Chapter 20
Enjoying a New Lease on Life
In This Chapter
Staying on top of your health
Interacting with everyone in your life
Making decisions about work
Finding your passion, honoring your spirit
Getting the most out of your life
Eventually, perimenopause turns into real menopause. One of these mornings you’ll take a look at your calendar and realize that your last period was a full 12 months ago. It may occur to you that you haven’t had a hot flash in ages, and that your moods are smooth and steady. Or you may already be beyond that magic 12-month marker.
Congratulations: You’re post-menopausal! At 16 or 30 or 45 you might not have thought of this as a positive milestone. After all, women in their second half century are old . Dried up. Sexless. Crones. Past their sell-by date. Yeah, right. Tell that to Tina Turner. Lauren Bacall. Gloria Steinem. Astronaut Sally Ride. Billie Jean King. Television Journalist Diane Sawyer. Dolly Parton. In fact, try telling that to any number of your friends, relations, and co-workers who are active, healthy, lively women of — as they used to say — a certain age.
You’ve seen the joke cards and birthday cake inscriptions: “Life begins at 40.” Many menopausal women will tell you that, for them, life began at menopause. In this chapter we talk about why, far from being the end of the line, lots of women find that reaching menopause marks the beginning of the best stage of life. We’ll also talk more about the context of your whole life and all that goes into it, not just about specific health issues.
Going from Menopause to Infinity
Sure, there are health issues to stay on top of after you reach menopause. Throughout this book we talk about the fact that changes in your body’s production of hormones are linked to an increase in your risk for a number of potential health problems, including
Cardiovascular disease (look back to Chapters 6, 12, and 16 for more on heart disease)
Osteoporosis (bone up in Chapters 5, 15, and 16)
Hypertension (more in Chapters 5 and 16)
Weight gain (check Chapter 18 for the skinny on diet and weight)
Memory loss (wait, wait — oh, yeah, remember to look in Chapters 10 and 15)
But you can take advantage of a couple of ways to make this part of life just as enjoyable, or even more so, than it always has been:
Make healthy lifestyle choices. The best lifestyle choices can help to minimize health risks. Sticking to a healthy diet and a regular exercise plan that you love enough to make it a part of your life can go a long way toward keeping you young — at heart and everywhere else (see Chapters 18 and 19).
See your healthcare provider regularly. It’s important to have a doctor who views this stage of your life as being promising and full of potential. When you were a young girl and got your first period, you may have felt like this was a good time to see a new doctor (maybe a specialist in adolescent medicine, and maybe a woman, if you had been seeing a man up to this point).
In many ways, this time of life is a lot like that one. Menopause is just as much a marker as adolescence was that you’ve reached a new stage in your development. If you’re happy with your healthcare situation, consider yourself fortunate and stay with the providers you’re seeing now. If you’re not, though, this is a good time to shop around for a doctor’s or physician’s associate with whom you feel more simpatico. It seems ironic to quote the tagline from a cigarette ad campaign when we’re talking about good health, but here goes. You’ve come a long way, baby. Make sure your health advisors aren’t stuck back in the 1960s in the way they view women at midlife and beyond.
Here are some tips when searching for a new doctor:
• Look for a healthcare provider who sees you as a whole person, not just a medical history or a bearer of symptoms.
• Help your doctor to avoid stereotypes about aging.
• Look for a doctor who advises you to be as active as possible (then follow the advice).
• Listen to the way your doctor talks about you and your health. Is he or she concerned not just with helping you to stay free of disease, but with your overall wellness and happiness?
Working and Playing Well with Others
Menopause and the changes in your life at this time can affect the people around you in various ways. This is certainly true of your husband or partner (who, don’t forget, is also aging). It’s true of your children, your friends, your boss, your co-workers, and everyone else.
Managing a family
Menopause can be a funny time for women with families, especially if you still have children at home. You may have spent the past few years wondering whether your periods would stop before your daughter’s began. Or wondering whether you could have just one more baby. Or living in fear of having one more baby. Whether this makes your life easier or harder, menopause cuts off some of your choices in this regard. Unless you plan to adopt, or fate fixes you up with a partner who comes with ready-made kids, you aren’t going to have more children.
Of course, you may have children still at home. This can be a wonderful time with your children. You may have more patience than ever and more of a sense of perspective on life’s ups and downs. Reaching midlife also seems to make the clock and the calendar pages turn faster. Suddenly the years of parenthood seem foreshortened — the years of childhood slip away faster, and your kids reach new life stages of their own, even as you have. Watching them make this transition brings a host of competing feelings: delight for them, worry, envy at their chance to explore new activities and roles, sorrow at their impending absence, pride at the job you’ve done raising them, or just plain relief.
