In Paris, where I teach each July, they don’t believe in air-conditioning. I flash every hour, like a junkie, jonesing not for heroin but for hormones. Besides flashes, I am dealing with insomnia and anxiety. When I wake in the night, my fingers tremble as I reach for the water glass on the side table. In the early mornings the temperature is in the high seventies. If I stay in the shade at the Luxembourg Gardens near the circle of stone queens, the heat does not yet blot out coherent thought. But as the temperature climbs into the eighties and then the nineties, Paris, with its cream-colored buildings, floral effusions, and rows of café tables lined with wicker-back chairs, becomes a furnace.
Evenings, after a day of teaching in a sweltering classroom, I sit on the couch in the fifth-floor garret apartment, trying to write comments on student papers. I feel the emotional blitz, as if I’ve been caught in a lie, and then comes fear. “I experienced a strong feeling of fear,” William Burroughs writes in his book Junky. “I had the feeling that some horrible image was beyond the field of vision, moving, as I turned my head, so that I never quite saw it.”
Back in Brooklyn, even in the air-conditioning and with the cool gel pillow pressed against my stomach, my body craves estrogen. But my brain does not get the estrogen it longs for and so, in sorrow and revolt, sends heat speeding along my nerves. I imagine the Pentecostal flame wavering just above my head.
The spirit, unlike the Father and Son of the Trinity, is more female, appearing only after the body is broken, permeable. The theologian Rudolf Bultmann has written that the Holy Spirit has two main manifestations: the animistic and the dynamistic. In the animistic, “an independent agent … can fall upon a man and take possession of him, enabling him or compelling him to perform manifestations of power.” In the dynamistic, the spirit “appears as an impersonal force which fills a man like a fluid.” When my husband, wanting a break from what he calls the arctic air-conditioning, cracks the window to let in the summer warmth, I feel a stream of sultry moist air move in, curl around the room, and hover over the bed.
I can’t sleep. I have trouble both getting to sleep and staying asleep. As with so much in menopause, scientists don’t know why some women have trouble sleeping. It may have something to do with lessening estrogen, but no study is conclusive. I lie in the dark feeling as De Quincey did when he was in opium withdrawal, as if a hundred years had gone by in a single night. I lie on my side but then throw off the sheet and lie on my back, pull up my nightgown, and hold the gel pillow against my bare chest. I watch out my bedroom window; hot wind rushes through the leaves, turning them to their silver sides. Summer is claustrophobic, the months in which, as De Quincy claimed, “the exuberant and riotous prodigity of life naturally forces the mind more powerfully up onto the antagonistic thoughts of death.”
There is a difference, of course, between my withdrawal and a junkie’s. The substance my body craves is not outside myself, not snorted or injected with a needle, but made by my own organs. My hormones diminish naturally, completely beyond my control. Some scientists say menopause is triggered when the number of viable eggs in the ovaries is too low; others admit they don’t know why egg maturation stops and hormones diminish. Without hormones, my body changes again, just as it did in adolescence when I was flooded with estrogen and began to menstruate. While menstruation still carries stigma in our culture—we are on the rag and considered unstable because of fluctuating hormones—the fertile years of a woman’s life are also considered her most essential. Menopause, on the other hand, is disparaged, even considered shameful. No one proposes we eliminate childhood, adolescence, or adulthood from the female life cycle. Only menopause is considered something to be cured and reversed, done away with completely.
Another way my dilemma is different from a junkie’s is that a junkie’s withdrawal, while uncomfortable, even excruciating, is considered necessary, a period of fire that leads to a more harmonious and balanced life. But many scientists, doctors, authors, and celebrities see the hormonal change as unnecessary, even old-fashioned. They would medicate my withdrawal, pushing me back on to hormones, back into menstruating, back into the docile, wet-pussied woman of an earlier phase.
In her book The Sexy Years, Suzanne Somers interviews Rita, a seventy-year-old woman who is on bioidentical hormones and still menstruates. Rita tells Somers all the things she wants to hear: “I have a youthful energy.” She and her husband are “having a ball!” Before she went on hormones, Rita was starting to feel like she was living in someone else’s body, alienated from herself. Then Dr. Schwarzbein, Somers’s hormone doctor, told Rita about hormone therapy. “He explained to me that having a period is the most natural way to go through this passage.”
