Infertility Survivorhood Meets Perimenopause
Sitting with my feet in the stirrups things were notably different from the year prior. My first visit to the gynecologist six months after we had lost our children, though preempted by good “I’m getting back to taking care of myself again” feelings, ended up being served with a big fat panic attack.
This year however I had come prepared. With Xanax and sexy clothes, to be precise. Yes, that’s right, I decided it would help to strut into a waiting room steeped in pregnant bellies wearing my very tight white pants, wedge heels and a sleeveless shirt. Super mature, I know.
I had shown up anticipating talking to my doctor about the intermittent, out of my norm and seemingly all of a sudden vaginal dryness and low libido I had begun to experience. And after inhabiting the mouth of the wolf waiting room, the conversation with my doctor was easy like phonics. She listened and validated that it was what I thought it was – mid forties sometimes ok but mostly not good egg quality causing erratic hormone production. She clarified this is completely normal for my age and also informed me of symptoms to watch for that aren’t. And, she provided appropriate empathy for my “suffering”, something I was not used to getting from doctors that deal with my vagina.
“Well,” I said after thanking her, “If I survived infertility, I’m sure I can survive this.”
Her jaw dropped a bit, her face remained blank. My kind, intelligent and communicative doctor had nothing to say.
“I’ll be fine.” I stated with a confidence it seemed she wasn’t used to, perhaps a different attitude than what is normally displayed by my notably less weathered fertile counterparts.
Home I went, gliding through the door, and later that evening was drooling to my husband about how great it was to have a clear, supportive appointment that actually entailed something “normal.” When you’ve gone through multiple diagnosis and failed treatments while belonging to a gender for which pregnancy (a full term healthy one, that is) is all too often the ultimate exorbitantly coveted prize, the label of “normal” under any circumstance is sweet as can be.
Could only an involuntarily childless infertility survivor exhibit such glee over a doctor’s appointment discussing low libido and vaginal dryness? I often wonder. All I knew in that moment was that it sure felt nice to be back down on the level of life’s more miniscule problems once again.
In a world where the price tag of having the grand gift and privilege of a child to educate is openly and perpetually lamented but the $77,000 price tags of not getting pregnant have no room in conversation, in a land where empty nesters publicly mourn in droves but those grieving the loss of parenthood altogether are silenced, it’s no wonder someone like me feels a tad ADRIFT. As a traumatized griever with no pregnancy or parenthood experience to speak of, I sure could use some reliable, conventional means by which to connect with my gender. No can do, apparently. Turns out my perception of menopause is just yet another difference carved out by the experience of infertility. I have not been able to connect with people on this front either – neither with the angst people partake in nor with their sloppiness in inserting menopause and all that leads up to it into the category of life’s major problems. Sure, I don’t want something glossed over that shouldn’t be, and I don’t want something that should be talked about silenced. From where I sit though, I most often find myself feeling that if people had to go through infertility (or any other traumatic life altering trial well out of their control) they probably wouldn’t be so overwhelmed by this normal and predictable life change in the first place.
That’s not to say that it didn’t and won’t push me, however. Oh, I just recently had myself a day……
It actually seemed to start with passport photos I had taken, which looked way uglier, no, let’s face it, OLDER than I had expected. I freaked. I considered having them re-taken, pointed out to myself that would be pathetic, and made myself submit them as is (my specific words to myself I believe were – “you’re going to get over it AND you’re gonna like it!!”). This only seemed to fuel my internal adolescent rant, as my mind then turned to the sex my husband and I hadn’t had that morning and the miserable feeling cycle I had just ended. Although it was cycle day 2 and I should have been at least starting to feel better, my mood took a sudden and nutty hormonal downturn that afternoon. It then hit me that I feel horrible for at least 11 days out of my now somewhat typical 23 day cycles and that that, no matter how you slice it, is kind of a lot. During band rehearsal I noted the spin class, chiropractic adjustment, acupuncture treatment and yoga class I had taken in the days leading up to my period had zero effect on my mood and energy level. I felt so miserable and light-headed during band I even had myself convinced for a solid two minutes that I was in the middle of having a brain aneurism.
With the walls closing in, I made my way home sure of two things 1) that because I was perimenopausal and losing my “youth” I’d have to stop shopping at American Eagle Outfitters because their target market is ages 15 – 25 and 2) That, although it was my dream what a mere ten minutes ago, I now feared being followed around by a big fat throbbing penis for the rest of the my life that I would not be able to keep up with and/or a husband for whom not only could I not make a baby but had failed in the sex department too. It was, momentarily, quite a lot to bear.
