What we can learn from three stories of early menopause

I hope you find these stories as resonant as I did.

I don’t remember the first time I learned about menopause, but I have a clear memory of the first time I heard about early menopause. I had publicly written about my own struggles with infertility, about having been told before I had even turned 30 that I would need IVF. As a result, I often heard from other people facing similar challenges.

One was a friend from high school who told me that a reproductive endocrinologist told her she had premature ovarian failure — she was, in her early 30s, on the brink of entering menopause. She was in shock.

The topic of early menopause — defined as entering this transition before the age of 40 — also kept coming up in reporting for this newsletter. I found myself really wanting to hear directly from those who had experienced menopause unexpectedly, at a time and phase of life that wasn’t what you typically associate with the term. And I wanted to know what we all could learn from listening to them.

I feel really privileged that three folks who experienced early menopause in different ways were willing to share their stories with me — and in turn, with you. We are using first names only, out of respect for the sensitive content and personal medical information shared.

I hope reading these will help us all engage in a more meaningful and holistic conversation together about what menopause is, who it includes, and what it means to feel less alone in it. And don’t forget you can always email me about the unexpected, both good and bad, in your life.

Here are their stories, edited for length and clarity.

Jennifer, 54, New York City

Found out she was experiencing early menopause after coming off of birth control

When I was 38 and a half, I decided I was going to manifest my partner. I really wanted to have a child. So I said, “Let me get myself ready for both.” So I got off the pill.

I kept on not getting my period, but it didn’t occur to me that it could mean anything.

Then three months later, I started getting night sweats, even though it was winter. I was rationalizing that it must be because my blankets were too heavy. But then I started getting hot flashes in the daytime.

I finally went to my gynecologist and she said, “Let’s do some blood work.” And she did. And my follicle-stimulating hormone (FSH) was off the charts, something you would see in a menopausal woman. She said, “Let’s give it another month and take it again.” And we did. By April, she was telling me, “Yes, you’re in menopause.”

It was a heartbreak.

I was feeling the sadness over the infertility and then also feeling very old and very embarrassed. I felt whenever I told someone, I didn’t see sympathy in their eyes — I saw pity.

I was so lucky to get referred to a reproductive endocrinologist and she was very proactive. She was not afraid to go there. She would say, “Are you having sex? How does sex feel? Do you need this? Do you need that? If it’s painful, we can give you vaginal estrogen. If your libido is down, let’s try CBD, let’s try testosterone.” I think having a doctor who’s willing to talk through all of the physical symptoms with you and is very much rooting for you to have as happy and as healthy of a life as possible is really helpful.

Amazingly, I met my husband two months later. I remember praying, ‘If I can’t have children, I at least want a partner. I don’t want to go through life by myself.’ I felt so lucky to meet him.

I would tell other people to just talk to the people that you feel can actually really help you. You don’t owe anyone. You don’t have to tell everybody. Find people that you trust and who are really rooting for you.

It’s good to have a therapist. It’s good to have a meditation practice. It’s a good moment to really keep your own counsel and develop your own resilience. Stay as connected to your body as you can. Dance, be intimate with your partner, dye your hair if you want to dye your hair. Don’t shun your body — cherish it.

Melissa, 35, Chicago

Had medically induced menopause after going through cancer treatment

I found out that I had cancer because my mom actually had it the year before. I was getting her through her mastectomy recovery and in the midst of all of that, doctors recommended genetic testing. She was positive for the PALB2 gene, which is a form of BRCA. It turned out I was positive for it, too. I felt I was doing the responsible thing by starting this intense breast cancer screening at 31. I went ahead and had my first mammogram — and they found cancer.

I had stage one estrogen receptor positive cancer on my right breast. I chose to have a lumpectomy and then I had radiation right after, 20 rounds of radiation therapy.

I think it’s hard for some people to understand that your cancer doesn’t really end after active treatment. For those of us who are in survivorship, it’s not present in our bodies, but it’s present in our lives. And the standard protocol for someone after active treatment with estrogen receptor positive cancer is to go on hormone therapy.

