12 Things I Wish I Knew at 40

“I wanted to live deep and suck out all the marrow of life, to live so sturdily and Spartan-like as to put to

My 40s were a decade of MAJOR self-growth. I learned the art of listening. I dropped my people pleasing (well, a lot of it). I mustered the courage to say NO and to ask for help. I consciously re-wrote my self stories. I left my princess gown by the side of the street and I donned my Queen Crown.

The wisdom of my 40s was hard won though. There were many rough patches and times I thought my whole life was unraveling. As I look back I have some nuggets of wisdom that I want to pass along.

  1. Perimenopause sneaks up on you.
    I actually started optimizing for menopause at 40 years old. I read the books and did the things. Still, menopause felt like distant island whose shore I would wake up on one morning in a decade or so with no more period… end of story. I thought I knew what to expect and was ready for smooth sailing, but I was SO NOT.
  2. Hormonal Changes start in our Mid-30s.
    I had no idea that the hormonal changes that get this party started actually begin in our mid-30s when we may be symptom free. I now understand that the emotional mayhem, exhaustion and sleep trouble I experienced in my early 40s were the first signs of this hormonal transition. Knowing this would have given me peace of mind. I also would have taken an entirely different approach to managing my mystery symptoms.
  3. You are going to feel like you are losing your mind because of HIGH levels of estrogen.
    This one is contrary to everything I thought I knew. I was under the impression that estrogen gradually decreases in perimenopause, like a leaky faucet with a slow, continuous drip. However, many women actually experience symptoms related to high levels of estrogen at this stage.

    I was unaware that the first hormone that typically decreases in perimenopause is progesterone. Estrogen and progesterone are two hormones that must be in relative balance to each other. So when progesterone levels drop, an imbalance that favors estrogen can result.
    This is called estrogen dominance.

    If you are not having hot flashes, there is a good chance that your doctor will not recognize your symptoms as perimenopause. After 2 years of repeated visits to my GYN for the mystery symptoms, she finally conceded to hormone testing. I guess my unconsolable sobbing made her uncomfortable enough.

    Keep in mind that hormonal testing only gives us snap shot of our constantly shifting biology. So estrogen dominance can be tricky to diagnose. I recommend getting tested when you feel most symptomatic.

    Knowledge is Power. Once I knew that high estrogen was driving me mad, I stopped worrying that I was losing my mind and I was able to recognize when I was in a surge. It inspired me to make targeted life-style changes and now I am feeling better than I have this entire decade.

    Knowing also helped me to steer my future onto the right path because there are several long-term health risks associated with excess levels of estrogen in perimenopause that include hormone-dependent cancers, high blood pressure, insulin resistance and diabetes.
  4. There are only 1400 qualified medical providers in North America to treat us.
    That’s right, for the 2 million women per year in the US who enter menopause, we have 1400 providers to share.

    In fact, a mere 20% of ob-gyn residency programs provide any kind of menopause training. Mostly, the courses are elective. And nearly 80% of medical residents admit that they feel “barely comfortable” discussing or treating menopause. It’s highly likely that your doctor is as poorly prepared for your transition as you are. I highly recommend finding a qualified doctor certified by the North American Menopause Society.
  5. You are going to feel and look 85% better when you put down the booze.
    I have never been a heavy drinker, but when 2 glasses of wine took me 2 days to get over, I threw in the towel and gave it up for good at 48. I learned that our tolerance for alcohol decreases as we age because our body makes less dehydrogenase – an enzyme that helps metabolize alcohol.

    Drinking dries out our soft tissues and contributes to dry looks. So if you want to look and feel your best, consider kicking booze to the curve.
  6. Taking care of your liver needs to be a top priority.
    The truth is that drinking alcohol is terrible for perimenopause and taking care of our liver is PARAMOUNT. We need our liver to clean our blood, remove excess estrogen and to metabolize fat. So when we give it extra, unnecessary work to do, we are setting ourselves up for more symptoms and poor long term-heath outcomes. Yes, even if it’s just one glass a day.

    Giving our liver busy work makes us fat too. Our liver will always prioritize clearing the alcohol from our body (because it is a poison) and put all other metabolic functions on the back burner. We end up storing fat (and excess estrogen) rather than metabolizing it in the meantime. As we age, staying hydrated on a cellular level also becomes more challenging.

    P.S. – I also gave up coffee because, like alcohol, caffeine is metabolized in the liver. It was a hard decision for me, but I have been sleeping like a log and slobbering all over myself ever since.
  7. Every fight/flight/freeze episode robs your health.
    We have all heard about how harmful stress is for our health. When we allow ourselves to enter fight, flight or freeze, our sympathetic nervous system actually robs our health. Think of health like a bank account. All of the things we do to cultivate good health like exercise, nutritious food and relaxation add up to our immediate and long-term health picture. When our sympathetic nervous system activates, it takes a big withdrawal from our health account.

    People who tend to go there are also wired to do so; their neural pathways become well paved roads. Self-soothing and forging a new path when stress comes up takes commitment and practice that is not only worthwhile, it is necessary to living better and longer. The good news is that perimenopause is the perfect time to create new habits because our minds and bodies are literally in the process of re-wiring as we go through this major transition.
  8. Your body is not your enemy.
    There were times I wondered if my body was turning on me or failing me in my 40s. The things that used to work just stoped working. So many of us have experienced a lack of medical support. So where does that leave us? It leaves us to be present with our experiences as unbearable as they can feel, instead of stifling them because… When I made the conscious commitment to listen my body, I heard it screaming at me to make big changes in how I was living. Was it fun? No. But I started to feel better and better and that was enough to keep me motivated. I knew deep down that in order to live the next 1/2 of my life to the fullest, I was going to have to go back to the drawing board and “love my body into permanent changes.
  9. Perimenopause is MOTHER OF ALL WAKE UP CALLS
    This transition is a time when all of the shit that’s under the carpet rears its ugly head – health issues, money, relationships, etc. When my carpet overfloweth, I could have tidied up, but I decided to look at it, to decipher it and to own it. What am I meant to learn here?

    I peered into the shadows and the dark places that I so long avoided and I found a paradox. I had to fully acknowledge and accept my circumstances, while simultaneously rejecting that feeling bad was just part of being a woman.
  10. Menopause related symptoms are common, but they are not normal.
    While our culture has yet to normalize menopause, it has normalized the symptoms that are actually not normal or at all necessary. This gives women the dangerous impression that we just have to suck it up. WRONG.

    Symptoms are indicators of underlying health imbalances that, when left unaddressed, will likely manifest into disease states. They are not to be ignored or covered up. They are to be investigated and resolved. There ARE changes you can make now to feel better.
  11. Looking Good and Feeling Good are the same thing.
    This one is simple. If you don’t like the way you look, work on feeling better first. Beauty is so much more than skin deep. When we accept, honor and take care of ourselves we feel good and it shines out into the World.
  12. How you think about aging directs your experience of it.
    I could write a whole book on this topic, but I will keep it short and sweet. Our mindset actually trumps everything else including: diet, exercise and lifestyle. This time can be rife with shame, denial, fear and rage. All of those feelings are valid.

    What is important is what we do with them. The limiting self stories we tell ourselves become our reality. So chose wisely. That’s right CHOSE – that’s what it’s all about. You get to chose how you live this next 1/2 of your life. The only thing we have is this present moment and we CAN make choices that set us up for the best possible future if we start right NOW.

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