Literature is rich with stories of men remaking women. There’s Pygmalion, of course, and its progeny My Fair Lady. In Hawthorne’s The Birthmark, Aylmer loves science as much as he loves his wife, Georgiana. He longs to, using poison, remove the birthmark, the small red hand like a tiny splash of menstrual blood on his wife’s cheek. After the operation Aylmer is ecstatic. “My peerless bride, it is successful! You are perfect!” But his wife understands what she’s lost in her complicity with her husband’s search for perfection: “You have rejected the best that the earth could offer.” The story ends with the “perfect woman pass[ing] into the atmosphere” and an acknowledgment that the imperfection of the birthmark “was the bond by which an angelic spirit kept itself in union with a mortal frame.”
Alymer has much in common with Dr. Robert Wilson, the author of Feminine Forever, the 1966 book that began American women’s obsession with hormone supplements. The book sold 100,000 copies in its first seven months after publication. While examining a new fifty-five-year-old patient, a woman who’s thin and pleasant, with soft skin, Wilson realizes that hormone replacement therapy could free women from menopause, keep them from witnessing “the death of their own womanhood.”
To Wilson, menopause is a disease: “Menopause—far from being an act of fate or a state of mind—is in fact a deficiency disease.” He believes a lack of estrogen not only ruins the female body—“breasts become flabby and shrink”—but also destroys the personality: “The transformation, within a few years, of a formerly pleasant, energetic woman into a dull-minded but sharp-tongued caricature of her former self is one of the saddest of human spectacles.”
Most distressing to Wilson of menopausal symptoms is the dry, unyielding vagina. Dr. Frankenstein–like, Wilson tells us that “few processes in the entire body are as dramatic as the estrogenic transformation of the vagina.” Under his careful care, one old woman found that her “pathologically dry, unyielding vagina had changed into a perfectly normal, supple, and resilient duct.”
Wilson seems genuinely afraid of postmenopausal women, as if we were penis-repelling monsters: “The mere fact that such woman castrates are prevalent—and getting more so every day as the world fills up with older women—does not make it biologically natural.”
Long before Wilson, doctors and scientists were bewildered by both menstruation and menopause. Aristotle thought a woman’s cycle was caused by “nova luna repurget,” the lunar cycle’s pull on all liquid, be it ocean waters or uterine blood. Hippocrates speculated that women let unneeded blood go each month because they were less active than men. Pliny felt the odor of menstrual blood caused new wine to go sour and made seeds sterile, buds fall off trees, and iron corrode.
Early menopausal treatments were equally clueless. Never eat sausage, particularly before bed. Sponge the body three times a day with aromatic vinegar. Apply several leeches to the anus. Fast on milk one day out of every fifteen. Drink the bone marrow of recently killed animals. Get a transfusion of dog’s blood. Even with treatment, these early books warn, menopausal women may become so sexually aroused they become prostitutes. They might also turn to the same sex for physical comfort. Some women will collect first one, then two, then a dozen cats. In the Q&A at the back of Edward Tilt’s The Change of Life in Health and Disease, a woman asks if now that she’s stopped menstruating, she’ll bleed from other places on her body. Tilt answers that, yes, she may bleed monthly from her mouth or her nose.
The recommendations from Woman’s Change of Life, published in 1958, one of the few early books on menopause written by a woman, gives more moderate advice. During the change, advises Dr. Isabel Hutton, husbands should give their wives their own bank accounts. Financial independence is soothing, as is moderate exercise and spa-like relaxation techniques. Women are instructed to lie on their beds and pretend to swim for twenty minutes before taking a soothing pine bath and then wrapping themselves in a warm, attractive dressing gown.
