In early May I turn forty-seven years old. Which at times, I find almost unbelievable because there are many moments in which I feel as uncertain and ungainly as I did at fourteen. Which, in fact, makes total sense because at forty-seven I’m as hormonally challenged as I was in 1986. Yep. Let that sink in. At forty-seven my hormones are as out of balance as they were when I was a spotty, moody, sometimes-really-unpleasant-to-be-around, teenager. Why? Perimenopause.

Perimenopause. Let’s say that again because it’s so unfamiliar to most people that my writing app tells me it’s not a real word.

Perimenopause, the stage all women go through, generally between their early forties and early fifties. These sometimes crazy-making years riding the hormonal rollercoaster which precede menopause and mark the end of a woman’s reproductive stage.

I continue to be astonished, ASTONISHED, by how little this is acknowledged or talked about. Here I am, in my fifth decade as a female human being and before I stumbled across perimenopause, while doing some health research four years ago, I had no idea that I would experience a second major hormonal transition in my life.

We hurtle into our teenage years with some anticipation of ‘hormonal stuff’. Our parents, caregivers and teachers are under no illusion that this period is challenging for the adolescent and the people around her. So why don’t we do that for perimenopausal women? We’re left to suddenly find ourselves in this unanticipated territory of mood and sleep disruption, short term memory issues, foggy brains, irregular menstrual cycles, heavy periods, migraines, digestive issues, low libido, weight gain, vaginal dryness and bloating, amongst other symptoms. We’re expected to continue moving at full tilt, all the while juggling careers and families, without any awareness or support. The people around us wonder what on earth is up with the sometimes crazy middle aged women in their lives, without understanding that their hormones are out of balance and it has a major physiological, psychological and often spiritual impact.

My perimenopause started in my early forties and was exacerbated by a series of miscarriages and the subsequent stress of these and other significant life events. Over the last several years I’ve come to understand how complex and extraordinary our endocrine system is. It’s tempting (but impossible) to tease out which symptoms are due to prolonged stress and which would have occurred regardless. It’s also a moot point because it’s just not that simple. For starters, pregnenolone – the master hormone for our sex hormones progesterone, estrogen and testosterone – is produced by the adrenal gland. The prolonged stress of our far-too-normal overwhelming lives, has a significant effect on our adrenal system and consequently how much pregnenolone is available for the necessary balance of sex hormones. In short, for most women in their middle age, life is chronically stressful.

So what can we do about it? How can we support each other and ourselves through this major hormonal transition? Well, quite a few things actually.

We need to talk about it, especially since our medical system certainly doesn’t.  It seems to me that one of the unhelpful consequences of the tiny nuclear families so many of us live in, is that we’re missing the wise grandmothers and aunties who can say to us, “Oh sweetheart, this is normal, I’ve been through it. I know how hard it can be, here’s something that will help.” In my experience, talking about this stage in my life with close friends, family and a knowledgeable and supportive health practitioner has made a huge difference. Understanding that this is natural and normal and that I am not in fact going crazy, has helped helped a great deal.

On a very practical level, what continues to be of quite remarkable help, is an awareness of those things that support me in managing my version of perimenopause. I’ve learned the hard way – as have many women – that while caffeine and sugar (dark chocolate, sigh) provide me with an immediate and glorious fix to my fatigue and low mood, the pay off is not worth it. These things stress my adrenals further, create even more imbalance and do not make for a happy Tink (or husband, for that matter). I’ve learned that stress makes perimenopause worse and so finally, after years of not really committing to it, I’ve found that a daily practice of yoga and meditation has a disproportionally positive effect on my mind and body. And finally (because I could go on but should get off my soap box), sleep. Nothing seems to knock me off my perch more than bad sleep, I’ve learned that having a light and early dinner in order to not overtax my digestive system, getting off my computer or phone by 9pm, in bed by 10pm and a short breathing exercise to relax my nervous system, are key ingredients for a decent sleep.

There is so much to say about this but in this instance, I’m not going to. Instead, I’m going to finish what has turned out to be an emotional plea to really just talk about this stuff with a shameless sales pitch. In navigating my way through chronic illness, adrenal overload and perimenopause over the last several years, I’ve seen a number of practitioners. My GP is very good, but he’s heavily time constrained by a system that is fundamentally not suited to treating chronic illness or, in the case of perimenopause, responding to something that is not a pathology but still requires support. However, recently I’ve been working with (i.e. as a client) and for (i.e. writing social media content as a way of continuing my herbal medicine study) a Kapiti based naturopath and medical herbalist. Her name is Daisy Wood (her real name not a perfect brand name!) and she is specialising in perimenopause.

