The Deafening Silence of Perimenopause: A mother’s path through.
When Anxiety Creeps In
I noticed the anxiety first. Not sure when, maybe two years prior. It was unusual for me, but there were external factors: a pandemic, aging parents 3,000 miles away, teenagers at home, financial worries. Anyone would feel anxious, right?
I would wake panicky in the wee hours unable to get back to sleep. Thoughts about my parents, kids, finances, human existence… would spin until after a while, I would just get up and face the day, exhausted.
The Physical Storm Begins
Then came the hot flashes. Manageable at first, they grew frequent and disruptive — random and unprovoked. The idea of sitting for a job interview drenched in sweat felt impossible. Soon after, the “night sweats” arrived. At 2 a.m., I’d wake soaked, changing all my clothes and sheets before trying to get back to sleep.
It got worse. I began crying uncontrollably — not discreet tears, but heaving, snotty breakdowns in front of near-strangers: an osteopath, the unemployment office, my doctor.
An irrational fear of homelessness took hold. I almost didn’t admit it, even to myself, because it felt so absurd. And yet it felt real.
Discovering the Real Cause
As it turns out, surprisingly, it was all tied to peri/menopause. Who knew?!
Luckily, hot flashes and night sweats are undeniable signs of peri/menopause. After thinking I could “just handle it,” I realized I needed help. I didn’t trust anything would help, but I had to try something.
At a friend’s persistent urging, I went to my gynecologist and talked about the hot flashes and night sweats. I didn’t mention the crying spells or joint pain — it felt out of scope — but I described the sweats. She prescribed a standard hormone replacement therapy (HRT): nightly progesterone, estrogen gel each morning, and a mild vaginal cream a few times a week. All bio-identical.
The Change Was Immediate
Within days, the change was nothing short of miraculous. Symptoms I hadn’t even connected with peri/menopause, faded:
My gums were sensitive and receding. The dentist seemed a bit surprised by my condition but said it was “normal” with aging. But I hadn’t changed my dental hygiene routine.
Despite doing Kegel exercises every time I peed (stop/start, stop/start), I was noticing less control. “Leakage” happened when I laughed, when I sneezed, and for no apparent reason.
Vaginal discomfort that wasn’t quite “dryness;” it just felt off and weird.
Joint pain I thought was arthritis.
Poor sleep, which in middle age is associated with later development of dementia and generally is a stressor that increases health risks.
Increase in UTIs. (This happened to a friend too but she would get flu-like symptoms that kept her in bed for days. A low-dose vaginal suppository once a week took care of it, which can often still safely be used by women who are at high risk of cancer and can’t take the standard HRT.)
My skin was itchy and got worse if scratched, causing hives. I suppose it was dry, but it just felt itchy to me.
I felt spacey, low energy. I could sit for an hour staring into space, just thinking.
Feeling overwhelmed almost all the time, I couldn’t deal with what would have been normal things before.
Embarrassingly I became forgetful. (My kids started joking about it.)
There was anxiety. I felt scared a lot of the time.
I was crying uncontrollably, out of the blue, or for “no good reason.”
I isolated myself from friends because it all felt like too much. I felt ashamed of what a mess I’d become, and blamed myself.
Of course, life stressors compounded everything: my father’s sudden death, my mother’s worsening dementia, a complicated relationship with my sister, and my daughter’s struggles with her own mental health. But the hormonal imbalance amplified it all until my life felt unmanageable. At least for a while.
Finding Support and Balance
Realizing that things were still out of control, I talked to my gynecologist again, who adjusted my HRT. In desperation, I also started working with a new therapist, and got an antidepressant.
I soon got some clarity and understood what was happening to me. I still had to deal with stressors, and work my way back through the clouds, but once my hormones stabilized, and I had some extra support, life began feeling manageable again, and I could exercise, see friends, take classes, and move toward recovery.
That was a couple years ago. Today I’m much, much better.
Why Is No One Talking About This?
But I’m stunned there isn't more public awareness. That there aren’t public service announcements or an ongoing public health campaign about this wide array of symptoms that affect 4 out of 5 women. In a world where there wasn’t so much silence around the topic, I would have recognized the symptoms immediately, and known where to seek help without questioning myself, or feeling confusion or shame; instead, I would have anticipated it and talked to my doctor and my mother and, and, and...
Hence my self-appointed campaign. My experience is not unique, but publicly talking about it, seems to be.
I am not suggesting that the path I took out of the depths is for everyone. Every woman is different and has her own set of considerations and issues. Not all women should, or choose to, take hormones, but what we can all benefit from is clarification of our symptoms, support managing them, with or without HRT, and less shame around the topic in general. A little knowledge goes a long way.
The power of hormones, on our minds and bodies, is enormous — throughout our lives. Yet somehow, peri/menopause is minimized, goes unacknowledged, and unfortunately, all too often, unrecognized.
Breaking the Silence
We have the power to change that: by informing ourselves and others, and simply talking about it…without shame. It's a normal condition, not a contagious disease, after all.
E. Starrett is an American living in Berlin with her husband, two kids and two cats.