Navigating 'The Lightyears'

What’s really going on with our bodies in our 30s and 40s?

According to preventative health protocols and what’s discussed in the media, our post-childbearing years until menopause (aka our late 30s and 40s) should be smooth sailing— no significant changes, steady periods, get your annual exams and you’re golden. Huh?! As women in this life stage, we beg to differ. Yes, life is moving as the speed of light in our 30s and 40s, but our bodies are NOT just coasting through on cruise control. Nyssa co-founder, Ellen, recently began to refer to this time in a women’s life as 'The Lightyears' in order to give it meaning and designation in all of the transformative stages women experience between puberty and menopause. Her essay about her personal experience during these ‘in-between’ years, when perimenopause is just around the corner but so many of us are wrangling young children and aging parents at the same time, really hit home. So many people in my life are navigating this period and, honestly, it’s pretty draining. Whether we have children or not, we’re all trying to keep our plates spinning while our hormones (particularly estrogen and progesterone) are ebbing and flowing like never before.

Over 1 billion women around the world will have experienced perimenopause by 2025. We’ve still got a long way to go before it ditches the bad rap and becomes part of everyday conversations about women’s wellness. There’s still too much shame, too such stigma, too little research and information. What we’ve learned in our work with Nyssa is that every single perimenopausal woman we’ve spoken to says the same thing: “why did no one tell me it was going to be like this?” (a call that’s so frequently heard during pregnancy loss and postpartum recovery, too). In this second edition of Body of Knowledge, we want you to come away with a real sense of what to expect in your late 30s and 40s– and what you can do to harness your hormones early on and set yourself up for a positive experience (this is extremely important: almost a million women in the UK alone have left the workforce earlier than planned due to lack of support and information surrounding their perimenopause symptoms). Knowledge is power and, as you’ll discover in my video interview with the legendary British journalist Lorraine Candy, when you know and can prepare for what’s coming, you’ll be able to joyfully step into this next stage asking yourself one of life’s most glorious questions: “What will my next adventure be?”

Warmly,

Mia (Editor-in-Chief, Body of Knowledge)

Woman Rising, Mary Beth Edelson

The Lightyears

by Ellen Kellogg (co-founder, Nyssa)

Two nights ago, I didn’t sleep well. Pretty typical mix of racing thoughts and probable over-caffeination. My 7-year-old son was in bed with us radiating heat like an octopus furnace. I knew he arrived somewhere between the hours of 2AM and 3AM, and I let him crawl over my pretend comatose body rather than adhere to my husband’s new rule ("The kids need to stay in their own beds!") because I quite like looking at his plump little face in the middle of the night. In these moments, my mind drifts back to studying the same face 7 years prior while willing him to sleep under the spell of a steady sway and Adele’s "Make You Feel My Love." I even travel forward in time, imagining a future self that longs for the clingy dependence of her little boy. "Where did the time go?" I will characteristically wonder— "What happened?"

I’m certain I’m not alone as a 40-something woman, mom, and ‘keeper of the [bleep]’ who is experiencing sleepless nights plagued by stress, increased caffeine sensitivity, possible hormonal shifts, and bouts of emotional surrender. My friend circle consists mainly of middle-aged moms— many at, or nearing, the pinnacle of their careers— and I run a company that develops innovations to address the unmentionables of womanhood. So, in a nutshell, my personal and professional lives revolve around women (myself included) airing our middle-age grievances. Among them:

"I woke-up in a cold, wet sweat last night… I literally had to change my pajamas."

"My PMS feels especially intense this month."

"I’ve been dealing with this pain in my lower back for months."

"I think I might be losing my hair."

"I’m too tired for sex."

"I can’t be touched right now."

"I’ve completely lost it."

"I’m overwhelmed."

"I’m too busy."

I’ve begun to refer to this stage of life for women as "The Lightyears." The time between our psychological childbearing years and perimenopause, in which life seems to be moving at the speed of light. Mentally, physically, and emotionally— as we raise children from infancy to adolescence, progress or pivot in our careers, deal with aging parents, and hold rank as heads of household— we cover enormous ground. This period in a woman’s life can last a couple years or a decade, but I’m confident that in either case the energy produced and consumed far exceeds what the passage of time would reasonably predict— just like with lightyears. 

