Perimenopause: The Fine Print

If you’re squeamish about “women’s issues,” you may want to stop reading now, because I’ve decided to write candidly about perimenopause, and quite frankly, she’s no joke.

At this point, most of us know far more about the topic than our mothers and grandmothers ever did, and for that, I’m grateful. Still, there are a few details that haven’t made it into public knowledge.

As a woman of a certain age, I thought I had a handle on what was coming. One of my closest friends read three different books on the subject and did an excellent job relaying the highlights to me. I’m not one to read advice books myself, but I’m more than happy to benefit from those who do 😉. In our early forties, this friend and I started lifting weights, added speed workouts, and made a vague but determined plan to “get ahead of it,” as though perimenopause were something that could be out-trained with enough lunges.

Between my unearned confidence and the fact that my husband is ten years older than I am, aging never felt particularly threatening. If anything, I’ve always felt like I had a bit of a head start on acceptance. I wasn’t clinging to youth or pretending time wasn’t moving forward. I felt ready to take this next phase on with some degree of competence.

Then last week, I got a yeast infection.

I know, not exactly a dinner party topic. Which is probably why no one mentions it. After a brief and completely unnecessary moment of wondering how this happened, I turned to the most reliable physician I know: Google. And there it was, buried in the fine print: yeast infections are common during perimenopause.

What?

I already knew about the hot flashes, the migraines, the night sweats, and the hair thinning. I had accepted, at least intellectually, that my body was going to change. But this felt like insult added to injury, as though my body had decided not only to rewrite the rules, but to do so without providing a syllabus. No one told me that perimenopause was life’s second puberty, and no one sent me back to health class first so I would know what was coming.

I was so caught off guard that I did what any reasonable person would do: I kept googling. Then I started asking around, because nothing builds community quite like collectively comparing symptoms you never imagined you’d discuss out loud.

Perimenopause, it turns out, can include brain fog, mood shifts that arrive without warning, and sleep that becomes so unreliable it feels personal. It can bring heavier and more unpredictable bleeding, fatigue that doesn’t respond to rest, breast tenderness, hair thinning, migraines, vaginal dryness, pain with sex, urinary tract infections, irritation, burning, itching, heart palpitations, dizziness, increased inflammation, and a slower recovery from exercise. And yes, yeast infections, courtesy of hormonal shifts that alter the vaginal microbiome like an uninvited houseguest rearranging your furniture.

None of this, I would argue, was adequately emphasized in the brochure. All of it, I believe, needs to be de-mystified.

Here’s the thing. Much of what I’ve experienced in this stage of life, especially the physical symptoms, can be found on the internet, even if they’re not widely discussed. What’s harder to find is the shift that I’ve experienced alongside it, the way that, as my body has become less predictable, other parts of me have become more grounded.

For most of my life, I’ve spent a fair amount of energy managing how I show up in the world. I’ve thought about how I’m perceived, whether I’m doing things “right,” whether I’m keeping people comfortable, or whether I’m meeting expectations that were never mine to begin with. That effort has been so ingrained, so automatic, that I rarely stopped to consider how much space it was taking up.

Over the past few years, that’s started to change. It’s not that I’ve become indifferent or detached, and it’s certainly not that I’ve figured everything out. If anything, there are more days when I feel scattered, when I lose my train of thought mid-sentence. But alongside that, there’s a growing clarity about what matters and what doesn’t, and a decreasing tolerance for the things that don’t.

I find myself less interested in performing a version of myself that’s polished or palatable, and more willing to be direct, even when that comes with the risk of disappointing someone. I notice when I’m stretching to accommodate something that doesn’t sit right, and more often than not, I stop.

There’s a kind of settling happening, even while my body is changing in ways that feel both uncomfortable and humbling.

We’re taught, in ways both subtle and explicit, that getting older is a kind of loss, a slow erosion of energy, beauty, relevance, and possibility. And to be fair, there are moments when my body feels like it’s proving that theory correct in real time. But there’s another side to it that I didn’t anticipate, a sense of being grounded that comes not from having control, but from needing it less.

It’s a strange trade-off.

My body feels more unpredictable and inconvenient than it has in years. At the same time, I feel more like myself. Not the curated version, not the one shaped by expectation, but something closer to who I am when I’m not trying so hard to get it right.

Even though my eyesight seems to be deteriorating at a breathtaking pace, many of the changes I’ve experienced have been clarifying in a way I didn’t expect. I may not recognize my body all the time, but I recognize myself more than I ever have, even if I occasionally walk into a room and realize I have absolutely no idea why I’m there.