Gen Xers have not let me down: The conversation itself is finally changing.

Darcey Steinke, one of the voices of the generation — she wrote the seminal Gen X novels Jesus Saves and Suicide Blonde and interviewed Kurt Cobain ffs — recently published a book about her own experiences with menopause, Flash Count Diary. It’s unflinching and addresses the gamut of menopause, including a reminder that most animals, unlike humans, don’t live past the end of fertility. (Woof.) She writes that sex in menopause can feel like being a teenager again: it’s uncomfortable and weird. “My feeling was there’s a lot of information but a lot of it is very misogynistic. Like, you look on the list of symptoms on a hospital website and it says ‘senile ovaries.’ I mean, nobody says ‘senile penis,’ you know? Or, like, ‘atrophied vagina.’ The misogyny is kind of built into it.”

Whether we’re looking at message boards around infertility, something I experienced, or mining for menopause information, so much of what’s out there centers cishetero relationships and male partners. It is a change in our bodies, our lifestyles, our energies and desires, but it is framed as the loss of what women have been valued for in society: the end of our childbearing years. “We live under a patriarchy still,” says Steinke, “and so I think while men have an interest in puberty, because there’s gains for them; they’re interested in female fertility and birth, because there are gains for them, but there’s nothing for them in menopause, so there’s a limited amount of information there.” It’s no wonder Gen Xers are not as interested in finding the advice available under this paradigm.

“I think there’s historically been this fear that if you were honest about where you were on the fertility scale, you might not have a man’s protection,” says Steinke. “But things are changing, and we don’t have to feel that way anymore.”

I’m not in menopause or perimenopause yet, but you better believe the last thing I care about is my ability to still be a sex goddess or the loss of my utility in childbearing. I just want to know what the hell is going on with my hormones and what my options are for handling them. I want to know the worst that could happen, not the best.

Heather Corinna, Gen Xer and founder of the real talk sex-ed site Scarleteen, says I’m not alone in that. “It’s important to note that people before us have talked about this, by all means. We just maybe haven’t heard them for a few reasons, including that peri-, menopausal, and post-menopausal people often aren’t heard, period, in Western culture, so the same goes for that info.” They're confident their cohort is disrupting that status quo. “For one, I think it’s fair to say that a lot of us do not want to hear about the great spiritual journeys that await us in this, or have a lot of soothing, so much as we want to know what the fuck is happening, what to expect, and what we can do about it. We’ll take care of the rest of our own stuff. We are literally a latchkey generation, on the whole; however we might feel about it, this is how we do things.”

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Dr. Wendy Wolfman, a professor of Obstetrics and Gynecology at the University of Toronto who holds the Carol Mitchell Chair in Mature Women’s Health, and is the President of the Canadian Menopause Society, bemoans that inaccurate information abounds, and that her Gen X patients often have no better luck than anyone else in finding the answers they seek. Though, she says, “there is reliable, good information out there, if you look in the right place.” She recommends going straight to medical experts, on sites like Menopause.org, The International Menopause Society, and menopauseandu.org

One big hole of misinformation? Exactly when menopause starts. The average age of menopause is 51 in North America, Dr. Wolfman says. “But that’s half before, and half after. And up to 1-2% will develop menopause under the age of 40, and I think that group of people have been totally ignored, and their options of treatment have not been presented in an accurate way. And many will have symptoms in perimenopause, the four to five years before menopause.” Katy Lemieux, 37, had a total hysterectomy, which put her in surgical menopause, or menopause kicked off by physical removal of her ovaries. “I was in no way prepared for how huge of a life change this would be,” she says.

The sense I get from my Gen X peers is they’re not interested in enduring that tumult. “I’ve become fierce with my doctors over my well-being,” says Joanna Delooze, who lives in the UK. “I stopped giving a shit if they didn’t like it.” Women like her want to hear more about their options to feel better, and now.

“There’s a whole variety of things, and there’s no one blanket option now,” Dr. Wolfman says. “The best treatment for symptoms that include hot flashes, night sweats, mood issues, and sleep disruption around menopause is hormone replacement therapy. It can be used safely by many women who are symptomatic. Local estrogen therapies are currently one of the best treatments for vaginal dryness, for example,” Dr. Wolfman says.

