Twelve period-less months, symptoms aplenty, and now… now… a future opens up both with and without new possibilities.

Menopause is here. 

Every woman’s life, including her menopause experience, is deeply personal and dynamic. Once the dozen cycle-free months have passed, and a woman enters menopause, her genetic reproduction journey has come to an end. 

For some women, entering menopause may feel like freedom, transformation, even amid the unexpected torrent of hormonal changes, emotions, and physical changes.

For other women, menopause may evoke feelings of sadness. Feelings of loss and grief can be part of the menopausal change and can feel overwhelming, even surreal, and painful. Intensity and frequency of feelings may vary, person-to-person, even day-to-day. 

It’s definitely possible throughout the course of continuing hormonal change that a woman can feel all of these feelings and more as she enters more deeply into this rich part of life. 

In light of Infertility Awareness Week, especially during this unprecedented time of COVID-19, let’s take a look at this important topic together.

A complex life transition

We checked in with Lora Shahine, MD, FACOG (Fellow of the American College of Obstetricians and Gynecologists) with Pacific NW Fertility for her thoughts and insights about menopause and infertility. 

“Menopause is a complex life transition for women with or without a history of infertility. It’s a combination of hormonal shifts, body changes, and emotional changes – often combined with a stage in life full of career, family, and external demands.”

“Menopause means the end of the ability to conceive a genetic child and for many women – this can feel like grief – whether a woman has completed her family building journey or not,” shared Dr. Shahine.  

“This loss can be especially painful for women with a history of infertility. Even if their fertility journey is in the distant past or they have completed their family, Menopause can be a trigger to the emotional toll infertility took in the past. Infertility has been compared to trauma and recovery compared to post-traumatic stress disorder (PTSD).”

Feelings of loss without infertility challenges

Some women may feel a sense of loss at menopause even if they didn’t have a strong desire to have or raise children. Others may feel a sense of bittersweet sadness or sorrow at menopause though they’ve had all the children they had their hearts set on. It may feel surprising, baffling, or even confusing. It is the nature of change, and sometimes change evokes unexpected feelings and emotions.

One woman, Barbara, described her experience for us, 

“When I turned 49 my menstrual cycle came to a halt. Month after month she did not appear. As the year of not having my period was coming closer and I was preparing to step over the threshold into menopause, I started to feel a deep sense of loss and grief. What I realized was I did not take the time during that year to say goodbye, thank her for being in my life, and to bless her.” 

“The day before the year was complete, my period came again. I was gifted another year to be with her and to be present to the process of saying goodbye. It was a rich year, which I am so grateful for. And when the final hour to let her go came, I felt complete and ready to move into what was waiting for me.”

Dr. Shahine encouraged, “Menopause does not have to trigger a negative response – it can help women reflect on their life so far – family, reproduction, and more. Recognizing that this transition can be emotional (positive or negative) is important. Menopause is a transition no matter who it happens to and making space for the emotions, being aware of the emotions that can arise are important.”

Important to note: Risk for depression in menopause

Whether or not depression has been part of her life experience prior to perimenopause or menopause, the risk of depression definitely increases with this transformation. According to Harvard Health Publishing (for Harvard Medical School):

“A woman’s risk of depression doubles or even quadruples during the menopausal transition.” 

Note: This doesn’t mean it’s a guarantee that a woman will develop depression during menopause, only that the risk increases. 

Still, if infertility has been a painful part of a woman’s life experience, an increased risk for depression during menopause may be helpful to know going in.

More support, including primary care Telemedicine: Learn more now.

What if all this is happening now? In the middle of the COVID19 pandemic?

Feeling the feelings of grief and/or depression, navigating changing menopause symptoms, and staying diligent about safety precautions during the coronavirus pandemic is a lot to process. That almost feels like an understatement. A few gentle suggestions to look at:

• Easier with support: Getting practical, emotional, medical support from a menopause expert is easier to access than ever with telemedicine. Our online clinic for women at Gennev offers myriad options, from 1x1 support to podcasts, webinars, and forums. Knowing you’re not alone can offer tremendous relief.
• Easy does it: A forceful, driving pace may not serve your body, mind, or spirit. Consider reflecting on priorities, journaling, talking with your partner and trusted, supportive friends. From work to family to self-care, consider your pace in doing “all the things.”
• Self-care: We’ve written many times how self-care can stave off or diminish menopause symptoms. During this COVID crisis, self-care is proving more important than ever. Nutrition, exercise, drinking water… these are a few of the self-care topics to consider. There are more options for sure, but these are daily self-care tasks to review and continually improve when you feel willing and able. 

For partners, family, and friends of women who are struggling

Our relationships and support systems are critical at this time, both with those in a shared household and outside it.

Shahine notes, “Friends can support women going through menopause by being aware of the emotional piece to this transition, being kind, and encouraging self-care.”

Good insights for all of us, yes? 

If you’re experiencing menopause, feelings of grief or loss, or simply want to connect with other women who are curious about the same things right now, join the community at the Gennev Community Forums.