🥪 Soul Snacks

4 min read

Dear Snackers,

The luteal phase is defined by Google’s AI feature as, “the second half of a menstrual cycle, occurring after ovulation and before menstruation.” My definition of the luteal phase is, “a rickety rollercoaster ride that your hormones go on every month for like a week, sometimes longer, generally not considered to be safe or fun. You can expect to feel like shit, with a side of anxiety, rage and tears, the onset of which might be caused by happiness or despair, either way, by the end of it, you’re just just happy to get the fuck off the ride.”

In seriousness, there is a wealth of information about symptoms occurring during the luteal phase, and I can say with confidence that I’m experiencing about 90% of them. Now that I am also in the throes of perimenopause, in combination with the luteal phase, I feel like I am at the center of a fucking feelings storm. In case you need a refresh, perimenopause is defined by the Mayo Clinic as “the time during which your body makes the natural transition to menopause, marking the end of the reproductive years.” But it’s not like we just stop getting a period one day and wrap the whole thing up - perimenopause can last upwards of a decade. What the shit is this shit? Women get a bad rep throughout these years, and guess what, it’s because we feel fucking crazy, because no one is helping us!

I was texting with a friend of mine today who is very much a rockstar OBGYN specializing in endocrinology and fertility and asked her what she thinks about Hormone Replacement Therapy (HRT) in perimenopausal women. She mentioned it is still not very common, since the Women’s Health Initiative (WHI). In case you’re not familiar, in 1998, the Women’s Health Initiative study was conducted amongst 16,000 women (aged 50-79), to examine the effects of HRT. Findings showed a somewhat small, but still significant, increased risk of heart disease and breast cancer when using certain types of HRT. As a result, all types of HRT were essentially dropped like a hot rock….until more recently. In 2019, The National Institute of Health (NIH) released a paper following up on the original study stating, “a reanalysis of the WHI trial was performed, and new studies showed that the use of HRT in younger women or in early postmenopausal women had a beneficial effect on the cardiovascular system, reducing coronary disease and all-cause mortality. Notwithstanding this, the public opinion on HRT has not changed yet, leading to important negative consequences for women’s health and quality of life.”

I follow doctor accounts who specialize in women’s health, I’ve done a podcast episode on perimenopause with an informed OBGYN, I have listened to countless other podcasts on the topic, and done a lot of my own reading and, still, I feel lost. The only thing I can extract with certainty, is that hormone therapy is absolutely not a one size fits all equation, and the only way to figure what’s right for you is with a good, trusted doctor…but where the HELL are we supposed to find the doctors who know what they’re doing in this area?

Personally, my symptoms are all over the fucking map. The physical symptoms definitely bother me, but mostly, it’s the irritability and anxiety during the luteal phase that I dread. My doctor friend suggested I talk to my doctor about taking an SSRI during “hell week’, as I like to call it sometimes. Even though I do suffer from anxiety, I have been able to manage it fairly well with other relaxation techniques and, largely, through movement, but it stinks feeling “off” for week out of every month, so maybe I should try that? Another one of my friends was just telling me she has absolutely zero libido, and sex is often dry/uncomfortable for her - a super common symptom of perimenopause. This can apparently be helped by something as simple as a topical estrogen cream that you literally put on your vagina…that’s right friends, reach on down there and smear some lotion on your lady parts like it’s fucking motor oil and let the estrogen take the wheel. Gentlemen, start your engines! My mind is blown, no one talks about these options, and it feels very overwhelming and confusing - there is no “common knowledge” about this stuff, which is nuts considering for how many centuries half our population has been suffering and feeling gaslit. Maybe you need SSRI’s for your mood, and cream for your hoo-hah, maybe you also need progestin, or some other shit for bloating, and don’t forget your magnesium, fiber, vitamin D, and while you’re at it, don’t stress too much - that’ll increase your cortisol and, therein, your belly fat - jeeezusss. 

Being a woman is really fucking hard and we definitely do not get enough credit for what our bodies endure in a lifetime. I find myself feeling like a bit of an insolent child when it comes to addressing perimenopause, however, sitting there arms folded with a scowl across my face like, “I don’t wanna do it!” In all honesty, I probably won’t make the effort to do anything about perimenopause hell yet - actually, that’s not true, I am already taking magnesium, eating a lot of fiber and protein, resistance training, etc - but in terms of other medical or hormonal interventions, I’ll skip it until things feel too unmanageable for me to handle on my own, at which point I will apparently have to move a freaking mountain to find the right treatment and a doctor who knows what they are doing. Until then, I’m also finding how much it helps to talk this stuff out with my friends. Something about knowing it’s not just me makes me feel monumentally less crazy and, in general, more accepting of the emotions around it all. Scroll down for links to the paper I referenced and a couple of resources that might be helpful if you’re getting your ass kicked by perimenopause. 

Caitlin

• READ:

  1. When trying to get a better understanding of the types of HRT available to women these days and the symptoms that different hormones treat, I found this website to be helpful in outlining what is available these days. Additionally, the website will help you connect with a doctor who can tell you what might work for you.

  2. Here is the paper published by the NIH that gives a nice overview of the original study from the WHI and a follow up to the ways in which HRT can work.

• DANCE: Two days ago I was feeling so stuck and weird and decided to throw on some favorite songs and dance in the kitchen and felt noticeably much better within ten minutes. Yesterday you guys helped me put together a list of dance songs I might not know about or have forgotten - here is a playlist of your suggestions - quite the range!