I’m holding a shot of tequila in one hand, a lemon wedge in the other, and laughing hysterically as my ex-boyfriend is fumbling to find the right words to toast my ovaries.
“To your Madame Ovaries!”
“To my Madame Ovaries,” I respond.
“They served you well, a hormone hotel, we bid them adieu, a Viking farewell! Cheers!”
Our glasses clink and our lips lock. His salty-lime kiss gets me aroused and his hand reaches between my legs under the table. I cannot think of a better way to celebrate the last night with my ovaries than one last romp with my body parts working in unison toward getting wet and reaching orgasm. I’m 44 years old and the next morning, I would be getting a bilateral salpingo-oophorectomy ― surgery to remove my ovaries and fallopian tubes.
Two weeks earlier, I learned that I carry the RAD51D gene mutation, which despite its name, is not rad ― at all. It puts me at an increased risk for ovarian cancer; a cancer so pervasive that when the surgeon described it as “nasty,” I immediately made the decision to have my ovaries removed.
“Can’t get ovarian cancer if I don’t have ovaries,” I nonchalantly repeated when I shared the news with family and close friends. But I would get early onset menopause, and that’s a conversation that most people don’t want to have — or know how to have, including my doctors. While they effectively shared the horrors of ovarian cancer, they seemingly glossed over the symptoms of menopause like it was a superficial cut that could be taken care of with a bandage. Maybe some ointment or an antibiotic ― if needed.
While recovering from surgery at home, I contemplate life without my ovaries. The thought of never, ever getting a period again makes me giddy like a little girl getting her first training bra. Having survived the bodily changes of puberty, and the monthly ups and downs of a menstrual cycle, surely, I could handle whatever this new hormonal phase (or lack thereof) would bring. Sprawled out on my couch and watching the menopausal matriarchs on “The Real Housewives of New York,” I confidently order a drawerful of pristine, white bikini underwear that will never know the humiliation of a tampon leak. And I added a set of expensive Italian linen sheets too, because luxury bedding is now worth the splurge without worrying about a menstrual marauder.
“This surgery is an investment in your future,” the surgeon emphatically impressed upon me when we first met. I take his words to heart, and after breaking the bank with my new undies and bedding, I decide that my next venture as a surgically-induced menopausal woman is to start dating again. I’m also extremely curious to see if sex will be any different. According to the doctor, one of the symptoms of menopause is painful sex due to vaginal dryness. He said that this pain “could be minor or severe” and that treatments range from water-based lubricants to prescription hormones. There’s nothing less reassuring than a medical diagnosis that comes with a range as broad as the cable guy’s appointment schedule.
After a few weeks of swiping on profiles, I find myself uptown at a cozy wine bar enjoying a glass of pinot noir with Jim, a recent divorcé with a receding hairline and who was definitely a few years older than his profile pictures. While he speaks about the anguish of his marriage ending, I start to feel flush. I motion to the bartender to bring a glass of water. My body temperature is rising with each sip and continues to grow.
“Do you feel hot? Is it hot in here?” I interrupt Jim’s story about his experience in couple’s therapy. I look around the bar to see if anyone else is outwardly displaying signs of heat, but everyone seems at ease, conversing and keeping their clothes on. “I’m OK, do you want another glass of water?” he asks.
I quickly realize that the heat is coming from within. Like a combustion rocket, it launches from my core up to my head and settles in the back of my neck. Trying to play like I’m not having some inner-body lava experience, I pretend to not feel the accumulation of sweat under my boobs and hope that my new cotton underwear is absorbent. As Jim drones on about the therapist saying that he needed to take accountability, I casually try to assess if there are sweat stains under my armpits. I swear that even my fingernails are sweating. I wonder if I have food poisoning or a COVID fever and before I can come to a conclusion, Jim reaches across the barstool with a flimsy paper cocktail napkin and wipes the sweat that’s dripping from my temples. Never in my life have I felt so violated and yet so taken care of by a man before.
Totally embarrassed, I excuse myself to the bathroom and when I look at myself in the mirror, I’m appalled. My perfect blowout has fallen flat, hair is sticking to the back of my neck like a turtleneck, and my makeup looks like face gravy. I run cold water over the insides of my wrists and stare at myself in the mirror. The heat subsides, and I’m left feeling cold and clammy.
“What the f ... ” and before I can finish the question, I realise that I just experienced my first hot flash. Maybe menopause will be harder than I thought? I throw cold water on my face and walk back to the bar to tell Jim that I vomited and need to go home. Even though it was apparent, I couldn’t bear further embarrassment by admitting that I had had a hot flash. The date would be memorable for both of us but for all the wrong reasons.