For me, my Lightyears began at 37. I’m five years in. In that time, I’ve started two businesses, raised two kids, joined two boards, and seen my mom through two major health scares. I’ve started to experience monthly night sweats, my OB-GYN tells me that I have a mild prolapse, and I’m either losing my hair or my part is expanding. Not just life, but life changes are happening at turbo speed. And yet, I treat my body, health, and wellbeing as if I’m on cruise control. I exercise daily, eat well, go to my regularly scheduled mammograms and check-ups, pop a daily pill to manage low-level anxiety, sleep (sometimes), and just. keep. going. Sure, I’ll change lanes if those around me are slowing down or there are warning signs ahead, but I’m NOT hitting the brakes. It’s as if being in The Lightyears has somehow separated me from my physical self. Until I inevitably crash.

Yesterday, I crashed. Not literally, but a sudden pain in my chest pulled me out of my time warp and self-sacrifice. I was standing at my coffeemaker waiting for my morning cup to brew, took a deep breath, and felt a sudden “zing” in my chest. I brushed it off at first (as I normally do with any ache or pain) but then it lingered a little too long. Next thing I know, I’m canceling all of my morning meetings, getting checked-out at an ER, showing an elevated d-dimer score, and being scheduled for an emergency CT scan— all while covering-up these unusual occurrences from my children. Turned-out to be nothing— or at least nothing detectable by modern medical protocol. Relieved? Yes. Resuming the Lightyears? Not exactly.

It occurred to me through this experience how little genuine care we give ourselves during this time of our lives. We might spend hours plucking stray hairs, getting teeth whitened, or dying our roots— in fact we build these things into our calendars— but when it comes to dealing with the real issues underlying our health and wellbeing, we often take a "wait and see" approach. Why? Because we’re busy. Because we’re embarrassed. Because we fear judgment of being considered "weak," "dramatic," or "incapable of handling it"— all stereotypes that I think many women feel the world is just waiting to validate.

If ever there was a time to not "wait and see" through the Lightyears, it’s now. There are countless articles and statistics pointing to the fact that middle-age women— particularly moms— have been among the most impacted by the incremental stresses of the pandemic on family life and balancing it with the ever-changing outside world. And, as well-documented, chronic stress is one of the leading risk factors for the acceleration of heart disease and cancer development in both women and men. OB-GYN and Fertility Specialist Dr. Lucky Sekhon— whom I consulted for this article— also reminded me that “as women’s estrogen levels begin to decline in menopause, they face a growing risk for heart disease and other chronic illnesses.” So, my fellow women in your Lightyears, it looks like we face a real modern-day double whammy!

Dr. Sekhon’s advice: “Get vigilant about your health and vocal about your symptoms.” She went on to explain that the medical community is still learning how the symptoms of certain diseases and disorders present in middle-age women because 1) they’re varied, and 2) they often coincide with the onset of perimenopause and menopause. “Take irregular periods.”  she explains. “These could be associated with a myriad of things— some serious like cancer, an STI, or hormone abnormality— and some rather benign or treatable causes such as lifestyle changes, new medication, or normal entry into perimenopause/menopause. We’ve made huge strides in our research around women’s health, but we still have a long way to go.” 

It’s on us to stop waiting, suppressing our symptoms, or suffering through. Sure, we could point fingers at the medical community and say "they’ve ignored us" or "they’ve led us to believe we should be on cruise control during this phase of our lives." But have we done a good job of making our modern 40-something female symptoms and issues known? Truthfully, I never would have gone to the ER with my chest pain if my sister, a physician, hadn’t said to me, "It’s not crazy, it’s advocating for your health." I understand some may argue that I shouldn’t have incurred the costly and time-consuming consequences of an ER visit. What good did it do? It merely led me and my doctors down an empty rabbit hole of tests and protocols. But, as indicated by Dr. Sekhon, there is still exploration that needs to be done down a great many rabbit holes before we can deem our medical knowledge and systems adequate for women in their Lightyears.

Coffee Alone at Place de Clichy, Sofia Lind

WATCH: Perimenopause, Parenting Teens and the Power of Midlife with Lorraine Candy

We’ve long admired the appetite of British magazine editor and journalist Lorraine Candy (Cosmopolitan, Elle, The Sunday Times) to address issues around women’s health that typically don’t receive much airtime in mainstream print. Putting to use her many years of journalistic experience, Lorraine and fellow former editor, Trish Halpin, offer advice on how to deal with everything life throws at you just as your hormones are going into meltdown thanks to perimenopause on their podcast Postcards From Midlife. From living with angst-ridden teens, to looking after aging parents and maintaining a career, while still trying to find the energy to have a sex life, they are on a mission to help women make the most of their magnificent midlife and to change society’s outdated narrative of what it means to be a peri and post-menopausal woman in 2022.