Daisy is at the tail end of perimenopause herself and the majority of her clients are women navigating their way through this phase of life. She is highly motivated, passionate, very thorough and kind. I haven’t delved into it here, but there are herbs that have been used by wise women (and indeed male healers) for thousands of years in the West and East to support perimenopause and menopause.  Daisy works with these herbs in addition to nutrition and other lifestyle factors. If you’re sceptical about naturopathy and herbal medicine, let me just add that my GP has prescribed the same herbs Daisy works with. If you live in Kāpiti, or the Wellington region, you can obviously go and see her, but she also has an excellent private Facebook group called First Flush where she very regularly posts material on perimenopause and converses with her community. Her posts on Instagram and Facebook are information rich and easy to read. If you want to learn more about perimenopause and find support for it, then my recommendation of her is wholehearted.

Originally posted at tink.nz.

I started writing this two nights ago, on the eve of a full moon, as the rest of the house was quiet, even the Guinea fowl. Last night, I was supposed to go to a gathering of wonderful women but I found myself too raw to be with people I didn’t know, so instead I continued writing. By the time I finished, I wasn’t at all sure what I’d do with these words. This is intensely personal, The thought of people I don’t know reading this makes me feel very vulnerable, but actually there are some things I really need my friends (and by friends, I mean my actual friends not just those slightly random people who’ve friended me on FB but I’ve never met) to know and maybe this will end up being read by, and resonate with, other women who’ve shared a similar experience.

We don’t usually have chocolate cake and ice-cream in the house but yesterday we had a special occasion, today there are leftovers and tonight I’m eating – without really tasting, fully aware that I’m self-medicating with food – my second bowl of chocolate cake and ice-cream.

A couple of hours ago, one of my close friends told me, with thanks to a sperm donor, she is pregnant. This evening, as she sat in front of the fire chatting excitedly to my husband about the amazing story of how quickly and easily she became pregnant, I stood in the kitchen out of sight, tears silently rolling down my cheeks as I cooked dinner. How could I possibly let her know that I found listening to this wonderful news almost unbearable? How could I tell her that this pregnancy, triggered in me a wave of grief so embodied it made my chest ache?

Last week I listened to a podcast entitled “Getting Grief Right‘ with grief counsellor Patrick O’Malley. He talked about the disservice that has been done by the dominance of Elisabeth Kübler-Ross’ five stages of grief and how there is in fact no one roadmap for grief. He went on to say that after decades of working with people who are grieving, it has become clear to him that one of the most important things people need is the opportunity to share their story and for it to be witnessed. People who are grieving need empathy, real empathy, which is actually much harder than it sounds (I know this from being on the giving end as much as the receiving one) because basically it means being able to be fully present for someone without giving advice or making well-intentioned comments designed to try and make the person feel different.

Over the last four years, when I’ve talked about the miscarriages nearly everyone has responded with undeniably well intentioned comments which are intended to shift the way I feel. For example ‘At least you know you can get pregnant’ or the variation ‘At least you know what it’s like to get pregnant’, then there’s ‘So many women go through this and go on to have a healthy baby, this will happen for you’, or ‘You just have to trust your body’s wisdom to have miscarried for a reason’, or ‘You’re still not too old’.

Even more challenging I think, has been when I’ve shared the decision to not continue trying and my process of making my peace with that decision and then having someone say ‘Oh that’s when it will happen for you, just stop trying and relax and you’ll get pregnant.’ I know they’re only trying to make me feel better, but essentially what this person is doing is disagreeing with me – I’m saying I’m not going to have a baby and they’re telling me I probably will.

Hardest yet, I think, has been this. A while ago I ran into a distant friend who is an older Mum to a new baby. She told me she was ‘shattered’ and went on to say that she wasn’t sure she’d recommend motherhood. She seemed to not entirely be joking, but I mostly took it as being something a wickedly sleep deprived new Mum might say. However within half an hour, she’d sent a follow up message saying that she knows babies is a sensitive topic for me, so she mostly wants to hide from me, but in this instance didn’t and said what she’d said because she didn’t know what else to say. Again, I have no doubt at all that she meant well and that she was exhausted but it had the opposite effect of making me feel better.