Ovariin, introduced by Merck drugs in 1899, was the first official hormone supplement. Ovariin was a brown powder made from the dried and pulverized ovaries of cows. It was reputed to lessen the menopausal symptoms of hot flashes and night sweats. After mixing it with water, women drank down their daily supplement. Before and during Ovariin’s rise in popularity, other cruder and more extreme hormonal treatments were used by both men and women. One aging doctor experimented with hormones on himself. In the 1920s, Dr. Charles-Édouard Brown-Séquard, a seventy-two-year-old neurologist and member of the Royal Society of London, made a rejuvenation liquid out of testicular blood, semen, and the juice extracted from the crushed testicles of guinea pigs. He reported in a paper given at a meeting of the Société de biologie in Paris that after injecting himself with the elixir, he needed less sleep, could stand for longer in his laboratory, ran up stairs, ate more, and had no trouble moving his bowels. Most thrilling was that the jet of his urine, low before his self-treatment, had afterward grown stronger and more arched.
Dr. Serge Voronoff, a Russian surgeon working in France, was the first to practice xenotransplantations. In 1917, funded by an American socialite whom he eventually married, Voronoff began grafting the testicles of young goats onto older ones. In 1920 he inserted slices of baboon testicles into a man’s scrotum. He also transplanted the testicles of young executed criminals into elderly millionaires. He claimed this process raised sex drive, improved memory, and made reading glasses obsolete. Eventually he inserted monkey ovaries into women. This practice became so popular that, to keep up with the demand, he set up his own monkey farm on the Italian Riviera and hired a circus animal trainer to run it. Voronoff was so sought-after that in the 1920s, at the height of his fame, he took over the entire first floor of a Paris hotel with his chauffeur, butlers, personal assistants, and two mistresses.
These examples of remedies, hormonal and surgical, seemed far-fetched, the kind of witchy concoction sold by itinerant medicine men from the backs of wooden wagons, quacks who claimed magical results from elixirs made of lamb’s blood and duck liver, until you learn that Premarin, the estrogen supplement taken by millions of women, is made from the urine of pregnant horses.
Introduced in 1942, Premarin remains popular today, with over nine million women taking the drug. An early ad in a medical journal shows a stylish gray-haired woman talking to two men at the theater. The caption reads “Help Keep Her This Way.” After Dr. Wilson’s Feminine Forever was published in 1966, prescriptions for Premarin soared to twenty-eight million by 1975. In the 1970s the drug was linked to uterine cancer. Wyeth Pharmaceuticals dropped the dosage and added progesterone, which was supposed to stop the drug from causing cancer.
Even as early as 1930, studies linked estrogen replacement to cancer in animals, but the drug company’s message that hormones were natural, and that women needed them to stay balanced, was powerful to both doctors and aging women. Doctors began to push women, as they turned fifty, onto hormone therapy (HT). It was assumed, though no testing has ever backed it up, that estrogen protected against breast cancer, osteoporosis, and even heart disease. Many doctors, scientists, and husbands wanted women on HT. An ad from the late 1960s shows a photo of a harried bus driver: “He Suffers from Estrogen Deficiency.” On the second page is a photo of an angry older female passenger: “She Is the Reason Why.” In the 1970s, the singer Patti LaBelle touted HT in television commercials and the supermodel Lauren Hutton made talk show appearances, paid for by the drug company, to pitch hormone replacement therapy.
As late as 1998, companies used the image of a discombobulated woman to sell HT. In one ad, Picasso’s Weeping Woman serves as the before image. The woman’s face is smashed into swatches of green and yellow, and the teeth in her large horse-like mouth are jagged. The after-HT image is of Renoir’s La loge. The young, blue-eyed woman wears a black-and-white striped jacket. She has a pink rose in her hair and strings of pearls around her neck. She looks not only composed but also sexually available, with her loose bun, red lipstick, and pale rice-powder makeup. “No Other Estrogen Delivers Like Estraderm,” it reads—implying, of course, that HT will turn fragmented menopausal monsters into compliant fuckable girls.
In 2002, the Women’s Health Initiative (WHI) study was stopped early because conditions that hormones were supposed to decrease—uterine and breast cancer, strokes, heart disease—all increased slightly when woman took hormone replacements. In 2005, the Radcliffe Institute for Advanced Studies held a conference where historians, scientists, feminists, and doctors came together to figure out what had gone wrong. Why, for more than fifty years, had doctors considered HT to be a magic bullet that protected women from age-related diseases? The most disturbing conclusion of the conference, and the one driven by an idea as old as the patriarchy itself, is that sex hormones explain women’s behavior and so need to be controlled. “It is generally believed that women’s nature and value derive from their capacity to bear children,” the final report read, “and that it is in society’s best interest to control women’s reproductive systems.”