The other side of this coin is that watching your children grow up may bring you a sense of sadness that these young years have passed for you. Some women find this especially true of watching their adolescent daughters reach their sexual maturity. Envy of youth isn’t pretty, but it happens to all of us to one degree or another. Try not to beat yourself up about it.
Looking back, looking forward
Progress doesn’t always proceed in a straight line. Sometimes it’s two steps forward, four steps backward, and a couple of baby steps forward again. The first medical text on menopause, published in 1837, offered women reassurance that what they were going through was perfectly normal, that menopause was not a disease, and didn’t have to be a big deal to get through: menopause was described as “a temporary inconvenience” was how the enlightened (male) author described the change of life.
Now try this one on. Almost 100 years after this enlightened (male!) author spoke so sensibly of menopause, medical journals took a giant step backward, and began using phrases such as “sheer misery,” “hatred between husband and wife,” and “cow-like passivity and disinterest” when describing menopause and what couples and women could expect from these years.
Do yourself and other women a favor, and refuse to be part of the stereotype, or to put yourself in the care of any healthcare providers who foster this kind of attitude.
You and your partner
When you married or started living together, or when your children were born, the dynamic between you and your husband or partner probably changed dramatically. Instead of going through life face-to-face, concerned mostly with each other, parenthood repositioned you. Your chief (shared) responsibility became your child or children. You began to travel through life side-by-side, facing outward to take care of children, jobs, a home, and all the responsibilities of adult life.
When the last child moves out, the dynamic will change again. By now you both probably have too much going on to re-create those intense, face-to-face, me-and-you-against-the-world days, and you might not want to anyway. In addition to shared interests outside of the home, the members of most couples also have interests of their own.
There are no rules for how a couple should behave at this stage of life together. Many find that this is a time of renewed togetherness and discovery of the changed and developed people you both are. Sadly, others find that the mutual changes in your respective goals, values, and outlook have led to irreconcilable incompatibilities. We can’t tell you what to expect, except to advise that change is almost inevitable during this part of your lives together. This can be scary as you search for new footing together. This period can also be exciting and wonderful, but it almost always takes some hard work, dedication, and commitment. Find what works for the two of you.
If you find that, for either or both of you, this period is simply agonizing, seek help from a professional counselor. You might benefit from couples’ (or individual) counseling if:
One or both of you feels angry and resentful.
One or both of you feels bored and stuck in a rut.
There are unresolved issues over an infidelity.
The relationship is physically or emotionally abusive.
If either or both of you are concerned, don’t wait until counseling becomes a last resort, and don’t assume that the need for counseling means the relationship is over. Think of it instead as an opportunity for course correction and renewal. Neither of you is the person you were when you got together, so it’s unrealistic to expect the relationship to be the same. It’s perfectly reasonable, though, to expect that it can be something new, and something better.
Sandwiched in between
If you’re taking care of both your kids and one or more of your parents, you’re not alone:
Close to half of all Americans between 45 and 55 have dependent children and living parents.
The American Association of Retired People (AARP) says that 22 million Americans take responsibility for caring for aging parents or other relatives.
Most of these caregivers are women (bet you’re not surprised).
Most women caring for older parents are also still employed either full- or part-time.
Caring for aging parents
You’re a part of the “sandwich generation.” As our parents live longer and many of our children stay home longer or return to the nest after leaving, we’re in the middle, taking care of members of both a younger and an older generation. Even as you may be offering loving and supportive good-byes to all the baby birds in your nest and looking forward to having some more room and time and resources for yourself, or yourself and your partner, new nest-mates may come to roost in your home.
If you’re one of these people, we know that you know that bearing this much responsibility — for one or more children, a spouse or partner, one or both parents, a job, a house, and other responsibilities in the community may become so great that just having a guest for dinner or having to feed the cat when your kids forgot to do it can put you right over the top. This kind of stress can get so bad that your health may begin to suffer.
Be kind to yourself. Take steps to get some help:
Enlist the assistance of siblings and other family members (including those kids).
Call on professional help. Ask your or your parents’ physicians for local resources, or call your state’s office on aging (look in the blue pages in your phone book).
Get some exercise nearly every day, and try to eat right.
Get a little respite by spending time with friends or engaging in hobbies.