Luckily, my husband and I found ourselves in conversation about it soon after I got home, and even more luckily he readily admitted his sex drive was less than it used to be. (When you’re in the midst of grieving and mourning the loss of your children, it’s only natural some of life’s other fun facts might allude a person). My chances of being pursued by a big fat throbbing penis for the rest of my life had just fallen by at least a ten – fold. And boy was I relieved.
He then mentioned that he thought about sex much less than he used to, a transition of which he was clearly very calm and accepting of. I, on the other hand was not so relenting.
“It’s sad and depressing.” I stated.
“Why? It’s a normal change in life,” said the only apparently sane person in the room.
“But I LIKED having sex on the brain all of the time,” I groaned. “It WORKED for me. Now there’s a blank space where that’s supposed to be too.”
And on I went, moaning that the days of having sex like sixteen year olds were over and realizing that so likely was the endless energy we had in our thirties we put into home buying and renovating and opening restaurants. I feared our last painting all – nighter may very well be in our distant past. Heck, in that moment I was convinced we didn’t have a single goal left in us. Please keep in mind this was day seven of feeling horribly fatigued and half dead (both hormonally and grief provoked) and that day five of this dirge was the anniversary of the loss of our children. And also the day I got my period.
“I really thought I could pull off being a teenager until I was like 80,” I sobbed. “I mean, I really thought I could.”
For whatever reason, it all seemed to hit me at once. That my energy level, the way I experience sex and what I needed out of life were inevitably shifting due to age.
Though my amusing display was laden with drama reminiscent of my “it’s 1986 and I’ve run out of aqua net extra super hold” debacles, I could see why the realization that life and our purpose in it was changing, even MORE than I had initially thought, was temporarily a lot to take in.
“I’ve had to say goodbye to so much – our children, parenthood, grandparenthood, life and myself as I knew it. I thought we’d at least get to keep our sex thing. We lost our children, it’s only FAIR that we should be banging all of the time.” I spewed through choked tears. In this moment it was hitting me that, although we could not have children like fertile people, we were going to age just like them. That there would be no prize for our losses felt rather harsh.
It dawned on me that I identified with and perhaps even valued myself a bit too much through my sexuality, maybe even using it as a compensatory measure for babies that we could not make, and that was going to have to change. “That’s not who you are or what you’re worth, punkin pie,” I assured myself. “If anyone can shed that skin and come out of it redefined, it’s you. As a matter of fact, I’m quite curious as to what you’ll come up with. You’ve been able to understand that whether you make a baby or not has got NOTHING to do with what you are worth, you’ll be able to easily imbibe that knowledge in regards to your sexuality too.”
And there we have it. Perimenopause arriving in the middle of grieving the loss of one’s children? Not that great. As a matter of fact, I’d advise avoiding it if I thought we had much of any control in life over either. It really is quite an unfortunate collision. Going through it with the distraction and fruitful challenge of raising children would have been excessively preferable. But perimenopause is not something I’m going to go around habitually moaning about as though it’s the rudest assault I’ve ever been dealt. Relative to the loss of my children, I can assure you it isn’t. And, it seems I’ve acquired more than a few skill sets along the way that will allow me to handle it rather well. Grieving the loss of parenthood expands one’s capacity to endure, accept and redefine well beyond that of the average person.
And lo and behold, the next day, though we remained a bit somber in our processing, my husband and I were up and running. And seemingly much more reconciled in accepting the “fading of our youth”. It’s not that this phase of life won’t be hard and I won’t feel pushed by it at times. But I’ve dual majored in hard and being pushed. Seems I’ve racked up a bit of a resume, bitches. And so, I leave you with the following:
Top Ten Reasons Why This Infertility Survivor is Not Intimidated by Menopause
10) Did I hear you say “Emotional Roller Coaster”? Why I’ve got a PhD in that.
9) I’ve already felt like shit for the past six years of infertility and grief hey what’s another ten more?
8) Unlike involuntary childlessness, there’s actually a yoga class for that. (Not one that I could personally get through without dissolving in laughter, but yeah. You get the point).
7) Which is tougher? Think hard now……..
a) a natural hormonal imbalance
b) debilitating side effects from a cocktail of 13 fertility meds
Make your mark dark
6) What’s that? You’re grieving the loss of your fertility, you with the two healthy easily conceived children? I seem to have that box good and checked. I’ll go cue the fertile world violins on your behalf.
5) Perimenopause and menopause are within the normal spectrum of life. Grieving the loss of one’s children while the majority of one’s peers are bearing and raising theirs, however, is not.