Breast cancer continues to be linked with hormone therapy. A 2013 study reported that after the WHI findings, hormone use declined from 40 to 20 percent in the United States and breast cancer subsequently decreased as well: “A corresponding and substantial population-based decrease in breast cancer incidence was observed, particularly for estrogen receptor–positive breast cancers in women aged 50–69 years, which was attributed to decreased use of hormone therapy.”
Hormone use remains a polarizing topic. Today, besides being made from horse urine, HT is also synthesized from soy and yam. Gels, patches, and creams exist in a variety of dosages. Women who have no family history of breast cancer or blood clotting can take HT for short periods of time to combat hot flashes and sleeplessness. Some continue to use HT to treat what they think of as a deficiency disease. Others feel hormones keep them from aging. All the personal accounts of menopause I found published in books ended with the come-to-Jesus moment of HT acceptance.
Gayle Sand’s 1993 Is It Hot in Here or Is It Me? registered the shock and suffering of menopause. But it cast this suffering as humorous. It’s a spiky, uncomfortable, self-abasing kind of funny. Every night Sand rides her raging hormones like a “white water rafter on a Sealy Posturepedic.” During hot flashes, she imagines herself as an ice cube, “but the ice always melts.” Sex feels like a “root canal.” Menopause has a magical effect on her sex life: “It makes it disappear.” Her husband is cuckold, playing “second fiddle to a hot flash and a dry vagina.” After trying alternative remedies, herbs, acupuncture, meditation, and yoga, Sand begins a full course of HT. Soon she is again feeling like her “old self.”
The Silent Passage, Gail Sheehy’s 1998 follow-up to her bestselling Passages, while less humorous than Sand’s book, uses this same narrative trajectory of menopausal disorientation followed by HT salvation. “Won’t I ever feel like me anymore?” Sheehy asks in her book’s opening pages. I had this feeling in early menopause of disorientation, of loss of identity, one I also remember from the first months of menstruation. In adolescence, though I struggled, no one suggested I should block hormones to keep me as I was. Sheehy assumes that our reproductive phase is our only real phase, the healthy and valuable one, a period that should be held on to at all costs.
Christa D’Souza’s book Hot Topic came out in 2016, well after the 2002 WHI study. While she offers a few positive examples of the menopausal transition—that hot flashes may aid life expectancy by making the brain more flexible and that menopause is a time to take stock of spiritual as well as physical changes—D’Souza, as a magazine editor and a fashionista, is clearly fearful of losing her femininity. She tells us in her preface that if we, her readers, don’t take HT and “want to be butch” about menopause, she hopes we’ll make it out the other side. After her search through alternative therapies and consultations with pro–hormone therapy doctors, she decides, even though she’s had breast cancer, to stay on HT. As Dr. Erika Schwartz, an internist in New York City, tells her, her worth outside the procreative hormonal years is zero. “Once you lose your hormones,” Schwartz says, “you are nothing more than roadkill.”
Saddest of the HT apologists is Suzanne Somers, who played Chrissy in the 1970s sitcom Three’s Company and went on to sell everything from vitamins to the ThighMaster and FaceMaster. Women like Somers who have spent their lives as sex symbols, making adaptations to male requirements, will share the negative view that men take of menopause. Men, Somers tells us in the first pages of The Sexy Years, find menopause “icky.” What she calls the seven dwarfs of menopause, “Itchy, Bitchy, Sleepy, Sweaty, Bloated, Forgetful and All Dried Up,” make women unlovable, even repulsive. Somers’s book is similar to Dr. Wilson’s Feminine Forever in its insistence on menopause as a negative passage, cured only by hormones. “Women who are afraid or confused about hormones will unfortunately experience the negative consequences of not taking them,” Somers writes. “How about rotting bones, dried up vaginal tissue, droopy breasts, skin with no elasticity.”
