Before my hysterectomy, when I was forty-four, I had more than enough information about what was the matter with me: peer-reviewed studies of cervical adenocarcinoma, multiple medical opinions, knowledgeable advice from friends and acquaintances. After the surgery, I found myself in a wasteland of desperate, incoherent blog posts, trying to understand my condition now that, technically, nothing was wrong with me at all. Three months after my uterus and fallopian tubes were removed, along with what was left of my cervix, I went to see the senior gynecological oncologist at a prestigious institution. I asked her about all the postoperative symptoms I hadn’t expected and couldn’t resolve. The most immediately pressing one was what the Internet had taught me to call—clinically, impersonally, at a safe distance from my mortification—anorgasmia. One out of every three times or so, a climax began, then suddenly disappeared. The doctors had mentioned pain and swelling, but not this. What, mechanically, was going on with me?
I was at a hospital ranked as one of the best in the country. The oncologist, this specialist of specialists, brought out an ancient-looking laminated book with illustrations of the pelvic nerves. She showed me the nerves that had been cut during my surgery (the ones controlling arousal), and the nerves that hadn’t (the ones controlling everything else). But she didn’t have any data, couldn’t name any studies, couldn’t answer my questions. When I asked her whether I should maybe consult a neurologist instead, she laughed.
I went to more doctors. They insisted that my problem was imaginary, or, if not imaginary, then emotional, or, if not emotional, then a symptom of perimenopause that I hadn’t noticed before—which is to say, it was natural, unavoidable. I was left with no answers other than that my problem was mine alone. My body no longer served any reproductive purpose; what else was there to say? I went home convinced that I would collect real data, that I would write about it, that I would do it all myself. I am still too exhausted and angry to apply critical thinking to this problem. It may be that my anger isn’t unique.
Darcey Steinke is a writer who, through a memoir and five novels, has explored the overlap of the spiritual and the sexual, rendering female subjectivity as both a site of resistance and a simple fact of life. In her new book, “Flash Count Diary: Menopause and the Vindication of Natural Life” (Sarah Crichton Books), Steinke is doing it all over again, this time from the perspective of a postmenopausal woman—herself.
In menopause, even the blondest and the most protected of women will join the rest of us in ignominy; they, too, will become, as Steinke writes, “not only invisible but also despised.” A hysterectomy isn’t the same as menopause, but it’s been, for me, a kind of preface to the story of what happens after privileged, fertile womanhood ends—the story that Steinke is committed to telling. Indeed, a hysterectomy can trigger menopause, even if the ovaries are left intact, as mine were. So far, I still have cycles, but they’re punctuated by ghost periods without blood. My primary symptom of perimenopause, which seems to have ramped up since the surgery, resembles the writer Suzanne Moore’s description of her own: “I don’t really have the mood swings that some talk about. I have just the one mood. Rage.”
Steinke, who is about twelve years older than I am, gets her first hot flashes in her mid-fifties. She suffers auras of foreboding, throbs with heat in the night, sweats through her clothes at work, strips down to an undershirt when she “flashes” on the subway. She starts a diary to log the frequency of her hot flashes, nine or ten per day. Eventually, as she writes, as she suffers and seeks to understand, the diary of tallies becomes the book we have in our hands.
In “The Change,” Germaine Greer’s wide-ranging account of menopause, from 1991, which Steinke cites, Greer posits that our aversion to menopausal women is “the result of our intolerance for the expression of female anger.” Menopausal rage is more than a symptom of disappointment at not being fertile or conventionally attractive or socially powerful—although it may be those things, too. It is brought on by the waning of estrogen, which in turn reduces serotonin production. Serotonin is believed to be the mood regulator whose sudden absence causes the anger that Steinke describes: “Irritability is a demeaning word, laughably imprecise when what I actually feel is a bright, ascendant rage.”
Steinke aptly compares the uncontrollable force of menopausal rage to the transformative anger of the Incredible Hulk and the “thorn in the flesh” of St. Paul. Unsurprisingly, the available analogies are all male; women are accustomed to translating their subjectivity onto men’s bodies. Plenty of movies depict female rage, but that rage is infantilized, sexualized, or subdued by the male heroes of the film. On women, even displeasure is unbecoming. On black women, multiply that a thousandfold.
Lately, female political anger has undergone some reappraisal. (In her book “Good and Mad,” Rebecca Traister writes, “It is bananas that women’s rage has never been given its proper due,” and other recent books by or about angry activist women concur.) Such outrage will perhaps eventually become palatable; we’re more willing to condone anger as long as it’s about something. But what if that anger isn’t separable from physiology? What if, as menopausal women discover more forcefully than the rest of us, the duality of body and mind is simply irrelevant?
Rites of passage are gateways to inclusion in an inner circle, but the milestones of female life are chiefly represented from the point of view of outside observers. Menarche, the gateway to womanhood, is seen as proof that women are viable objects of desire for men. Pregnancy, the gateway to motherhood, is seen as proof that women are viable sources of children. That the birth process also produces a mother is a mere footnote to everyone but the mother herself. The features of menopause are commonly described as losses—of fertility, beauty, sexuality, attention-worthiness. So would they appear to an outside observer.
