Menopause Hits Different for Asian Moms
It is never too soon to talk about menopause, especially when it feels like anxiety instead of hot flashes.
Last week I learned that I am in perimenopause. If you don’t know what that is, count yourself lucky and then start doing your research. I have been in perimenopause since 2020, but because of my age (I’m 38), the word never came up. Instead, because I was 34 and had a two-year old, the words “postpartum depression,” “new mom” and just plain “hormones” were the words my doctors used to diagnose the sudden and intense changes in my period, my insomnia, and my anxiety. No healthcare professional said a word about menopause until last August when a nurse checking me into my well visit said I might want to look into it after I gave her the date of my last period (three months before the appointment). Her suggestion was quickly and loudly brushed off by my GP who insisted I was way too young.
Only this week, after a new gynecologist ordered a blood test because I had missed several periods for the second time in a year (don’t get me started on my GP brushing this off) do I understand why I started feeling so out of control four years ago. I am in perimenopause. And if I don’t get a period by September, I will officially be in menopause, or early menopause as it’s called for women under 45.
As you can imagine, I have spent the last week wondering how different I would have felt if I’d had this clear biological explanation and accompanying treatment plan for what still feels like a long, dark period of my life. I want to talk about menopause and symptoms of perimenopause today because maybe I can help you the way I wish I’d been helped four years ago.
Menopause, as Dr. Jen Gunter explains in her book The Menopause Manifesto, is “puberty in reverse.” It is a phase of life when women are no longer able to get pregnant. Menopause is not a disease, nor is it unnatural, we just don’t culturally celebrate menopause the way we do when we get our periods. But this lack of attention comes with increased risk for women’s health. The average for menopause is 50, but women go through menopause between ages 40 and 60. Early menopause is considered anytime before age 40. The years leading up to menopause are called perimenopause and can last between 4 and 10 years or longer. In perimenopause your body begins producing less estrogen and progesterone. After you reach menopause, your risk of developing acquired Heart Disease, Osteoporosis, and Dementia goes up due to lack of estrogen. Those risks increase the younger you are.
Women like me who experience early menopause (or even premature menopause, which is menopause under age 40) can go on Hormone Replacement Therapy. HRT can reduce these risks significantly by pumping a cocktail of estrogen and progesterone into your body. But HRT comes with its own risks, and many doctors suggest a cocktail of supplements to start. Right after I got my perimenopause diagnosis, my husband and I went to Costco where I bought bulk bottles of calcium citrate, magnesium glycinate, fish oil, and Ashwiganda, which my husband cautioned he’d read can have the opposite affect of making some people feel dead inside. “Just watch how you feel,” he said as we proceeded with caution.
Our culture tends to attribute hot flashes and dry vaginas as the symptoms of menopause, and while those symptoms are certainly true, a woman’s experience depends on her ethnic and socioeconomic factors. Women of color are at an elevated risk of having more severe symptoms and/or misdiagnosis, which adds to the explanations for why my perimenopause went undiagnosed for so long. Black and Latina women are at risk for experiencing more severe and longer symptoms of perimenopause.
For many Asian American women, particularly those of East Asian descent, brain fog and anxiety are common symptoms. Though research is unfortunately emergent, I am amplifying the findings in this study because the researchers also found that Asian American women, and again particularly those of East Asian descent, report fewer hot flashes. I am hesitant to say that I don’t have hot flashes. I’m not jinxing myself before September, but if I were to compare my experience with hot flashes to my experience of anxiety, I would tell you that my doctor was calling my apples oranges.
If you are not of East Asian descent, and curious about symptoms you’ve been having this explainer may be a useful starting place for you.
All week long, as I processed my new diagnosis, I texted with girlfriends in their thirties about their changing periods. My blue bubbles said, time and again: ask your doctor about perimenopause. We are never too young. These texts feel like a new rite of passage.
Nobody wanted to tell me I became a mother at the same time I was losing my ability to bear children. To cope with my deep-seeded rage, I am keeping a gratitude journal and looking outward. I am writing this post to urge you to ask your doctor about perimenopause. Get the information as a precaution. Forward this piece to your friends. I am willing to be a cautionary tale if I can help one person get help in a timely manner.
I can’t reclaim lost time, but I can tell you that the sooner you start talking about perimenopause, the sooner you can seek treatment for whatever your symptoms are. And if like me you are in premature or early menopause those treatments, when you finally access them, can save your life.