Plus, there are medications that can address nerve pain; and for premenopausal women, antidepressants can provide relief from vasomotor symptoms of menopause, including night sweats, skin flushing, and hot flashes; and oral contraceptives, which can help manage irregular periods, hot flashes, and other hormonal symptoms. Gen X is the Prozac generation, after all, so we’re comfortable with the idea of mood stabilizers, and using birth control to achieve various lifestyle improvements.

“Psychedelics have helped navigate body and psyche shifts related to fertility for me,” says Tanaïs, author and founder of the beauty company Hi Wildflower. And lots of Gen X folks are willing to experiment with other treatments, too. (Acupuncture and cognitive behavioral therapy both also make the cut as far as Dr. Wolfman is concerned.) As J. Chamberlain, a Gen X artist who is going through menopause now, says, “What’s annoying and sad is how menopause is dismissed by many as just another thing we have to do, like grocery shopping.” We are a generation that’s fiercely attached to the ideas of freedom and independence. Of course we’re applying that desire for control to the hot-flash-and-hormonal time period rather than just riding it out.

And to the topic of exactly who is riding this out: Gen X is perhaps the first generation of women to hit menopause accepting that queer people, non-binary folks, trans women on HRT, and trans men may be riding alongside us, too. Corinna, who is non-binary, is writing a book due out in spring 2021, called What Fresh Hell is This? Perimenopause, Menopause, Other Indignities, and You—a Guide, which they call an inclusive, horrified-but-guardedly-hopeful tour through perimenopause and menopause. “I actually had to go back into therapy writing this book because of all this research I’ve been doing; so much of it is misgendering, and it can just be painful,” they say. “There’s also just very little out there for queer people. You’re reading this book or article and they’re talking about ‘the husband,’ and it’s like, wait, what? Or they’ll talk about if you have vulvovaginal issues, that of course the biggest issue is that a penis needs to be in your vagina, which, yeah, that’s not an issue for everyone.”

Perhaps the most novel among the ways Gen X is approaching menopause is seeing it as a positive in the first place. Bethany Ball, a 47-year-old writer in New York, says she's embracing the moment to take on some healthier habits. This, she says, is in contrast to her mother who “was a maniac, drank too much, ate a lot of junk. I’m trying to be really healthy, get my exercise, do yoga, eat well, take care of myself.” Many are turning this experience into something they can manage and exercise power over, which Dr. Wolfman owes to having strong women pave the way ahead of us. “I think that is one difference; there are now more important, visible older women who provide great role models for younger women, [and show] that women can provide important contributions to society after menopause,” says Dr. Wolfman. “Women live longer now. We live a third of our lives after menopause.”

It’s a chance to reframe our thinking about ourselves and our value, too. “We’re becoming more discerning, not less relevant,” says Carrie Esposito, another Gen Xer in the midst of menopause, when talking about the stereotype that women fear becoming unimportant when their fertility fades. Not for nothing, but plenty of women who’ve either had bad luck, or a generally exhausting time navigating fertility, are happy to bid all that stuff adieu. I have PCOS, and I’ve suffered through the worst painful periods for more years than I can count, while going into sky-high debt to get pregnant with my daughter. I’m really not sad to say good bye to periods, you know? Michaella Thornton, 42, is a baby Gen Xer like me who conceived her daughter via IVF with what she calls her “last golden egg.” She says, “I am at peace with saying a fond fucking farewell to fertility because I never had it to begin with.”

This is also the generation that made childfree-by-choice an honorary title rather than a hushed, shameful identity. Marcelle Heath, Gen-Xer and curator of the Apparel for Authors interview series, says, “I never cared about being fertile, and am happy without children, so perimenopause doesn’t mean the end of anything — rather the focus for me is on change.” That change can be fiery and hot (yes, literally). “When I have a hot flash,” says Helen Grant, 55, “I just tell myself I’m assuming my final dragon form.” And Ball says, “I’m embracing my inner crone.”

Indeed, the sex-life shifts that come with menopause can often be something to celebrate. “There are some surprisingly amazing perks to living in an infertile body as a post-divorced 40-something,” Thornton says. Gen-X blogger and teacher Janet Rodriguez adds, “Menopause is the best damn time of life: I write better, think better, play harder, and I get more action than most of my friends.”