The Vagina Wars

And other shitty things about menopause you won’t find from Google…

I’ve been hesitant to write about menopause in any explicit detail, even though it’s been over seven years since I experienced the first signs. I do mention it in my book – Every Shitty Thing– briefly, in throw away comments as I grasp for humour. As if there’s something funny about it. There isn’t. I worried that if I harped on I’d bore my audience to death, especially the women who haven’t reached that stage of their life yet. In fact, I bet every non-menopausal woman has already stopped reading this — if they even started. Menopause is just not that interesting. Unless you are in the thick of it, you don’t give a shit. I didn’t before menopause. I used to think “Ah whatever, I’ll deal with that when the time comes. It’s just another part of life. How bad can it be? I can’t wait for the the period dramas to be over and I don’t get them anymore.”

Wrong thinking!

“Careful what you wish for, love…” My mother’s favourite cliché still haunts me from childhood. She’s been gone for 13 years but I swear she still whispers that in my ear.

The things I would sacrifice if only I could bleed again on a monthly basis…

I’m not going to worry about boring anyone or harping on about it anymore. It’s time I started paying it forward about menopause. My experience, which has been traumatic at times, has been one of my biggest learnings. How can I not share it if it helps someone avoid a few pitfalls, or at least makes them more aware?

When you Google menopause, one of the first things you see is this:

STATISTIC 1:

Doesn’t sound too dramatic does it?

What is should say is this:

Menopause is signalled by a consistent 12 months since your last period. Occasional missed periods could go on for years. The first time it happens it will scare the shit out of you because you’ll think you’re pregnant. You will purchase numerous pregnancy tests, convinced that you are. The anxiety could cause a total breakdown. You do not want a baby at age 45, or any other year thereafter. This process will happen several times before you realise it must be the first signs of menopause, i.e. perimenopausal.

STATISTIC 2:

They forgot the anxiety, mood swings and depression on this list.

Firstly, back to statistic 1.

Common symptoms include hot flushes (as we say in Australia, not flashes) and vaginal dryness – we’ll get to the latter in a minute.

Hot flushes are not what you imagine (overly warm, sweating more than usual). You will literally feel like you’re on fire. Jumping into the mouth of a volcano is an apt description. You will, for the first time, understand what your ancestors, the witches burned at the stake, went through and you’ll empathise for real. You will want to rip your clothes off — and you do, so be careful if you work in a public place. You will have little warning of the impending fire — 10 seconds at best — and it can happen more than a dozen times a day. Good luck if you’re in a business meeting. You will never wear long sleeves ever again — definitely not a coat, even if you live in Siberia. Air-con is your new best friend.

But trust me, the fire is the least of your problems.

You will eventually, almost certainly, resort to hormone replacement therapy (HRT) even though you swore you never would, just to make it stop. The decision will mess with your head, but not as much as the mess to your body. The trials and tribulations of HRT are long and arduous. You will try numerous types — there are hundreds — until you find one that works. In the meantime, depending on which HRT you’ve been taking, you may experience weight gain, nausea, dizziness, panic attacks (even if you’ve never had them before), weird abdominal pain (and other random pains), and even possibly changes in the cells that eventually lead to cancer (mine was pancreatic). Of course, you won’t know any of that unless your blood has been drawn for testing more times than you can count. Your doctor is now your best friend. The upside: the fire is gone at last.

STATISTIC 3:

Before we move on to the vagina wars – because that will need an entire page – I’ll touch on, briefly, anxiety and mood swings, and what to expect.

This new hell will have you believe you’ve been possessed by a demon entity while you were sleeping. You have no other explanation for your change in personality. You don’t know all the facts about menopause yet, even if you’ve read it all and think you do. You are in denial. Everyone else is the arsehole, not you. Your fears and insecurities are on steroids. If you thought they were bad before, you’re in big trouble now. If you were fearless and self-assured before, you will change. People, especially your family, mostly your children no matter how old they are, will become the enemy — and you’ll question why you ever had them in the first place. You hope a plane crashes into your house and kills everyone, but mostly you. Your morbid thoughts depress you, and so does everything else. Then the unthinkable may happen. For the first time in your life you turn to mood stabilisers. You’re desperate. Nothing you’ve experienced before menopause – a dysfunctional childhood, sexual abuse, addiction, post-natal depression, betrayal or divorce – has ever warranted prescription drugs. Zoloft is your new best friend.