Somers pushes her readers to take hormones for the health benefits but also so that they remain compliant. “When estrogen levels sink during menopause,” she writes, “a woman’s body releases more testosterone, which causes women to be aggressive, but without that soft, clear-thinking, patient component to balance the aggression.” This statement is both scientifically ungrounded and insidious. Somers wants women to take hormones so they remain feminine, kittenish purveyors of “horny sex.” One of the gynecologists interviewed in the book, Dr. Uzzi Reiss, tells Somers that there are three types of women: twiggy, athletic, and curvy. The curvy type, he says, are short with D-cup breasts and weak muscles. They have extremely high estrogen. “I don’t want to generalize but woman of this type (Curvy) are happier and less complex and it seems that their approach to sexuality is much simpler.”
If we don’t go on hormones, Somers tell us, our husbands are bound to leave us—much as how Dr. Wilson sympathizes with men who leave their “unhormonized masculine” wives. Somers repeats a half dozen times throughout The Sexy Years that menopausal women are “bitchy” and “impossible” to live with: “We can’t sleep, we’re hot and then cold, we’re tired all the time, we break out in embarrassing sweats, we’re bitchy, and we lose our sex drive, so after a while a man is going to say ‘who needs this?’ and go out and find the new, improved version of you.” The antidote to this dilemma, according to Somers, is bioidentical hormones. Women must take them to remain young and lovable. She writes, “Finding balance for me has been like finding the fountain of youth.” Somers advises as menopause begins going on hormones in dosages that replicate your body’s chemistry at thirty and menstruating monthly until you die.
Long after I finished reading these books, they irritated me. At first I thought it was because each author goes on HT, a choice I saw as potentially dangerous unless you’ve had a hysterectomy. Maybe I was jealous. If my mother hadn’t had breast cancer, if I didn’t remember the smell of her mastectomy wound, the black threads stitched into her chest, I might have tried HT myself. Links between estrogen and cancer, while conclusive, are also percentage-wise relatively slight. Who am I to judge if a woman wants to take the risk?
It wasn’t so much the hormones, I eventually realized, as the tone. Each book is the literary equivalent of a submissive dog offering its jugular to the more powerful species: man. In complete thrall to the culturally supported variety of moist, compliant femininity, these authors are unwilling to rethink youthful constructions of physicality and creativity or to accept responsibility for growth across the life span at every transitional phase. They pretend to break silences and offer revolutionary truths but in reality are spreading propaganda for the singularity and importance of the reproductive years and for estrogen replacement itself. They are like the girl in junior high who sees you floundering, but instead of supporting your otherness, shows you how to put on makeup, curl your hair, and diet so that you too can enter into a rigid femininity and join the generic popular crowd.
Men have been marketed a similar, if less invasive, antiaging wonder drug in Viagra. It encourages men to deny their vulnerability, to resist the idea of aging and insist on penetrative sex over a lifetime. Older men are dealing with their own physical challenges and insecurities. Ads for Viagra play on their fears of not being able to get it up, of not pleasing the women in their lives. Counter to the message in the ads, many of the women I spoke to felt hostile toward the little blue pill. A friend told me that in the 1990s, she and her husband, then both in their sixties, had not had penetrative sex for years. Their sex life had grown so much better, “tender and adventurous.” With the advent of Viagra, foreplay vanished. She felt forced, whenever he told her he had taken a pill, into having intercourse. “My husband was more interested in the idea of himself with an erection than he was in our actual sex life,” she said. Men’s obsession with penetration is understandable. Without intercourse the human race would not exist. But outside the procreation of children, men later in life would be wise to open up their idea of what constitutes a sexual act. Eventually my friend’s husband figured out that a hard penis did not always lead to good sex. Other men may also come to this conclusion. “The bedroom may be the place where the Viagra myth ends,” writes Meika Loe in her book The Rise of Viagra. “To [the drugmaker] Pfizer’s horror, while millions of men asked their doctors for a prescription … only half requested a refill.”
After I stopped cycling, I was able to feel both the wonder of cycling and its relentlessness. As a teenager, I thought of my ovaries as baskets full of eggs. In actuality the ovaries are less baskets and more high-tech superlabs. Eggs are maintained at a variety of stages. Fluid-filled blisters called follicles, each containing one egg, are basted with hormones. Female eggs are the biggest cell in a woman’s body, about the size of a grain of sand and twenty-six times bigger than a blood cell. After eggs receive a signal to begin the process of maturation, it takes about 150 days before they are released. Egg cells have a different embryological origin than every other tissue of the body. They are also potentially immortal and supersensitive and have an inner intelligence. Scientists believe that the huge number of eggs that at first develop inside a female fetus’s ovaries—nearly seven million—is a vestige from when we were fish spraying out eggs on the ocean floor.