Four years ago I lost three babies, all less than eight weeks old, within six months. It is only recently I’ve been able to refer to them as babies rather than ‘miscarriages’. I am still grieving, although now not so much for them — as I consciously made time and created space to grieve after each miscarriage — but for me. For the loss of something I really, REALLY, really wanted and felt, deep in my soul, was a part of my future. I am now grieving for the loss of an opportunity to feel a baby grow inside me and to be a Mum to a tiny human Adam and I created together. 

I’ve just turned forty five. I’ve been unwell for the last four years. Losing those babies knocked the stuffing out of me. A whole bunch of tests later it would seem that a considerable amount of stuffing had been knocked out of me before I got pregnant. After years of prolonged stress, I was, the doctor assumes, adrenally fatigued before I conceived. Four years later I feel infinitely better, but it’s anticipated that I’ll need another two years to fully recover. My child bearing window is rapidly closing (if it hasn’t already). I would really love to have a baby but to be perfectly honest, right now it feels like a choice between me and a baby. At the moment, even a few days of insufficient sleep sets me back and while it seems that nothing is guaranteed with motherhood, I’ve yet to meet a mum who doesn’t suffer through months or years of sleep deprivation.

To add another layer to this story, I was, as a psychologist once said, a parentified child. I’ve spent a lot of my life being a mother to my alcohol dependent mother. I was still doing that, in many respects, when I got pregnant. It was only when I moved Mum into dementia care a couple of years ago that my whole body heaved a sigh of relief and I felt that weight of responsibility lift. So while it might seem to some people reading this that I’m being selfish choosing my health and vitality over a baby, the decision follows decades of putting someone else’s wellbeing ahead of my own. However this layer doesn’t diminish the grief I feel for the loss of mothering my own baby and it is a grief which is impossible to avoid because I’m surrounded by friends who are mothers of young children or babies or who are mamas-to-be.

I read this to Adam last night and he gently reminded me that I need to ask for what I need, not just for what I don’t need. So here goes. I need my friends to know that I love you and love spending time with you but sometimes it’s just too hard to go to your children’s birthday parties or your baby showers. I love hearing about your children and sometimes it would mean a lot if you would stop and acknowledge that I lost mine. Pause for a moment and say ‘I’m so sorry Tink, sometimes it must be really hard to hear me talk about my children all the time.’

I wish I’d had more time with my Dad to talk to him about his experience as a doctor. I have a deep interest in healing and I remember one of the few things he said about his life as a surgeon was that one of the great failings of Western medicine is it’s non-acceptance of death. In 2013, in June, then September and then again in December I lost a baby. Now I’m coming to terms with the loss of my dream of being a mother. Friends, wherever you are but particularly those of you I see more often, I need you to witness that grief and if you can, when you can, I would be so very grateful if you could hold a bit of space for it.

Originally posted at tink.nz.

A little while ago, a friend admitted that when we first met four years ago, she found me slightly intimidating. I was, she said, doing all these amazing things and well on my way to becoming like another friend of ours, who is often cited as an example of an Amazing Woman Doing Amazing Things. But these days I’m not doing anything noteworthy and a part of myself, my ego most likely, felt deflated by her words. “Oh” Tink’s Ego said “but I want to be amazing again…”

An even littler while ago, I had a dream about not being enough. I dreamt of familiar people who do exceptional things, busy as bees in a collective working space and I felt I should be there with them. Instead I was on my way to a leisurely lunch with my husband and I was conflicted, the familiar voice of my inner critic was fierce with her Shoulds. “You should be doing something worthwhile” she said.

What haven’t I been doing? I haven’t had a job, I haven’t been out saving the world, I have not aimed for fast and/or high growth for ElementAll, my online clothing business. Why? Quite simply because I haven’t been well. Savings, a very small business, a family inheritance and a husband have supported my much lower key lifestyle.

What have I been doing? I’ve tried to rest but I’ve also moved my mother into dementia care, sold a family home, got married, taken care of our animals, slowly cultivated my relationship with Peka Peka, equally slowly cultivated ElementAll, tried to recover from miscarriages and learned a lot about food as medicine. None of these things are ‘tweet-able’ (with the possible exception of the clothing, although slow growth is far from sexy). For me, of course, they’re all significant but as far as my tribe goes, they’re not noteworthy, they are in fact very ordinary.

Of all the things I’ve been doing over the last four years, the most challenging and – in my experience – the most culturally unacceptable (apart from not drinking alcohol) has been rest. I differentiate here between sleep and rest because there would seem to be widespread consensus now that good sleep is critical for health. Rest, however, is a much more slippery creature.

