As we perimenopause

P’s bag is stuffed with packets of sanitary napkins. They’re colourful, orange, blue, green, with neat imprints of napkins, flowers and petite girls. The packets peep from between her clothes, straddling an overnight kit and a bag of medicines. She’s staying at the hospital.

The sight of sanitary napkins borders on a sense of familiarity. When in stores, seeing them on the shelf always has drawn me towards them. Consumerism is real! But also the need to be prepared and comfortable. For my generation, napkins were what mothers introduced us to before we discovered tampons and menstrual cups through friends.

I stare at P’s stash of sanitary napkins and a deep sadness hits me. She’s no longer going to need them because she’s about to have her uterus and ovaries removed, to remedy a health issue. Menstruation is going to be over for her suddenly. And with it will come the loss of a habit her body and her emotions have gotten used to for 35+ years.

Days after the surgery, as she sits at the landing of the first flight of stairs, exhausted and in pain from the climbing, her mother will pat away stray strands of hair from her face and cup it and stare at it lovingly. That moment of wonder is when women understand.

P has been a housewife for as long as she has been married. In her late 40s now, she’s already starting to resemble her mother. Her life has been about doing household work, raising kids and serving her in-laws. There is no residue of the girl who wore mini skirts and wore her hair in short bangs. The one who wrote down the lyrics of songs that made it to the Grammy’s and sang aloud, and learned the moves for Bollywood numbers.

The new P is someone else. She speaks in whispers, as though worried her thoughts will be interrupted or overheard. She tucks information in her heart, afraid she will be found out. This P nurses her body from the tiredness of employment as a housewife. This P is synonymous to her uterus.

As she recovers from the surgery, she will realise that with the absence of her reproductive unit, she has abruptly menopaused. There’s no perimenopause for her. She hadn’t yet gone through the highs and lows of perimenopause. The journey has been sudden and the destination hasn’t yet sunk in. And, she will have to get rid of the sanitary napkins.

I remove them from her bag and put them into mine. I’m perimenopausal, I tell her. I’ve missed a period and I don’t know when the next one is coming.

I’ve experienced severe bloating, coupled with phantom cramps and restlessness. The pain would spread across my abdomen, making me weep and wonder if pregnancy would feel the same way. What would it feel like to hold a full baby in your belly? Would it feel like I’d had too much to eat? Would it be painful? I will never know now that I have entered perimenopause.

It's a lonely journey, this. No one tells you you will experience a hundred things. Eh, they will say, you’re about to stop. But no one explains what you need to know-- the same as when you first started and they didn’t tell you your periods were not some hemorrhage.

No one tells you perimenopause makes your periods erratic and you will need to carry provisions in your bag always, since you never know when to expect it. Tracking your period calendar doesn’t help anymore because the courses are no longer by the chart. No one tells you your knees will start to buckle and osteoporosis will set in. You will struggle on the staircase.

No one tells you you might experience tinnitus, irritability, dizziness, brain-fog, restlessness, insomnia, forgetfulness, low mood, eczema, weight gain and hot flashes. My gynaecologist made a list of the symptoms when I asked her. But many women don’t or can’t afford to see a specialist when they’re going through perimenopause. Our mothers went though it silently and many of us follow in their trajectory. But it helps to converse.

Speaking to some of my girlfriends who’re also perimenopausal has helped see my own situation with more clarity. Not all women menopause at 50 as is often predicted. Some menopause as early as 40. Regardless, the symptoms for menopause can begin to set in a decade before one arrives at it. For some, the transition is brief. Regardless of the length, perimenopause means you might suddenly feel like you’re on fire, experience irritability and sadness, and physical pain and a number of other symptoms.

As women head towards menopause, we lose bone density and muscle and quickly gain weight. My friend S decided to start lifting weights last year to deal with the symptoms. Now her legs are taut with strength and exercising has helped her stay steady. And she’s eating more fiber and less carbs.  

There are a thousand thoughts that might cross a woman’s mind during perimenopause. They’re around fertility, sex life, health, weight concerns but also around relationships. It can be hard for a perimenopausal woman to stay upbeat.

And as Phoebe Wallerbridge writes for one of the scenes in Fleabag, when menopause comes, you’re suddenly free, but your pelvis floor crumbles. It’s a mad balance women are expected to keep. From the curiousness of puberty through years of fertility, the only days of peace every month are the remainder after subtracting ten day of PMSing, a week of menstruating and another of ovulating.

It is possible to take tests to determine menopause age and fertility. And this can help women prepare mentally for what’s coming. Most of all, it would help to know friendships, family and loves won’t abandon us as suddenly as health tends to.