The ripening egg, once chosen, is responsible for the variety of hormonal changes across the menstrual cycle. Each day of the month, a woman’s hormonal balance is slightly different, which means a woman’s brain chemistry is different every day. In the last days before menstruation, when progesterone drops, the brain is 25 percent different chemically than it is a day earlier in the cycle. Recent brain research suggests that the female brain is so deeply affected by hormones that the increase or decrease affects a woman’s reality. For a cycling woman, the days just before her period, when hormones drop, are most like the hormonal landscape of menopause. What the culture ridicules as PMS—saying it stands for pass my shotgun, psychotic mood shift, or pimples may surface; joking that “they call it PMS because mad cow disease was already taken”—I remember as a time flooded with a delicate longing, a soul sickness, a sense of sudden lucidity.
“Cycling,” one woman told me, “I felt like there was a stranger in my body.” Many echo this feeling of a lack of control. “I move this body around,” writes Samantha Irby in her essay “Hysterical!,” “but I am not actually in charge of it.” Another woman feels her body while cycling was “constantly betraying me.” During her periods, another woman felt like “a big heavy mammal.” Her pain was brutal. “I felt like I was giving birth to an alien,” she said. Another remembers her periods being like six-day lava eruptions: “I’d jump out of my bed and blood spread everywhere. It was like a crime scene.” Many women can’t believe, after cycling, what they had to endure. “It’s almost like the hormones made me feel dirty. It was like cancer—they took over my body each month,” one said. Older women are incredulous when looking back: “Was that really me? Did I really go through all that?” and “It seems unimaginable now what I suffered. Did I really have to fool with bleeding every month for forty years?”
Once the hormonal onslaught is over, its beginnings can also seem surreal, freakish. One woman remembered the terrifying feelings stoked by hormones morphing her from girl to woman. “Sprouting breasts, hips, acne, my body had already (at 11) begun to feel unfamiliar—painful beginnings of breasts disturbed my flat chest, black hairs appeared like thin sprouts under my armpits.” Another woman remembered her early girlhood receding: “When I looked in the bedroom mirror, I wondered, Who is this person?”
My daughter, too, felt the incredulity, the otherness of menstruating. When she was nine, I explained about the hormones, the egg, the uterus, the blood. In health class she learned the biology of the cycle, though she was more fascinated and disturbed by the slide show of genitalia infected with various venereal diseases. Each year I’d give her a refresher. She was going to bleed, but she wasn’t wounded. It was natural. She was thirteen when I picked her up from the subway station and she announced that it had happened. During her oral report on Oedipus in English class, she felt a warm sensation between her legs. I gave her the heating pad and Advil and reminded her of the stash of tampons and sanitary napkins under the bathroom sink.
The next month, I was in my office when she burst in, her face fearful. “I got it again!” I realized then how abstract all my explanations had been, how inconceivable. I explained that, yes, she’d menstruate every month. “I thought you got your period,” she said, “and that was it.” She seemed dazed while I explained again. The egg, the uterus, the hormones, the sloughing off, the blood. “You mean every month I’m going to bleed?” I nodded. Her reaction reminded me of how unfathomable all female transitions—menstruation, birth, menopause—actually are. Our bodies shape-shift and writhe. What my daughter said next registered her shock but also that she’d absorbed at least a little of my family’s Christianity: “Goddamn you, Jesus!”
The only side effect of a lack of hormones that actively worries me is declining brainpower. Dr. Julie Dumas, a neurobiologist at the University of Vermont, did a study in which she tested the memories of menopausal women who complained of fuzzy thinking against those of non-complaining women. She found that not only was there no difference between the two groups but that the complainers did a little better on memory tests than the non-complainers. “Frankly,” Dumas told me, “the studies are all over the place because cognition isn’t only biological; there is also experience, emotion, the richer stuff that menopause does not alter.”