Investigate adult daycare centers in your area. Even the occasional use of centers or respite caregivers can give both you and your parents a break.
Ask your employer if your company’s Employee Assistance program has resources for adult caregivers.
Retiring Gracefully (or Not)
Being menopausal at home is one thing. For many women, dealing with menopausal symptoms at work can be altogether different. In the United States, women make up roughly half of all the workers in the paid labor force. Most of these women plan to continue working up until they reach retirement age. This makes it likely that you’ll go through menopause while you’re still working.
Taking care of your body on the job
When it comes to workplace issues, some nations are a few steps ahead of others. In the United Kingdom and Australia, for instance, meeting the workplace needs of menopausal women is actually an issue that’s being discussed and worked on.
If you’re pregnant, laws in the United States and other countries protect your job. You can’t, for instance, be fired for being pregnant. And if your pregnant body aches when you stand up all day, the law says they have to give you a chair — or change your duties, or protect you from potential workplace hazards. We think it would be nice if employment law made basic, compassionate allowances for things such as:
Making sure perimenopausal women with unpredictable, Niagara-style periods have access to decent, private bathrooms, and permission to use them whenever they need to. Ever try teaching a classroom full of 4th graders all morning without being given 10 minutes to change a tampon?
Ensuring that a little fresh air actually enters the workplace of women whose internal thermostats are likely to set themselves, without warning, to thermonuclear. Nobody loves a workplace princess who hijacks the air conditioning, but is it too much to ask that the powers-that-be let you cool off for a few minutes to keep you from passing out?
Advice, support, and informed personnel in the company health office.
Time off for medical appointments.
While we’re at it, how about fewer menopause jokes from the guys in the boardroom about hot flashes, and more offers of support?
If you’re dealing with menopausal symptoms on the job, try these tips:
Plagued by hot flashes? Keep cool water or iced tea in the office fridge.
Dress in layers — say, a cardigan or jacket over a shell — so you can remove one or two without your co-workers think you’re initiating a game of strip poker.
Exhausted after a night of insomnia? In the best of all possible worlds, call in and say you’ll be working from home today. Don’t work in the best of all possible worlds? Perk yourself up with a brisk walk on your lunch break.
Looking before you leap
How does the notion of changing jobs (“At your age?”) make you feel? Terrified? Amused? Excited and wistful? If you fall into the latter group, it may be just the right time to think of making the leap to something new. Many women find that, after they’ve weathered the emotional and bodily changes that come with menopause, they feel braver and more able to take on lifestyle changes. The hard truth of knowing that probably a little less than half of your lifespan lies ahead of you may make you view your time as something that’s more precious than ever. This can make you less patient with a job that makes you unhappy.
Don’t let anyone hand you any baloney about old dogs and new tricks. Before you hand in your two-week notice, however, ask yourself some important questions:
What skills do you have to bring to a new job? What kind of work environment do you enjoy? If you can envision your dream job, what does it look like?
Do you want a new job because you want a new job, or because you think it will fix other problems in your life?
What kind of work environment makes you happy? How busy do you like to be? Do you enjoy having people around, or do you like to work by yourself?
How long can you afford to be unemployed while you look for or create another job for yourself?
How will changing jobs affect your health insurance?
Finding Your Spirit in Whatever You Do
So you’ve come out — or will soon come out — on the other side of menopause. Gone are the periods (which, we admit, may be a source of regret for some). Gone are the hot flashes. Gone are the “menopause moments” — those brief episodes of frustrating and embarrassing forgetfulness. In exchange, you get back your sense of emotional well being, your equanimity, and your even temper.
Appreciating the upside
Many women find that getting through menopause brings them unexpected physical, psychological, and emotional gifts:
Freedom from worrying about an unwanted pregnancy: This can contribute to a freer, richer, more spontaneous sex life, as well as to a sense of closure with respect to your reproductive years.
A larger sense of freedom: We don’t just mean freedom from worrying about whether there’s a maxipad in your purse or a tampon in your pocket. We mean a broader sense of freedom from worry about whether you can take care of yourself and your life, and from worry about what others will think of you if you speak your mind or do what you want to do.
More energy: Lots of women talk about not just needing less sleep after menopause, but of having a greater sense of energy, power, and possibility.
Less concern with living according to the expectations of others: In this way, as in others, menopause mirrors adolescence, giving you a sense of play and exploration, an open space in which to reinvent yourself.
