Monday, August 6, 2018


One of the more interesting things that's happened in the last 3 weeks - not that I'd call it enjoyable - is that I have learned a thing or 12 about the perimenopausal hot flash. You know this whole midlife hormonal shift thing can be kind of miserable. So many things, that work just fine for so long, all of a sudden, just flip the fuck out. Look, I'm no stranger to night-sweats, which I've been having monthly, for 3 days before my (still clock-like) period kicks in, probably for going on 2 years now - but the hot flash is its own special thing that, till 3 weeks ago, I'd all but not yet experienced. I just assumed that a hot flash is a night sweat that happens in the daytime but apparently that's not the case.

Today I bring you (my younger readers or those who are fortunate enough to miss this) a primer of perimenopausal symptoms. Let's start with the diff between the hot flash and night sweats: Night sweats, causing one to wake in a panic of perspiration after having (seemingly) maintained a nice and normal temp under covers, are really unpleasant. You wake up disoriented, freezing, soaking and feeling gross. Often, the active fix is enough to wake you up for a couple of hours potentially just before day break. And, if this phenomenon happens to you (as it does to me) deep in the PMS hate-on phase, well, it's not so fun for those around you.

Hot flashes, a crystalline metaphor for midlife, are entirely different. For starters, you feel them as they come on (day and night and day and night), not simply in retrospect. FWIW, I asked approximately a zillion women to explain them, prior to my own encounter, but no one has been able to do so to my satisfaction. Here's my kick at the can: What happens - at least to me - is that my interior starts to feel like the molten centre of the earth and then that feeling manages, through some unknown conduit (I mean, maybe it's knowable but I've only been having these for 3 weeks so give me some time!) to make its way to every surface of the skin. My feet - always freezing little blocks - are the harbinger. They heat up as if cozied by coals. It's pleasant until they get so hot that I have to rip off my socks and step on tile. Gradually, I also feel an emerging heat sear in my torso, chest, neck and head. It's a bit like cooking from the inside out. And natch, there is sweating but it's more of a dewy kind than the deluge of sweating at night. Again - you can experience these numerous times, all through the night. They just wake you at the onset (or if they don't, you're unaware on the flip side).

Not that I'm much in favour of either but, on balance, I'll take a hot flash.

When my mother was going through this life stage she was tormented by a few specific things: flashes, mood swings and brain fog. Honestly, the hot flashes made her miserable but, for my money, the brain fog was the most challenging. At one point, my sister and I were vaguely concerned about a diagnosis of early-onset dementia (sorry Ma!). (Note: in the years following menopause my mother's brain resumed its previous and spicy sharpness so I can only assume it was hormones. Also, my sister and I were young and hormonally chaotic in our own right when we were making this assumption, so take from this what you will.)

One of the beautiful gifts of intermittent pain is that it puts everything into perspective. My mother was so unhinged by the hot flashes (she really suffered) and I suspect I might be too if I weren't managing what I hope to be the most significant of my own perimenopausal boulders: pain. Now, my pain is definitely more knowable than it ever has been, but pain is not particularly knowable. It's strange to say this but I am so grateful to have experienced many types of pain on multiple occasions because now, at least, we are acquainted. Pain is miserable but it's ignorable (to some extent) when you disassociate it from the darkest well of fear.

The first time I had the right knee issue, the left foot issue, the left hip issue, the right shoulder issue, the migraines, the searing ear thing (that brings the tinnitus), the myofascial grip of my entire torso - I was fucking afraid. Now when I meet these, and they have all recurred a minimum of dozens of times (if not hundreds of times), I send them my compassion. We're in this together but I have nothing to gain from defining myself by my pain and so I have to accept its presence while fundamentally rejecting it. This sort of mind-fuck is apt to make one quite adaptive.

Youth may be wasted on the young but middle-age gives what it knows we can take. I'm incredibly grateful that, though my memory is not good (never has been, but def it's worse now), my mind is agile. Even as I go through a phase known to unmoor far greater minds than mine, I'm with my self. I know myself.

Other than the night sweats, the hot flashes and the pain, I'm coming through this life phase rather well. Sure, it doesn't pay to get cocky. This post is about expressing gratitude - not poking the bear :-)

I didn't feel, when I was young, that hardship was a force for good. I grew up in a family with a deeply entrenched narrative about luck and worth and I have to say, now I don't believe that good fortune is anything other than just that. It's not a sign of one's familial primacy. You are lucky until you're not and, if you're really lucky, the day you're not does not appear. The next best option is to experience things that throw you into chaos - things that make you think, feel, consider - things that make you stronger and broader and deeper than you were. When you start to understand that this is "good fortune", then you are wealthy beyond measure.


  1. Ahh that last sentence. That you can come to that place, and state it so succinctly, is the essence of wisdom. Thank you.

  2. When I was facing my first breast cancer diagnosis 11 years ago--but before it was a definite thing--somehow I had the guts to visit the family cemetery plot over the US Memorial Day weekend (end of May). I was afraid of what might be coming so I went to converse with my ancestors buried there who managed to survive Nazi Germany (I don't feel I can complain to them very much). And what I got from that conversation was a very strong sense that my cancer wasn't going to be about death, but rather, would be an experience of life I had not yet had. Which was, in the end, exactly what it turned out to be, in many remarkable ways. So whenever I am facing the scary unknown, I try to remember that. It might just be an experience of life I haven't yet had. Best of luck to you.