I have had several conversations this week about the conflict between ‘natural’ and medicated treatments for perimenopause. There are many people who are wanting to be as kind and gentle as they possibly can with their bodies, and when facing symptoms that have become too much, feel that reaching for a medical solution is ‘failing’ and there is shame attached.
Not anti HRT
Just to get things clear right now, though I am often mistaken for someone who is ‘anti’ HRT, this is not the case: I think we have a right to support ourselves in any damn combination for as long as it works for us. Always. There’s also a quite reasonable resistance to the mainstream narrative of ‘just take the drugs and shut up’ which seeks to pathologise a normal stage of life and completely negates the psychological emergent process of ‘becoming’. I’m often asked ‘if I take the drugs will I miss out on the rite of passage?’ Not a question I can answer of course, except to remind the enquirer that perimenopause and menopause require space, quiet, kindness and deep nourishment. These are all qualities that are more available the more privilege you have. If the miracle happens and you feel dramatically better all of a sudden on HRT (which does occasionally happen) these requirements: space, quiet, kindness and deep nourishment, still have to be met: constantly running around like an ovulating 20 year old will still take you into burnout.
It’s made me ponder on what we’re trying to achieve. To feel well, yes, but there’s more that lurks beneath, an iceberg of hidden beliefs and assumptions that are only partially making themselves known. Identity for one: ‘I’m not the sort of person who takes medication/goes to yoga/steams my genitals’ etc etc. Who we think we are is a moveable feast, most especially as we are in a process of transition.
What is ‘natural’ anyway?
Herbs used for generations are still treated before being consumed, and unless you’re picking and preparing treatments yourself, in real life most ‘natural’ treatments are sold through Holland and Barrett so come with the full range of hidden processing, plastic and transportation costs to ourselves and the planet. So there is no ultimate ‘natural’ gold standard.
Many people in my community (by which I mean the gorgeous combo of 1-2-1 clients, group mentees and Nidristas, and the Woman Kind gang) are sensitive, trauma-healing, earth-loving, spiritual path following, feminist folk. There’s also a generous sprinkling of neurodivergence too. These are people who generally hold alternative world views to the mainstream and are perhaps, more deeply affected by what is going on around them, and more likely to be suffering from the effects of stress. At the same time, they’ll be wanting to manage their symptoms in a holistic, natural way, creating a big conflict.
There’s also a heap of toxicity from manipulative types who insinuate, or even state directly, that a physical or mental symptom persists because a person hasn’t addressed their trauma effectively. A sophisticated blame and shame, which utterly disregards the pitiful resources some have to survive on, turning a blind eye to societal and racial injustice, environmental toxins, ancestral trauma and deprivation. Trauma manifests in the body, yes. The body can sometimes magically unlock and release people from trauma, yes. Being kind and developing a more loving relationship with ourselves heals deep trauma, But our systems are complex and in flux and don’t let anyone ever tell you you’re not ‘good enough’ to heal. I shall come and sort them out, otherwise.
Another aspect is that we are always in flux.
The much longed for ‘balance’ though often trumpeted on magazine covers, is an illusion. Life happens, our bodies shift, the kid gets sick, there’s a presentation, we get depressed again in December… in the micro and macro we are changing ALL the time. There will never be an arrival at a fixed point of OK-ness from which you will live happily ever after.
What is ‘health’?
At the pointy end of that submerged iceberg is our notion of health and well-being. Once again, this is an illusion often used to sell us treatments and mediations based on the idea that the only all right place to be is in glowing, vibrant boingyness. Now I love a bit of vibrant boingyness myself, but this is not ever a permanent state, and the majority of us have to learn to live with physical and mental difficulty. Some of us live with a lot of difficulty. The notion of vibrant health as an achievable goal for all effectively ‘others’ at least half the population. It means that those with chronic conditions and disabilities are then cast out of the conversation all together.
There is no medal for muscling through on sprouted seeds alone.
But historically the female body itself, having little political power, become the battlefield: flat tummies, smooth skin, natural childbirth, breast/bottle feeding, grey or dyed and now HRT or ‘natural’. Often virtual and/or real life peer pressure can be overwhelmingly toxic as folk cling desperately to the choices they have made about their bodies. I have now exited all menopause fb groups except the wonderful Woman Kind because peoples’ rigid opinions were unkind. Plus natural routes can be very expensive and if you are struggling at work anyway, how do you then raise the cash to be natural?
HRT FOMO?!
HRT is often inaccurately promoted as making you live longer, have smoother skin protecting you from dementia and heart problems, have a look at this article for more on that bollocks, so no surprise I also get asked, ‘I’ve not got any symptoms but I’m afraid I’m missing out if I don’t take HRT’. Yes that’s right HRT FOMO. So in the face of a mainstream saying ‘we deserve the drugs’ and twisting these inaccuracies into an anti-ageing, fake feminist argument, how do we decide how to care for ourselves?
Ultimately there has to be a balance between what our resources (financial, energy, time) allow, the severity of the symptoms we experience, the life load we are holding, and our capacity to allow our process to follow its cycle.
How to choose perimenopause treatments
Given all the above, here are some things that might help to guide you through the minefield. The suggests are relevant whatever form of treatment you are exploring.
Susun Weed’s protocol
The queen of menopause herbs suggests addressing symptoms in this order.
- Do nothing, i.e. rest more
- Collect information
- Engage with energetic healing
- Nourish and tonify
- Stimulate or sedate the system
- Use supplements
- Use drugs
- Break and enter – surgery, psychoactive drugs etc
Look outwards and inwards!
Yes both! Gather information from reputable sources, and also spend time enquiring into what your body needs. I can humbly suggest that both are covered in Second Spring. As it’s free and available you can always create a quiet 10 mins for yourself an enquire of the symptom of body part:
What do you need from me?
What do you want to express?
How can we work together for the greatest good?
Consider when choosing
How can I love myself better?
Which is the kindest option for me right now?
When trying anything out
Start low and slow
Review
Always check in with yourself, even when something is universally recommended, it may not suit you, or not right now anyway.
Does this intervention make me feel more myself, or does it take something away?
More questions?
If you want to deepen your understanding of your own symptoms and track your perimenopause this affordable online course may be of interest, or you can join me at our monthly Art & Craft of Menopause Q&A.
