Early this past summer, I noticed an ad for cooling sheets on my Instagram feed. No matter how many ”Barbie”-related posts I clicked, I kept getting fed temperature-controlled clothing, and heating pads, too.
The bizarre combo revealed an unfortunate reality for me: While everyone was fixated on a groundbreaking movie about womanhood, my own had taken a hit. And so, at 42, I chose to undergo short-term, medically induced menopause — giving myself to science for the sake of potential motherhood.
A little context first: My relationship with my period has been complicated. It first showed up at Barnes & Noble when I was 11. After that, my cycle was mostly predictable and not particularly painful. I spent the next two decades mostly unaware of the complicated inner workings of my reproductive system. But that changed pretty abruptly and painfully. Once or twice in my late 20s, I’d prayed for my period to arrive. About a decade later, I’d give anything for it not to show up on any given month because that would mean pregnancy.
My first pregnancy at 37 came naturally and easily — but ended at 18 weeks. After another similarly traumatic loss, we moved on to IVF. During my three years of fertility treatments, I’ve had poor outcomes, an embryo transfer that was unsuccessful and didn’t end in pregnancy, chronic endometritis, biopsies and exploratory surgeries, including a laparoscopy in March 2022 for a blocked fallopian tube.
I was taught, in life, that hard work and perseverance in life are rewarded — but when it came to fertility, there was no guarantee of a return on investment. Every obstacle felt like a hit to my womanhood, even my femininity. My mind and heart were mine, but my body was beholden to biology I had no control over.
Another recent biopsy found inflammation, which, my doctor told me, was an indication of silent endometriosis. It’s a version of the already-misunderstood condition that affects 20% to 25% of women of reproductive age, often with few to no symptoms, and can contribute to failed IVF outcomes.
According to that same 2019 study, an estimated 60% to 80% of unexplained infertility is associated with undiagnosed endometriosis — a quiet, unseen enemy that terrorizes beneath the surface and can take up to seven years to diagnose. It’s a mysterious disease only fully detectable with invasive surgery.
And that’s where my little menopause adventure comes in. Another treatment option, outside of surgery, is two to three monthly doses of the hormone suppression therapy called Lupron Depot, or leuprorelin. It’s a medication that suppresses inflammation outside the uterus that has grown due to endometriosis — and provides a more stable environment for a viable pregnancy. Some researchers believe that treatment (especially when used in conjunction with another medication called letrozole) can aid the chances of successful embryo implantation. But while medically induced menopause has been shown to increase success, it’s also not a decision to be taken lightly.
It’s a brief but grueling process with potentially long-term effects or difficult symptoms, including calcium and bone loss — and feelings of depression or even psychosis, I was warned. There’s also a possibility, though rare, that a period won’t return. As a cherry on top, it’s also not always approved by insurance, despite its necessity for many potential birthing people.
I’d grieved the loss of time, embryos and pregnancies, and for me, there was only one choice to be made before another precious embryo transfer.
Although I was lucky to not experience depression from the therapy, my mental health was impacted. My identity became intertwined with my body in a way it hadn’t been before, and the more physical hits I took, the more my sense of self waned. In brief moments of discomfort, I questioned the process I’d entered —but those intrusive thoughts always concluded with me thankful for the science that allowed me to keep going.
Fertility psychologist Julie Bindeman advises that, when weighing this decision, “Always make sure to get a second opinion, and thoroughly consult your doctor. It’s important to take everything into consideration, both the benefits, and the deficits. Especially for women in their 20s, who are further away from certain symptoms than those in their 40s.”
But I’d grieved the loss of time, embryos and pregnancies, and for me, there was only one choice to be made before another precious embryo transfer. One that transformed my summer into a season filled with endless, steamy moments at home. Hot flashes — which came and went as they pleased — rushed through my body like a roller coaster, pumping out heat, then ice. Random mood swings. An even more random libido.
Physical intimacy suddenly required choosing between desire and discomfort. I craved physical closeness with my husband, but when being with him made me wither in pain afterward, we decided to put a pin in our sex life during the treatment. Painful sex is a potential symptom experienced by some of the 190 million women worldwide with endometriosis. I’d never dealt with it until then. But it was also a symptom of menopause (due to dryness from a lack of estrogen) and created a dilemma that no woman of any age should have to navigate.
I’d praised myself for how easily I’d adjusted to IVF medications over the years. But a medically induced menopause was different. All the physical reactions were visceral, and the changes were swift. Luckily, I hadn’t experienced any depression, or worse. But managing my manufactured hot flashes still had its challenges.
Dr. Aimee Eyvazzadeh, a fertility specialist and reproductive endocrinologist who calls herself the “Egg Whisperer,” has said that “Surviving Leuprorelin comes down to some simple tips, like a heating pad, access to air conditioning, or fans, an acupuncturist, sleep aids if needed, and support.” She further breaks down her survival guide here.
But more important than tangible essentials are self-care and support. Though it’s less discussed, having an ally is vital — even if you only have one. Beyond a peer group, though, partner support is crucial to mental health.
That support may manifest in various ways. For me, it resembled a partner who threw on a sweatshirt when I turned up the air conditioning. As Bindeman puts it, “they don’t need to be sitting on the roller coaster with you, but they should be standing by the entrance.” My husband endured my more frequent annoyances with a higher endurance than usual. His typically strong-willed nature was replaced by a hug or a quiet understanding that these momentary storms of emotions were mostly out of my control.
I didn’t feel like myself this past summer, but I have gained insight — not just into the importance of layers or hydration — but something deeper. For the first time ever, I stopped trying to achieve a “summer body” (whatever the hell that means) and somehow found acceptance within a new, evolving one. I’d spent so much time during fertility treatments in anxious suspense, but for once, I focused more on each day in front of me.
Eyvazzadeh also highlighted the importance of mindfulness. She tells fertility patients, “The journey is a marathon, not a sprint, and in this personal race, one day the finish line will be in sight.”
I’m grateful, and as I continue to do IVF treatments, I’m still hopeful for a successful outcome. It hasn’t been easy, but my perseverance and my faith in becoming a mother remain strong. It’s the driving force that keeps me going through every pill, protocol and hormone injection.
On the other hand, when the time for natural menopause does eventually come, I will at least be a little prepared. Most women enter this phase fairly cluelessly because it’s unfortunately still a taboo topic. But I’ll be ready because of this strange and sudden window into the future… with a set of cooling sheets.