4) Facing limits, having life as you knew it melt into complete and utter internal chaos, redefining oneself, wading into the unknown……well that successfully sums up MY normal…….
3) Ability to transform? Why I’ve got a PhD in that, too.
2) Unlike in the face of life’s harsher brutalities, the way I chose to perceive and deal with it might actually fucking matter.
1) Unlike infertility, you know it’s coming. Only those who have had to navigate without it know the true gift of forewarning.
infertilityhonesty 
I’ve come to the conclusion that doctors specializing in vaginas generally do not know how to respond to comments about infertility, particularly when said comments are delivered with an air of sarcasm. For example, at my IUD insertion appointment I was getting the rundown of how well it prevented pregnancy, blah blah blah and my comment was something along the lines of “my assclown ovaries already have a proven track record of being pretty fucking useless and did a damn fine job of preventing pregnancy on their own” and that I was getting it so that I didn’t have to worry about bleeding to death. She literally had to pick her chin up off of the floor.
I might have to copy your idea of dressing sexy for the appointment since I am (over)due for mine!
I did my passport photos on a free iPhone app and then printed them off at Walgreens for $.18 and cut them out myself. I made my husband take approximately 27 pictures before I found a suitable one.
Totally feel you on the vaginal dryness, loss of libido, etc.! I hope the hot flashes pass you over because those are not fun either. Or worse on the rare occasion that you actually feel like having sex and your body cooperates, and your husband is up to it at the same time, having a hot flash mid coitus is a total mood killer. (I can’t believe I actually put that in writing……)
Finally, I totally agree with your top 10 list. Now I’ll shut up. 🙂
You’re a match for the gyn profession if there ever was one! I also loved, well hated – loved/hated, you know what I mean – the time you had to take a preg.test, made some snarky comment and the nurse practitioner retorted with a sappy “you never know”. And PS it was cycle day 12!!!!!! At least that’s how I remember it. Ahhh, she probably has 3 kids.
I advocate dressing sexy for gyn appointments. It’s immature, low minded and quite effective.
And no worries on your last paragraph, my post was a study in TMI and likely topped some of my other posts, which are also contenders.
“If I survived infertility, I’m sure I can survive this.” CLASSIC! That’s going straight in to my folder of quotable quotes….
Driving licence renewed last month (applied early in case I failed the eyesight test – something to do with my age and maybe having to get distance glasses; not this time!)
The photo…yeah – really not pretty, and no second or third take either. In my head I still think I’m rockin’ 35 (ok 40) but my body is starting to send out messages that tell me, and show me, another story completely.
While doing my mum a favour at her place this week, quite a physical job but no big deal having done it before in the past, but for the first time I really struggled, my body was telling me in no uncertain terms to start acting my age, at least physically. The energy reservoir just wasn’t there. The sweat was running off me, I had to stop every half hour for a drink break – ok I really needed to catch my breath. It was a real wake up call, and not one I wanted to hear at all. And when did my strength decide it was time to start fading out?
And I hear you – the dryness, the libido up and disappearing in the night, the sleeping with a sheet only… still waiting on the hot flushes to start, hey, something to look forward to! Have also noticed the cycle is starting to play havoc with the emotions again, that snippy, short temper seems to be making a comeback every few weeks… oh the hubby will love revisiting those days again (the sarcasm never left)!
Can’t catch a break can we? It would be nice to think there’s an upside somewhere along the way after all the trauma. Turns out we’re due no favours either.
I love your top ten list. I’ve already got this page bookmarked for future reference for when I need to remind myself about keeping menopause in perspective. Thanks
So honored to be in someone’s folder of quotable quotes!
“Turns our we’re due no favours either” – Ha! I thought I had learned that and was surprised during my little rant I still had some expectations in that department. My husband and I still laugh at my rant. And yes, given everything we’ve gone through, as far as aging and menopause, at least under normal average circumstances, I think we’ve got this:-)
While sex during and after menopause is different, it doesn’t mean worse. In a lot of cases, including me, it was better. Just plain, true and simple lovemaking with your partner without the fear of getting pregnant or not getting pregnant. Buy yourself some gel for the dryness and party on!!!!!!
Got it already, my friend:-) The gel, that is. After all we’ve been through, I know we’ll make our way with this different phase too.
Great read. Thank you for writing this!
Appreciate you reading it (and all of my TMI)!
I remember saying to my fertility guy (North Americans I think call them REs) that after two ectopic pregnancies, IVF sounded like a breeze! He pointed out that as I was already stressed, I might find IVF harder than I thought. In some ways a cumulative grief.
