A job that demands 150%, travels to 12 cities in three months, an intense personal life, and little regard for her own resources: That's what life looked like for Jennifer Chan de Avila in her mid-30s – and she loved it. At that time, she was working as a postdoc at a university in Berlin planning to pursue an academic career. A university career means a lot of pressure, a lot of personal sacrifice, and a lot of extra work to prove herself in academia. But Jennifer was comfortable with this fast-paced life. Stress had never been a problem for her before, whether as a scientist, a journalist, or at her student job in the nightclub – she always could rely on her body and its performance, no matter how much she demanded of it.
It was even more difficult for Jennifer when, at the age of 36, her body suddenly showed her a limit that she had not expected until much later: menopause. Like approximately 1% of all women, Jennifer's natural cycle stopped about 15 years earlier than average.
Although one in 100 women experience what is known as "premature menopause" or "premature ovarian insufficiency," it is rarely talked about. As a result, it took Jennifer a long time to suspect what was going on and have a diagnosis. Premature menopause was accompanied by highly stressful symptoms: extreme hot flashes, up to 18 in one night. Consequently, insomnia and fatigue. During the day, she was bothered by panic attacks and depressive moods that led to difficulties at work. "When someone asked me to prepare a short presentation on my results, I sometimes burst into tears. I no longer felt up to any challenge," Jennifer recounts.
Farewell to youth and fertility
A few months after the first symptoms, an ovarian cyst was detected in the gynecological consultation and surgically removed. Initially, this was also held responsible for the symptoms. But they remained. Moreover, the onset of symptoms coincided with the use of the morning-after pill, which is why irregularities in the cycle were initially associated with that.
At some point, Jennifer was convinced she was mentally ill. She did not recognize herself and could not explain the changes of her nature. When she finally visited an endocrinology practice, everything happened very quickly: a blood test, a half-a-minute conversation with the doctor, diagnosis of premature menopause. Jennifer's hormone profile corresponded to that of a post-menopausal woman. This information was supplemented with the question of a desire to have children and the assessment that hormone replacement therapy was absolutely necessary. The short and not very empathetic conversation left Jennifer shocked and desperate. Although she had no desire to have children, in her perspective she was suddenly confronted with the end of her youth, femininity, and fertility. These attributes are given great attention in many social circles, especially in Jennifer's home country Mexico.
"Patriarchal social structures lead us to believe a woman's worth is related to her youth and fertility, and this needs to be dismantled."
Interestingly, these social constructs were precisely what Jennifer attributed her research to. Her academic focus was on gender and gender relations. She was surrounded by a modern, progressive environment, and she was very aware that defining a woman's worth through fertility and youth emerged from an oppressive patriarchal system. Nevertheless, self-doubt overcame her after the diagnosis, the feeling of not being complete without her fertility. Deconstructing this perception built through years of social programming were Jennifer's greatest challenge. In addition, she struggled with having the choice to start a family taken away from her, regardless of a current desire to have children.
Exercise, fresh air and doing things you love – mindfulness has been extremely important to Jennifer since her diagnosis.
Training as a menopause doula
After Jennifer got used to the idea of menopause and started hormone replacement therapy, which fortunately alleviated her symptoms, a period of rebellion followed. "I wanted life as usual, I wanted to work, party, drink, date, not give up on my fast-paced life in Berlin," she reports. But slowly she had to accept that her body knew limits and that she had to take care of herself. This realization led Jennifer to gradually change her lifestyle: she reduced her workload, made sure to get enough sleep, started meditation, exercised, followed a healthy diet, and gave up on alcohol. Ayurveda, yoga, and spirituality were the biggest contributors to Jennifer feeling good about her body again. In the meantime, mindfulness comes naturally to Jennifer and those around her have also become accustomed to it. Her circle of friends supported her during this time, some friends were deeply touched and really suffered with her. Thus, she was able to overlook the occasional uncomprehending comments such as "Don't be so silly, menopause wasn't so bad for me either", which were rare but did happen.
Jennifer had to realize that the topic of menopause, and especially premature menopause, is hardly present in society. The challenge for a woman to say goodbye to her fertility and the feeling that of now being an "old woman" is largely left to be dealt with alone. The fact that society often portrays postmenopausal women as "invisible, irrelevant, unhappy, and bitter" does not help. To support other women during this time, Jennifer is currently training to become a menopause doula. A doula provides mental support in addition to medical care from the medical profession and takes on a mentoring role during the challenging phase of menopause.
In the future, two approaches could help: Society must move away from the ideal of youth and fertility as judgment criteria for a woman. In addition, a stable network must be created through education and counseling services to catch and support women as they enter menopause and thereafter.
Information on premature menopause is available here.