I had a fantastic conversation with Lorraine that’s a must-watch for anyone approaching this phase of life. We talk about parenting teens, how to self-advocate when you start having perimenopause systems, the benefits of HRT (Hormone Replacement Therapy), the increasing importance of female friendship in midlife and much more. Lorraine’s insightfulness, elegance, and sharp knowledge of her subject matter is as inspiring as it is informative. Please do share with anyone who might find it helpful.

WATCH: Why You Should Look Forward to the Menopause

It would be remiss to talk about perimenopause and not mention this scene in Fleabag. Kristin Scott Thomas delivered a masterful monologue on the liberation that follows the “cycles of pain” that women experience throughout our lives. There’s something deeply powerful about a woman in her 50s so frankly preparing a woman in her 30s for the change to come. I’m moved to tears every time I watch it.

LISTEN: Managing Urinary Health in Midlife with Dr. Lopa Pandya

Look, you may think you don’t need to think about your pee. But you will. As we enter our 40s, bladder issues tend to crop up as levels of estrogen start to drop. Estrogen is responsible for causing the urethral and vaginal tissues to thin and as women age, pelvic floor muscles can start to relax. Both of these factors can lead to urinary incontinence, increase the risk of urinary tract infections (UTIs) and more. But there’s plenty you can do to to proactively take care of your bladder, pelvic floor and general gynaecological health.

To kick-off the third season of Nyssa’s podcast, The Unmentionables, I spoke to Dr. Lopa Pandya, a reconstructive surgeon in the Department of Obstetrics & Gynecology at UI Health. We get deep into the urinary and gynaecological issues that women and vulva owners may need to attend to in their late 30s to late 40s. We talk about the different types of incontinence, the impact of birth on the bladder and pelvic floor, UTIs and much more. Lopa is a brilliant doctor and vocal women’s health advocate. We hope you find her deep-dive into below-the-belt issues as helpful and informative as we did.

“Incontinence is common, but it’s not normal. Same with prolapse. Fibroids. Endometriosis. You do not have to just “deal with it”. And surgery isn’t always necessary– there are lots of other options you can try first.”

– Dr. Lopa Pandya, OB-GYN

READ: BoK Article and Book Recommendations

• The shroud of secrecy around women’s intimate bodily functions is among the many reasons experts cite for the lack of public knowledge about women’s health in midlife. But looking at the medical and cultural understanding of perimenopause through history reveals how this rite of passage, sometimes compared to a second puberty, has been overlooked and under discussed. Why is perimenopause still such a mystery?

• We recommended Maisie Hill’s Period Power in our last Body of Knowledge edition around period health but, hey, we just can’t keep away. Maisie also wrote the incredibly informative book Perimenopause Power. She writes: “When it happens we are often unprepared for it, and are unsupported as we make our way through it. Even one perimenopausal symptom can change your whole life, so although women’s experiences of menopause vary from gentle to turbulent, it is always significant and we ought to honour it…it can be scary, but there is gold amongst it that can give us great understanding, wisdom and strength in our older years.”

• Surviving perimenopause. “I was overwhelmed and full of rage. Why was I so badly prepared?

• Your period could change in your 40s. Here’s how to manage the shift.

Did You Know?

• Perimenopause may last for 4 to 8 years. It begins with changes in the length of time between periods and ends 1 year after the final menstrual period.

• Does a higher allostatic load (the wear and tear on the body that comes from the accumulation of chronic stress) lead to an earlier onset of perimenopause or a longer menopause transition for women of colour, who are constantly navigating a race-conscious society and systemic racism in the medical industry and beyond? We know that hormones are highly sensitive to stress, and at least one study suggests that “psychosocial stress was predictive of an even earlier median age of menopause in African Americans” among others.

• Yes, you can have better sex in midlife and beyond.

• New research from Health and Her has revealed that one in 10 women have suicidal thoughts and 86% suffer mental health issues as a direct result of perimenopause.

• As women enter the latter stages of perimenopause, vaginal dryness and dyspareunia also become more likely, affecting about 1/3 of the population.

• 73% of women in the U.S. don’t treat their perimenopause symptoms.

Thank you, as always, for reading. If you have questions, perspectives or anything else you’d like to share, we’ll be hanging out in the comments and can tap our network of experts to help answer any queries you may have. In our next edition, we’ll be going deep on the statistical realities of vaginal tearing during childbirth– and, most importantly, what you can do about it.

See you soon,

Mia x