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When Perimenopause Feels a Lot Like a Midlife Crisis


Who am I? What am I doing with my life? How do I want to spend my remaining years? I no longer recognize myself…. Am I living the life I want? Should I quit my job? Divorce my spouse? Get bangs?

When women say the above phrases — or phrases like them — to ourselves between the ages of 40 and 56 or so, the questions arise: Are we saying them because we’re dealing with perimenopause or menopause? Or because we’re having a midlife crisis? How can we tell the difference? And does it matter?

Menopause is defined by not having had a period for one full year. Perimenopause begins several years before that (in some cases up to ten years before), when the body begins to make less estrogen. Symptoms of this estrogen loss can include hot flashes and night sweats, lower libido, fatigue, irregular periods, vaginal dryness, urinary leakage or urgency, insomnia, weight gain (especially around the midsection), and mood swings and emotional changes—including anxiety, extreme emotionalism and sensitivity, lack of confidence, anger, and depression.

It’s those last symptoms—mood swings and emotional changes and all that those entail—that, depending on how they manifest themselves, can read a lot like a midlife crisis.

If you feel depressed, anxious, irritable, and angry, if you aren’t sure of yourself or of the decisions you’ve made, and you’re in your early 40s to early 50s, are you perimenopausal, or are you having a midlife crisis?

The Happiness Peak — and the Fall

Or are you simply experiencing what researchers have identified as the bottom of “the U-Bend”? According to Mindy Greenstein and Jimmie Holland, authors of Lighter as We Go: Virtues, Character Strengths, and Aging, research has shown that among people between the ages of 18 and 85, the age group that feels the greatest sense of happiness and well-being is …wait for it … 82-85. This result was so surprising that various researchers performed numerous studies in all parts of the world (from 72 developed and developing countries in all) to double-check the findings, which held, while all kinds of variables were accounted for.

“This U-bend of well-being has been found over and over again,” Greenstein and Holland write (though they are careful to point out that these are statistics that refer to people in general, not to every single individual). What is equally interesting (at least, to someone in midlife, like I am), is that the lowest point of well-being was also remarkably similar, according to these studies—and it seems to be right around age 50 to 53.

Which, of course, is also right around the time of menopause.

So back to the woman in her midlife who is stressed-out, anxious, unhappy, and wondering if she should leave her husband or wife, quit her job, or get bangs: What, exactly, is she experiencing? And does it matter?

According to Kristen Wells, MD,a surgeon specializing in breast cancer in Wisconsin, it does matter. “I think the woman should take a wait-and-see attitude,” she advises, when it comes to making big decisions. “Because if it’s hormones, if it’s perimenopause, then the woman could make a big mistake she regrets later.”

This is indeed what happened to a responder on the “Patient” forum. She wrote:

“I was happily married to a wonderful husband for 15 years. I became perimenopausal at 49. I became depressed, had an affair, filed for divorce. It’s been a year now and I’m alone and very depressed. I went from a happy, loving wife to someone completely unrecognizable. Now I’m starting to understand the effects of hormones on my behavior.”

A wait-and-see attitude would have helped this woman, who was approaching menopause after all (the average age of menopause is 52), though for women who experience perimenopause for a decade, that’s a harder call to make. For those women — and others — medication such as birth control pills, antidepressants, or hormone replacement therapy might be a good option if they’re experiencing serious symptoms. And of course, women must be careful, as “Labeling everything as ‘just another menopause symptom’ may be preventing a woman from moving on in her life,” advises Julie Dargan, in When Menopause and Midlife Crisis Collide.

Knowledge Is Power

Education is also important. “I’ve had patients tell me they wouldn’t have divorced if they’d understood their symptoms at 50,” Diana Bitner, MD, author of I Want to Age Like That: Healthy Aging Through Midlife and Menopause, says.

And speaking of divorce, should we consider “filing for divorce” a serious symptom? After all, after the age of 50, 65 percent of divorces are filed by women.

Louann Brizendine, psychiatrist and author of The Female Brain, sees this trend as part of the female’s changing brain. During perimenopause, less estrogen is produced, which means that less oxytocin is also produced. Oxytocin is the feel-good hormone responsible for wanting to take care of others and show love for them; it’s stimulated during hugging, massages, cuddling, and sex. Just when the woman loses her fertility, oxytocin is decreased, which means that women also lose their interest in caring for others.

“The mommy brain unplugs,” Bridendine says. “Menopause means the end of the hormones that have boosted communication circuits, emotion circuits, the drive to tend and care, and the urge to avoid conflict at all costs.” So, if there were any issues or problems in a marriage by this time, women might be ready to act upon them. Therefore, according to Bridendine’s findings, it probably isn’t a coincidence that the ratio of women to men filing for divorce is 3:1 after menopause.

If all of this sounds a bit depressing, there are positive aspects to this time of life as well. The gift of perimenopause and menopause is that they come at a time of our lives when we can ask ourselves the Big Questions when it’s not too late to make changes. If we find that we are unhappy with some aspects of our lives, we still have the time and energy to turn things around. Given the hormonal changes that come during this time, it’s probably wise to make certain that we do all we can to take care of our bodies and minds first: all experts seem to agree that exercise helps treat many symptoms of peri/menopause. Many doctors find that HRT is extremely helpful given the right timing. And certainly the U-Bend of Happiness research shows us that statistically speaking, well-being lies ahead.

In my own life, I’ve found that going through perimenopause, being hit by a car and having major brain and head issues afterwards, and being at the nadir of the “U-Bend of Happiness” all at about the same time, have left me feeling more confused and unhinged about myself and my life than I have since puberty.

But my own research has taught me a few tips. I exercise, I eat right, and I’m looking into hormone replacement therapy before I do anything rash—like get bangs.

This essay was written by Kelly Dwyer, a published novelist, playwright, and freelance writer.

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