I was on Tamoxifen for two years, which is standard for someone who is pre-menopausal, of a still-fertile age. But it is a drug that basically makes you a menopausal person. I was three months in and it was like, “Yeah — now I’m having hot flashes. Now I’m feeling vaginal dryness. I have lost my sex drive. I’m feeling old in this body.”

I wish I had known about the term medical menopause before I was diagnosed. I think I could have responded better if there was a label on it, if someone had told me, “You’re going to be in medically-induced menopause.”

The toxic gratitude of it all can really weigh you down as you’re going through hormone therapy, like, “I guess I must be really happy right now because I have this chance at life again and I skirted death,” but it’s hard to carry that feeling when you’re feeling the way you do on this medication.

I had just gotten engaged when I got my cancer diagnosis. I got married and after two years on the Tamoxifen, I went off of it so my husband and I could begin trying to start a family. Our baby is five months old now. I have stopped breastfeeding. And it’s time for me to start back on the Tamoxifen.

I think I’m fighting through my own fears of getting older, because I keep hearing myself describe what I’m going through as feeling like an old woman in a young woman’s body. I’m trying to understand why I’m using those words and why that feels both accurate and like a negative thing. I am getting older and that’s all right, but it’s hard to square away having to press the fast forward button in my life.

Charlie, 35, New York City

Experienced menopause after taking testosterone for gender-affirming care

I started taking testosterone in 2010, when I was 20. A couple of years after I started taking T, I started experiencing hot flashes, although I didn’t know that they were hot flashes. I was at my trans group and I was saying, “Man I keep getting, like, really hot. I’m very, very itchy, feeling very strange.” And another guy in the group was like, “Oh wow me too!’” But still, I didn’t really connect it to being trans. Finally, someone in my group was like, “Oh you know, that’s probably menopause.”

Once I realized that I was in menopause, I was able to better sit through the hot flashes mentally and know that it wasn’t my fault. I was better able to rationalize what was happening and then I was also able to start having strategies for getting through my hot flashes.

My number one strategy that I started utilizing was keeping t-shirts in the freezer. I would have a bag of t-shirts in the freezer at work and then also at my house. One of my favorite things has been talking to my friends’ moms about this. I was dating someone for a while and one time their mom was mentioning that she was having hot flashes and I said, “Oh you should keep a t-shirt in the freezer and then put it on when you have a hot flash.” And she sort of laughed but was definitely weirded out. And then I said, “Oh I get hot flashes.”

I’ve heard from other trans guys who say they experience some sort of dysphoria around the fact that they’re experiencing hot flashes or early menopause, but my perspective is more that these are just hormonal changes and hormonal changes are part of the process of aging — and how lucky I am to be aging.

Understanding that other people also have hormonal changes has made me feel more connected to other folks that weren’t just trans — just understanding that, yes, bodies change. The longer I spend on this earth and inhabiting my body, the more I realize that we are all so much more similar than we realize.

I would encourage people who are experiencing menopause and other symptoms of aging to embrace those changes. Especially as a trans person and as a gay man, there are so many of my ancestors who were not able to age to the point where they saw themselves experiencing the hormonal changes that come with aging. How lucky I am to be at an age when I am seeing my body change, in a way that means I have lived for so long.

I almost forgot!

Like everyone else, I’m still thinking about the death of actor Diane Keaton — and how the reaction to her death has centered the ways she celebrated aging and personal style. I’ve lost count of the tributes I have read that rightfully acknowledged what a rarity she was, and how heavy the loss of a star of this wattage is, because of the way that she allowed herself to age on screen before all of us and absolutely celebrated it.

In light of September’s Fashion Week season, it feels like an especially significant loss. I have been thinking a lot about Vanessa Friedman’s analysis of this season’s shows and her emphasis on the pressure that fashion puts on women to physically change their form, to present themselves to the world as smaller and quieter — frequently literally, as depicted this season in clothes that nipped waists, covered mouths, and eliminating the possibility of moving arms.

Keaton’s life on screen was such a vivid reminder to take up space — intellectually, artistically, aesthetically — and to define the space around you instead of letting it define you. A good reminder in the wake of her death, and always.