If you search for synonyms of rest you will find a list of verbs that describe actions which are mostly neither aspired to nor celebrated: Relax, ease up/off, let up, slow down, pause, have/take a break, unbend, repose, laze, idle, loaf, do nothing, take time off, slack off, unwind, recharge one’s batteries, be at leisure, take it easy, sit back, sit down, stand down, lounge, luxuriate, loll, slump, flop, put one’s feet up, lie down, go to bed, have/take a nap, nap, catnap, doze, have/take a siesta, drowse.

If you search for antonyms of rest, you will find a list of actions we reward with praise, money (although generally much less of that in the world of non profit endeavours) and social media attention: Advance, awakening, busyness, action, energy, employment, action, labor, strive, struggle, toil, slave, sweat.

However it turns out that rest is essential for a healthy mind. “Idleness is not just a vacation, an indulgence or a vice; it is as indispensable to the brain as vitamin D is to the body, and deprived of it we suffer a mental affliction as disfiguring as rickets,” essayist Tim Kreider wrote in The New York Times. “The space and quiet that idleness provides is a necessary condition for standing back from life and seeing it whole, for making unexpected connections and waiting for the wild summer lightning strikes of inspiration—it is, paradoxically, necessary to getting any work done.”  (See also Why Your Brain Needs More Downtime)

The body also needs rest. “Right now you’re reading. But for a minute your thoughts may wander (you’re reading about rest, after all) and your mind shifts to random thoughts. You’re doing “nothing.” Meanwhile your body is re-making you with extreme velocity.”  As Matthew J. Edlund M.D. pointed out in a piece for Psychology Today, rest is regeneration. “Inside each of your ten trillion cells fly a billion protein-protein interactions every second. Every one is an information event. Every one helps change you, remake you, so you never, ever stay the same. But as far as you’re concerned, you’re doing “nothing.” You’re just “wasting time.”

The stress of significant life events and decades of relentless doing have left my body and mind depleted. This has shown up as fatigue, digestive issues, allergies and anxiety. Test results this week have confirmed – finally a diagnosis – I have adrenal fatigue or adrenal insufficiency. This means that my body is producing much lower than normal levels of cortisol (the “stress hormone”) which influences, regulates or modulates many of the changes that occur in the body in response to stress including immune responses, anti-inflammatory action, blood pressure, blood sugar levels and central nervous system activation, amongst other functions.

Adam has encouraged me, and my body has forced me, to rest. There are days where cooking meals, walking the dogs and vacuuming is all I can do before sinking into the sofa with a cup of herb tea. Until I find my attention caught by the long grass and drag myself outside to do twenty minutes of weed eating. Because it turns out I’m not very good at not doing and I’m very good at worrying about the things I’m not doing. I sit down and quite quickly become subtly agitated by the joint forces of my inner critic and busyness addict and within minutes I’ve thought of something which needs to be done.  A big house, an online business, animals and a spray free garden mean that there is never nothing to do and in case I run out of chores, I’ve also accumulated a huge pile of non-fiction books laden with information. Thus I get caught in a loop of needing to rest but resisting it and I end up doing everything – including the rest – in a kind of half assed way.

But finally I’ve had enough of taking one step forward and one backwards and slowly (everything seems to be slow these days) I am learning to rest, to provide myself with the essential space I need to heal.  Unexpectedly this space is teaching me other things. It is teaching me to befriend my Inner Critic,  thank her for The Shoulds and remind her that she is not in fact driving this vehicle. It is teaching me to befriend my fear, particularly of the unknown (being unwell for four years and not knowing why has done a stellar job of generating fear of the unknown). It is teaching me to find joy in the ordinary, in slow cultivation rather than instant gratification, and it is teaching me to unwind much of what my culture has taught me about growth and progress and success….It would seem that sitting in the vegetable garden and quietly observing has taught me as much as getting stuck in with tools and a determination to create order.

Poet, peace activist and spiritual leader Thich Nhat Hanh has said that “We humans have lost the wisdom of genuinely resting and relaxing. We worry too much. We don’t allow our bodies to heal, and we don’t allow our minds and hearts to heal.”  Slowly, one very mundane day at a time, I’m reconnecting with this wisdom, disconnecting from the addictive busyness, letting go of The Shoulds and allowing my mind and body to heal.

Originally posted at tink.nz.