But then, on the other hand, I welcomed menopause, because it was something – as you say – that all women go through. I didn’t grieve the loss of my uterus after my hysterectomy (thanks, menopausal fibroids) because it had never been any use to me, and had only ever caused me grief!
#6. I’m with you on the violins. I remember a friend of mine talking about her 40th, and marking it as the end of the childbearing years. She did this in front of two couples who were unable to have children. Sheesh!
It’s going to take me awhile longer to get used to being underwhelmed by things that seem to concern others, generally speaking.
And yes, as far as mourning the end of one’s child bearing years, perhaps there’s a time and a place. Around people who wanted children but couldn’t have them – NOT ONE OF THEM.
So I stumbled across real, actual research about this very thing – some study that looked at moms through adoption vs. biological moms who conceived without incident, both going through menopause. My memory is hazy, but I think the researchers were surprised that the fertile moms struggled more with that emotional loss of fertility, even though they’d completed their families; they expected this to reopen a trauma for the adoptive moms, but when they actually talked to people, menopause had already lost its significance for women who’d grieved their fertility long ago. It seems we all go through it at some time, but fertile women are blindsided by it later in life.
(Because the Real Housewives are my dirty pleasure) I remember NeNe (at 40-something) responding to catty comments about her age by saying, “I can get pregnant tonight!” and I though, wellllllllllll….not so sure about that. (Women who have never struggled are so naive about the real, medical truth of AMA.) And on the Beverly Hills franchise, Brandy trashed the other women on the show by announcing, “At least I still get my period, bitch.” And then there are Phaedra’s comments to Kenya Moore (which I have written about on my own blog) calling her a “barren woman” with “rotten eggs.” Not that Housewives are the be all end all, but it does reveal a little something about our culture and notions surrounding fertility, which is connected psychologically to beauty, femininity, youth and, sadly, to a certain extent, a sense of worth. I have a therapist on one hand telling me, “You are not your eggs,” and then I have a thousand different subtle messages telling me and millions of other women that, well, that’s not entirely true. So the loss causes grief and sets this identity crisis (on some level) in motion for all of us, but by the time it strikes, infertiles are, like, already so over that. Me? As soon as the hot flashes come, I want my ovaries out so they don’t kill me as POF is linked to elevated cancer risk in a field with virtually no screening for early detection. All a matter of perspective.
Interesting regarding the research. Not too surprising though. I think the self worth aspect you point out in your 2nd P is a component. Many who have children easily I’m sure subconsciously connect this fact to their worthiness, whereas those of us who can’t have been harshly pushed to disconnect our sense of self worth from the ability to reproduce. Plus I know for me, and likely for many who go through treatments, the loss of fertility was entangled with so many other excruciating experiences it would be impossible to single it out.
I went into my doctor’s office a couple of months ago and she couldn’t even do a Pap test cause I was so dried up, it hurt. It occurred to me that I had noticed it months before but pretty much ignored it cause I had zippo interest in sex anyway. The only thing I noticed was that I could even insert a tampon without great discomfort. I told her that my nether regions were pretty much on revolt and I didn’t care anymore what the hell my vajajay did. I had had enough of my lower half not doing what it was supposed to do years ago. She told me to make friends with my vagina. As if I hadn’t been obsessed with my lady bits thanks to infertility. She gave me a prescription for vaginal estrogen. Whatever.
“Make friends with your vagina”???? Groan. Way to empathize, doc! It seems, judging also from other comments I’ve gotten, the profession of gynecology has got a long way to go as far as being educated on infertility. It’s sad, since they should be the one faction of the world that is informed beyond the typical uni-lateral view of human reproduction.
As someone who is… and apparently will be… suffering through perimenopause for years upon years… you get used to it oddly. And you figure out the sex. Trust me, it was not fun at 30 to never be in the mood, despite desperately wanting to be in the mood. Lubes and other enhancements help a lot. For the first 2 years of the lower libido I was in denial. But once I got through that, we found new ways. Now we spend a lot more time revving things up and I actually find I quite enjoy it! There are less “quickies” as that just kind of never happens for me. But, I think we are both quite happy with where we’ve landed.
The fatigue shit though is annoying. I get sick of being tired for no reason.
Anyway, you are correct, infertility has prepared you for this. you’ll get through it no problem. When I’m frustrated with it, I just think “it isn’t as bad as having cancer.” And you can probably think “it isn’t as bad as…” well many a thing you had to deal with during your treatments and what not.
I really appreciate you lending your perspective on this, Nicole. I honor your experience and your wisdom. With whatever I’m dealing with now in the libido department, at least it’s at an age where one can reasonably expect it. I admire they way you’ve handled, and the way you share, all you had to go through at such a young age.