The hot flashes continue throughout the night followed by powerful shivering. Halfway through, I leave a desperate message with the doctor’s answering service explaining that I need a pill or a cream or a holy miracle and a bucket of ice to continue living.
I thought I knew my body ― for most of my life, I had mild periods and relatively insignificant symptoms of PMS. I expected menopause would be the same for that reason, but also because the doctor and his staff breezed right over the topic before cutting out my ovaries. Everything they spoke of ― from the symptoms to the solutions ― involved a range as big as the Rockies.
“It depends,” was a common answer to my questions, but I am now no longer in a “it depends” situation ― the toll that menopause takes becomes very clear, very quickly. I fear leaving my apartment for any sort of social or professional situation. The idea of being around people while sweat gushes from every orifice of my body makes me want to hibernate in my apartment until I can trade it for a coffin.
I start paying more attention to women that are in their 50s (the average age when menopause happens) ― celebrities, politicians, reality stars ― and wonder how the hell did they get through menopause. It’s a topic that is rarely acknowledged or discussed. I’ve never seen anyone have a hot flash on the red carpet or while standing behind a podium. Never mind who’s had a face lift or how much they spend on filler, I want to hear conversations about how they’re dealing with hormone depletion and its horrible symptoms, like vaginal dryness, painful sex, hot flashes, night sweats, forgetfulness, thinning hair, weight gain, saggy skin and more. And don’t tell me these can be managed by keeping a healthy diet, exercise and sleep.
My doctor recommends that I try a transdermal combination hormone therapy patch that contains estrogen and progestin. It’s a clear disc that sticks to my lower abdomen and it’s relatively discreet ― no more noticeable than the scars left behind from surgery ― so I can be comfortable being naked in front of someone (under them, on top of them) without feeling self-conscious about wearing it.
The doctor also tells me this is a temporary fix. Hormone replacement therapy (HRT) has been a source of controversy following a deeply flawed but widely publicised study by the Women’s Health Initiative in 2002, which suggested that HRT was potentially more harmful than helpful. Over 20 years later, we’re learning that HRT can be highly beneficial for symptomatic women who are within 10 years of the onset of menopause, or under 60 years of age. The consensus is that the decision should be tailored to the individual woman’s particular needs. I learned that getting my needs met means being prepared for doctors’ appointments with questions about recent studies and alternative solutions, sharing new symptoms (hello, brittle nails and joint pain) and being comfortable with advocating for myself.
As it turns out, I need HRT. Within days of wearing the patch, the hot flashes and night sweats subside. I begin to feel like myself and, in a few weeks, decide to start dating again. I’ve always tried to keep a sense of humour about courting and this time is no different. If anything, it’s even more comical because I am upfront about my surgery, lack of ovaries and my hormone patch. How’s that for a first date conversation?
It would have been a legendary “meet cute” if things worked out with Jim, but there was no second date. I eventually meet someone and as I share my ovarian cancer story, he shares that his mother died from the disease. It’s not the most romantic topic to bond over, but hearing her story reaffirms the decision I made to have my ovaries removed. He’s the kind of man that turns on the A/C and opens the car windows when a flash appears, and he’s not bothered by the hormone patch stuck to my naked body. But maybe that’s because he’s a few years older than me and takes a little blue pill to keep his body working like that of a young man in his prime.
I now realize that I entered menopause with a positive attitude rooted in naiveté. With each hot flash, I became annoyed and embarrassed by my body’s natural reaction to hormone depletion. And then I grew angry and frustrated with a society that tries to control women’s bodies and the conversations about them. Whether sharing my story or asking questions, I refuse to be quiet about menopause.
“Listen, the hot flashes are coming, and you will be miserable,” I warn some friends over dinner and drinks one night. All of us are in our 40s. After the laughter stops, they start sharing their own stories about their bodies feeling different, missed periods, sleepless nights. “Talk with your doctor, it could be perimenopause ― the years leading up to menopause,” I say. I’m like the kid on the playground that first told you how women get pregnant, but at least this time, I speak from experience.
All of this has taught me to really cherish my body, which is capable and healthy. As much as I’d like to remain in this moment and slow down time for the next few years while I’m on hormone therapy, I’m also looking forward to my future ― the one that I surgically invested in.
Danielle Martinetti is currently working on a book of personal essays about her experience with mother loss, singlehood, baking and choosing to live happily ever after in New York City.