I actually have mostly been hampered because of nonanonymous people. My dad reads this blog, you know? Hi Daddy! I love you!
And I mean, it's awkward. I don't actually want you, whoever you are, to know specifically about my sex life and all that jazz. But now that this blog is really out there, and hopefully being read, at some point, by another young woman like me stricken with cancer and all its never-ceasing life-changing consequences, I want it to actually be useful. Not just interesting. Actually. Useful. So, I'm going to talk about these supposed unmentionables, but generally, not specifically. Some of these things may be happening to me, and some may not, and you'll never know unless I tell you about it over lunch. So let's do lunch. Unless you're my dad, in which case I love you mkay bye.
If you're offended by words like vagina and intercourse and orgasm and antidepressant and depression and profanity generally, this is your cue to exercise your free will and self-control. My blog probably isn't for you.
Installment One: Chemical Menopause
Menopause isn't fun. It isn't particularly unfun either. It's a thing. I don't hate it. I just wish it came later, when it was supposed to come. I've magically been chemically aged by about 15 years, and probably more than that. Some people have early menopause just because it happens (although generally it still doesn't happen overnight), but the average age of menopause is 51. That's what sucks. I mean, I was hoping to go into menopause some day, as really all of you out there with vaginas should hope, because the only standard way for a female human to not go through menopause is to die before menopause. And believe me, you don't want that. (If you do, please call a suicide lifeline. I'm not kidding around. Possibly someone reading this is really miserable right now, which makes sense, and needs that type of lifeline.)
My main objection to menopause, other than the standard it's-not-fair-I'm-too-young-for-this-early-onset-menopause-will-shorten-my-life truth, is that I'm not and will never be part of The Club. When I talk to people who aged into menopause the normal way (because you know... they AGED into it), they tend to have a kind of "welcome to The Club" attitude. Like, "yeah, you were going to get here at some point, sorry it's early, but welcome to The Club."
I'm not in The Club. The Club worries about things like osteoporosis. Joint aches. Hot flashes. Mood swings. Weight redistribution and weight gain. Insomnia. Vaginal dryness and atrophy. I worry about those things too, since holy hot flashes, Batman. But more than that - I worry about estrogen. Estrogen can FUCKING KILL ME. Regular menopausers still have some estrogen. The female body makes estrogen in the ovaries mainly, until menopause, but then in other places - for example, "the liver, adrenal glands, ... the breasts, [and] [f]at cells". Although much less estrogen is made than the ovaries did premenopause, "[t]hese secondary sources of estrogens are especially important in postmenopausal women." Unless you have hormone-sensitive breast cancer, you and I will never be in the same menopause Club.
Did you notice that a bunch of these article have URLs that include the word "disease"? Menopause as disease. Thanks, world. Let's judge every fucking thing with poor semantics. There's not enough stigma in our lives already. Seriously? It's just offensive.
Did you know that estrogens have an effect on about 300 different tissues throughout a woman's body? Me neither. I wish I didn't know that. Because estrogen can KILL me now. So I can't have the estrogen that card-carrying members of the regular menopause Club can have. I have to prevent estrogen's creation by my body (actually, prevent something about how a protein turns it from an unusable form into a usable form blah blah blah whatever) by taking an aromatase inhibitor (AI, and not artificial intelligence). So now hopefully estrogen won't feed my cancer (time will tell), but it also won't help out those 300 other tissues. That sucks for those tissues. And for me.
Brain function. Estrogen affects brain function. Chemo brain is a thing, but AI brain is a thing too. It might be the same thing. There aren't a lot of studies. But the AIs are also a culprit. I am going to write about chemo brain more later.
Mood. Estrogen affects brain function. A lot. Mood is a brain function. More on this later too. But it's also related to estrogen.
Vagina. Estrogen withdrawal makes vaginas dry. I don't know about you, but a dry vagina isn't very useful to me. You can use estring. If your oncologist says it is OK. That puts estrogen in your vagina, so hopefully it won't wither away and die. Some oncologists don't think it's OK to use an estring. It spikes your blood levels of estrogen. See supra ("Estrogen can FUCKING KILL ME."). But some oncologists think that spike is a very short term thing and then the AI will prevent the killing part. But if you don't have at least local estrogen here are some of the fun symptoms of vaginal atrophy:
- Vaginal dryness, burning, discharge, itching
- Bladder and urination: burning, urgency, infections, incontinence
- Intercourse: bleeding, discomfort, decreased lubrication
- Vagina itself: Shortening and tightening of the vaginal canal
Sex Drive. Menopause affects your sex drive. Some people have more, reportedly; some people have the same; and some people have less. [If you have more, please comment below to substantiate this claim as even remotely true.] It is disheartening to read articles that say things like "sex drive isn't worse after menopause" because "you're over 50 and there aren't kids in the house to worry about." I know most menopausal women getting it on and most women over 50 getting it on are the same people. I understand what that Venn diagram looks like, because I is smart and I done studied set theory.
Weight. Your weight changes, usually going up, both in absolute numbers and in location on your body. These shifts -- more weight, and higher up near your waist -- are crap and suck.
Heart. Fuck. This too. Estrogen plays some role, but everything about menopause is bad for your heart. LDL cholesterol goes up, blood pressure goes up, triglycerides go up. And that weight shift? It tends to become visceral body fat, which is like the fat dudes carry around their waist and in between their organs. It makes your heart unhappy. Fun times. At least the years of life I'm losing come off the end, even though they feel like they got stripped out of the middle.
Fertility. This is a tough one. Menopause is by definition the end of fertility. This can be a hard pill for woman to swallow at any time, even a woman of average menopausal age -- I've seen some have a hard time swallowing that pill. It doesn't matter if you want any kids/more kids. It's in your head, which is pretty much as real as things can get. Probably because evolutionarily we're useless then? -- but see the Grandmother hypothesis. The uselessness is of course, as you know, bullshit. But you can't procreate any more. I'll discuss how this loss of fertility, even if you didn't need it any more, affects people in another post some time too. For now I just want to say, for anyone reading this who is losing fertility before having started a family and who wanted to start one -- including even before finding a partner with whom you'd want to start one, one day -- I am sorry sorry sorry sorry FUCK. It is such a mind fuck, it really is, and please please make sure you talk to your oncologist about fertility preservation options before you start chemotherapy. Before is the time to talk about it. Because even if you choose to do nothing about it, before is the time to talk about it. Knowledge is power, my ladies.
So Many Other Things. If this isn't enough, you can use The Google to find more. Lists like "The 35 symptoms of menopause" aren't hard to find. How do you think I wrote this post/I don't know that much about menopause.
So. It's not the same for those of us chemically-induced into menopause by breast cancer and those who have breast cancer after menopause, because the farther away from 51 we are when we dive into that hot-cold-hot-cold-hot-cold-hot pool, the more years of non-menopause we lose. When I was first diagnosed, someone who I greatly admire said, "There's no good time to have cancer." True. But some bad times are worse than others.
So that's it. It is what it is. I don't have any advice. I'm a big fan of following my doctor's advice, and I'm not your doctor, so I'm not going to advise you specifically on anything. But talk to your doctor. Do all that you can to get to the life you want to live. Don't give up. It's your life -- don't just survive it. Live it. Quality of life matters. Peace out.