Less tolerance for putting up with things that annoy you or waste your time, and less tolerance for people who don’t treat you well: Because (we hope) this is coupled with a diminished likelihood to let anger take center stage in your emotional life, you probably won’t need to blow anyone out of the water with your displeasure. At the same time, you may feel completely comfortable asking an intimidating maître d’ for a better table, explaining sweetly to your insurance company why they’re in the wrong to reject one of your claims, or turning down a lunch date with someone who makes you feel inferior.
A reassessment of what’s important in your life. Maybe vacuuming the living room can wait while you take the dogs for a walk or write in your journal. Perhaps this is the year to turn the chairmanship of the community center bazaar over to someone else so you have time to paint every morning. Maybe you need to get away by yourself for a weekend once in a while, just to walk in the woods or meditate or go a whole day without talking. Or maybe you and your sweet baboo will finally quit putting off that trip to Paris.
Seeing things in a new light
Midlife and the onset of your post-menopausal years are busy and sometimes hectic. Still, we find that this is a good place to stop and rest for a moment. You may find yourself wanting to take stock at this point and ask yourself some of the big questions:
Am I happy?
Am I achieving what I want to be achieving?
Am I making a positive difference in the lives of the people I love?
What do I want to do with the rest of my life?
Some women, at this stage in their lives, report feeling a sense of spirituality and connectedness with others that they had never experienced before. You may have had to deal with the deaths of one or more relatives or friends. You may even be coping with the death of a spouse or lover. Many women at this age have faced health scares of their own. In short, while old age is still pretty far up the road, having to deal with issues of mortality may change the way you look at life. Sadness is normal in the face of unavoidable crises of this sort, but so is a bittersweet new sense of perspective on life from beginning to end.
It’s quite possible, though, that becoming intimately aware of the transient nature of life will just make every moment of it more precious. Take care of your life and the lives of those around you. Live every moment as if it is important — it is.
Facing the Silver Screen
At the video store, do you ever have the urge to ask the clerk to direct you to the section of films starring people who were alive during the Eisenhower administration? Pop some popcorn and invite a few friends over for your very own Menopause Madness Film Festival.
The African Queen: Katherine Hepburn steers a steamboat down the rapids, wins the battle for the Allies, finds true love with a reprobate steam boat captain, and never loses her handkerchief — or her cool.
Bread and Tulips: When bored, neglected wife and mother Rosalba is accidentally left behind by her son and her philandering husband at a vacation rest stop, she takes control of her own life, with charming results. Get the Italian original.
Calendar Girls: Helen Mirren and the members of the Rylstone Women’s Institute of North Yorkshire reveal themselves to be innovative fundraisers.
Fried Green Tomatoes: We love watching Kathy Bates’s repressed Evelyn Crouch as she transforms herself.
The Grass Harp: From a story by Truman Capote. The critics thought this was a coming-of-age story about a young man in the south. We think the real coming-of-age story revolves around the young man’s timid aunt, Dolly (Piper Laurie), who finally learns to stand up for what she believes.
Mrs. Henderson Presents: Who doesn’t want to grow up to be Dame Judi Dench?
Prime Suspect: Helen Mirren again (what can we say?), starring this time as Detective Chief Inspector Jane Tennison in the gritty British television crime drama series.
Shirley Valentine: Pauline Collins finally gets the vacation she’s always wanted — and more.
Something’s Gotta Give: Let’s see . . . Jack Nicholson or Keanu Reeves? Who says older women don’t have choices?
Living Happily Ever After
Your experience of menopause — and of the many years ahead — will be shaped by lots of different things:
Your health
Your expectations for this time and the expectations of those around you
The way the other women in your family view menopause and midlife
The opportunities available to you in your work and your life
When you were a child, people would ask you what you wanted to be when you grew up. Throughout your life you’ve had to make decisions that have helped to shape the answer to this question. A handful of choices you’ve made along the way — about education, romance, employment, where to live — have gotten you where you are today. We hope that’s a good place.
Menopause can be viewed in lots of ways: as a journey, a milestone, a process, a path. We especially like to think of it as a ride that takes you places you’ve never been before and opens new and unexpected doors in your life. Most of all, we like to think we’ve helped you not only to survive this little milestone in your life but to relax and enjoy the ride.
Now it’s your turn to help the women in your life who are just starting down the perimenopausal path. Encourage them to stay informed, to take charge of their own health, and their own lives, and to expect the best (or at least to not expect the worst) of these years.
Finally, we wish you the best of health and all the happiness in the world. Most of all, we hope you never stop asking, “Where do I go from here?”