If your body was once a temple, it is now the temple of doom. You embrace the drugs.

I could expand greatly on the items in statistic 2 – and many others – but for the purpose of this essay my focus is on the big one: vaginal dryness.

Imagine, if you can, that your husband’s/partner’s penis has become a living razor blade. As he enters you, no matter how slowly, you will feel as if you are being sliced open. This gets worse as time passes and your oestrogen levels continue to diminish. There is no lubricant on earth that remotely resembles oestrogen. Anyone that tells you otherwise is a liar. The loss of this hormone will strip you of everything that makes you feel female. You had no idea how important that stuff was before menopause, not really. Gone are your days of random hard pumping sex. The mere act will become a tedious checklist of prep work and careful manoeuvring. If you’ve been married for more than 20 years you will probably give up sex entirely. If you’re on your second or third marriage and still in the honeymoon years you are fucked, but not literally. You’ll become very good at blow jobs. I’d like to say blow jobs are your new best friend, but can we really say that about blow jobs?

And you won’t find any of that in the brochures. #Truth

I’m not finished with the vagina. Not even close. Believe it or not, that’s not the worst part.

Up to 50% of menopausal women will need to familiarise themselves with Lichen Sclerosis.

STATISTIC 4:

They make it sound less dramatic than it is, trust me. And it doesn’t necessarily start in POST menopausal, — that’s simply when it gets worse.

This Pandora’s box will have you believe – in the beginning – that you have a very bad case of thrush. The usual over-the-counter pharmacy medications aren’t working. By the time you get to the doctor, if you haven’t gone mad already from the excruciating itch that never stops, you’ll be so desperate you will consider calling your old drug dealer friend who can hook you up with enough weed to kill any pain. You hope. Ice packs are your new best friend. Sitting on them for most of the day will help. When your husband mentions sex, you will be tempted to stab him. Stay away from the kitchen. Your GP doesn’t know what’s wrong. It’s at this point you convince yourself your husband is having an affair (your insecurities hit an all-time high, you may double dose on Zoloft) and you’ve contracted some hideous STD (sexually transmitted disease). When swab and blood test results come back – hopefully before the separation – you learn it’s clearly not thrush or an STD (thank God), but your GP finds no abnormalities in the testing. You will want to kill yourself at this point as it seems like the only solution. The next step is specialists. Some will tell you it’s all in your head. Seriously. But then you’ll find a gynaecologist who does believe you. On examination he knows what it is – but he doesn’t name it – and simply prescribes a corticosteroid cream. It works initially and, two weeks later on a follow up appointment, you consider offering him a blow job because he’s a miracle worker.

Don’t be fooled. It’s temporary. All an illusion.

Advice to the wise. At the first sign that your usual thrush cream isn’t working, find a specialised dermatologist. If you’re in Melbourne, her name is Helen Saunders. She is the miracle worker. No blow jobs necessary. You will learn everything about Lichen Sclerosis. The ointment you need can only be purchased from a Compound Pharmacy, with a specialised prescription. After an intensive two-week treatment – and months of suffering – your vagina will feel sort of ‘normal’ again, but it will carry the scars of war like any other person who has been in battle. Eventually you’ll also learn that, once a week for the rest of your life, you’ll need to apply the ointment to avoid flare-ups. You’ll forget sometimes, but the raw tenderness you feel after peeing will remind you — you forgot your ointment this week.

I compare Lichen Sclerosis to herpes — or baggage — that shit stays forever. Even tattoos can be removed eventually. I’d get my entire face tattooed if I was guaranteed to bypass menopause. I’m not kidding.

There is so much more, my mid-life friends, that I could share — about my world, the things I’ve learned about menopause over the years — but it would be a book.

I will mention this in conclusion though: bio-chemical hormone replacement (BCHR). This is something I discovered from a kind nurse, a stranger I met while having a routine procedure in hospital in 2014. BCHR is a kind of alternative HRT treatment — less assaulting, yet still effective. I’m no expert, but I feel like I could be. If you are opposed to taking HRT, do some research on BCHR, you won’t be disappointed. Feel free to reach out and ask questions. If I can help, I will.

Marcia Abboud