Some studies do find that older women are slower on cognitive tests. When parsed, though, many of these studies also hint at the steadiness of the menopausal brain. Dr. Benicoo Frey of the Women’s Health Clinic in Ontario, Canada, wanted to see if menopausal women had slower mental reflexes than fertile women. In 2008 he tested both groups. He used photographs with either happy or fearful faces, with the words “happy” or “fear” written in red over the eyes. Some of the photos were mislabeled, and women had to press a button when the word-face matchup was off. Dr. Frey found that in the first trial both groups scored equally, but in subsequent trials the younger group scored slightly better. What interests me is not this discrepancy but that the MRIs of the older women showed less activity in the amygdala, a part of the brain that registers emotion. This could mean either that the older women were less afraid of the fearful faces or that the slight delay was not slow but Zen-like, mindful. “We hypothesized,” Dr. Frey told me, “that the midlife transition might be associated with a shift toward greater top-down regulation with subsequent more cognitive control and less emotional reactivity.” In other words, menopausal women, counter to cultural stereotypes, react with fewer emotional highs and lows than younger women, and they pause to contemplate before they answer.
The Sisters of Perpetual Adoration are a Carmelite order of eleven menopausal nuns who live in the Haight-Ashbury section of San Francisco. The order, originally established in Guadalajara, Mexico, moved because of religious persecution to California in 1928. The nuns wear white tunics, red scapulars, and black habits. Their main occupation is prayer, and they pray throughout the day both separately and together. Twice a month they pray for twenty-four hours straight. All life is subsumed in prayer, and even the nun’s hot flashes are considered spiritual. “I think of it as getting closer to God,” Sister Betty told a researcher, “of getting closer to eternity.” The neuroscientist Dr. Sohila Zadran, of Igantia Therapeutics, is working with the sisters to see if hot flashes may protect the brain and be one of the reasons why women tend to live longer than men. Zadran believes flashes are an example of an active Darwinian adaptation. She told me about the “halo effect,” in which the nuns seem to catch flashes from one another. By setting up an infrared camera in the convent chapel, Zadran saw for herself the halo effect. First one nun started to glow as the camera registered heated blood flooding into her arms and legs, and then one after another, a red aura flared up around each nun’s body. “It was an eerie sight,” Dr. Zadran told me, “the glowing nuns and behind them the glowing stained-glass windows.”
The Holy Spirit again. Though this time in a scientific frame. Inside a flash I often think of Mary at the first Pentecost. What Acts identifies as an “upper room” may have been sealed, warm, constricting. If Jesus was thirty-three when he died, Mary would have been in either perimenopause or menopause itself. Maybe she flashed first and the heat spread, like it did among the nuns, from disciple to disciple. “To be a created thing is not necessarily to be afflicted,” Simone Weil writes, “but it is necessary to be exposed to affliction.”
We are promised many things if we go on HT: level moods; sleep; smooth skin; wet, pliable pussies. But what do we gain by not going on hormones, by going through the junkie-like withdrawal, staying with this disorienting and relentless adaptation? Darwinian adaptations are glacially slow, impossible to monitor. They occur through gradual modification of existing structures. Over thousands of years a male bird gets bluer feathers to help him attract a mate, and a dolphin’s hoofs slowly spread into fleshy flippers. My withdrawal is adaptive as well as liminal. De Quincey claimed that the agony of his withdrawal from opium felt more like a birth than a death: “During the whole period of diminishing the opium I had the torments of a man passing out of one mode of existence into another.”
In “Choosing Paradise,” a story by the British writer Sara Maitland, an aged Eve sits on the stone wall that surrounds the Garden of Eden. She’s found the garden again but she’s torn about going back. She remembers her youthful happiness there but also doesn’t want to desert the life she’s made for herself. Eve decides against reentering perfection. She does not tell Adam she’s found the garden again—or that she’s stopped menstruating: “The curse is lifted, he does not rule me anymore.” Rather than claw back what she’s lost and remain in perpetual stasis, Eve decides to go with acceleration. In choosing her aging body, her imperfect life, Eve makes a decision that many women do in refusing HT. “I realize looking back how controlled I was by my hormones,” one woman told me. “It’s a relief to no longer be driven by them.” Eve’s decision links back to her first curiosity-driven bite. “Going forward,” she reminds us, “is more interesting than being happy.”