In Amsterdam, at the eleventh European Congress on Menopause and Andropause (age-related hormonal shifts in men), Steinke finds exactly this sort of subjective erasure. A man on a panel “talks of shrinkage, lack of pliability, dryness. All his descriptions explain how the vagina might feel to an incoming penis. The vagina as a viable penis holder. Not how a vagina might feel to the woman it belongs to.” In her own book, Greer raises the possibility that hormone-replacement therapy for menopause is a male conspiracy to neutralize and contain women’s wisdom and rage.
We are culturally prepared to perceive women’s natural aging as uninteresting at best, pathological at worst—deserving of dismissal or disgust or both. Steinke makes a neat collection of five centuries’ worth of vile examples of the “male bafflement and repugnance” and “boilerplate misogyny” through which menopause has been perceived. Demonologists in the sixteenth and seventeenth centuries considered signs of aging to be proof of sorcery: “Chin hairs. Witch. Wrinkles. Witch. Warts. Witch. If, in the presence of others, a woman grew red and perspired heavily, then she was a witch. . . . If she was quarrelsome, angry, spoke loudly, and moved, at times, in quick bursts of chaotic energy, to open a window or get a ladle of water, then she was definitely a witch.” Quoting TV shows and movies, Steinke suggests that we’re not past condemning women for the inevitabilities of time and nature: men joke about women’s tantrums, women’s varicose veins, about all the visible proof that women are, strictly speaking, no longer of use.
Failing to find common ground in the human world, Steinke turns to the natural one. She takes an immediate interest in pilot whales and orcas, the only other animals known to undergo menopause. She visits Lolita, an orca who has lived at the Miami Seaquarium for nearly half a century, since she was six years old. Her pool is “less than four lengths of her body, its depth less than one length.” Steinke describes her swimming “frenetically from wall to wall, like an agitated soul trapped inside a concrete body.” If she were free, Lolita would likely be entering middle age in her pod, part of the Salish Sea whale clan, in the Pacific Northwest. The clan is led by two matriarchs—Ocean Sun, the eighty-five-year-old whale believed to be Lolita’s mother, and Granny, who is a hundred and four.
Steinke gets interested in these whales, and then obsessed. For her, Lolita becomes an amalgam of scientific proof and spiritual symbol. “I am restricted, stuck in the box the greater culture uses to enclose and reduce older women,” she writes. In the same way, Lolita is “a prisoner who must be grateful to her captors, a female who does tricks in order to be fed.” Steinke can’t save herself, but that imprisoned orca—she might yet be saved.
When Steinke travels to the San Juan Islands, in Washington, for a whale-watching tour, she finds a balm for the loneliness of menopause. The whales give her something like a peer group. Steinke is at her best when she writes searchingly, before the moment of understanding, as in the narrative of her encounter with the geriatric Granny. She calls friends back home on the East Coast to tell them she’s seen the whale in the wild, but, each time she recounts the story, she worries about “selling out the experience, making the encounter sound like yet another entertainment.” She is wary of becoming merely an outside observer: “When I describe the whales as vibrant, muscular, huge, the whales become visual objects separate from myself. But what I actually felt was a dilation.” This is not an encounter between two species, but a visceral connection between two bodies. Seeing Granny, she writes, “was like having my daughter, an event outside human evaluation.” When Granny disappears, a few months after this sighting, Steinke feels a quiet, eerie sense of communion. She imagines how the great whale must have experienced death, losing the strength—or perhaps the will—to rise to the surface for air, then sinking to the ocean floor for the last time.
There may be comfort in affinity with the natural world, but there’s a limit to what insight it can provide. Steinke needs to understand her body’s passage not just as a fact of nature but as a lived experience that half the human population is destined to undergo. “I knew so much more going into both menstruation and pregnancy than I did going into menopause,” she writes. Where is the literature about the menopausal transition? Situating herself in the literary world, it turns out, is a more vexed project than situating herself in the natural one. In an attempt to find companion texts to her own experience, she reads memoirs by gender-transitioning men and women, which “posit hormonal change as both arduous and interesting.” They don’t exactly offer a community of peers, but engaging with them is more helpful than studying whales.
Steinke partakes in the current trend of cross-genre memoir—stories that are heavily decorated with quotations, part autobiography and part commonplace book. Sometimes authors get the blend right, but usually the quoted texts are unsurprising, and they stand in for the textured analysis of real life. In Steinke’s case, the standardness is perhaps the point. By starting a dialogue with a rote lineage of writers—Simone de Beauvoir, Judith Butler, Kathy Acker, Audre Lorde—Steinke isn’t just saying, I’m in the group. She is saying, There is no established group yet, but this is where we have to start.
The group of women writers is one I belong to now, though its membership wasn’t always what I had in mind. So few badges of femininity are badges of honor. Before I was a mother, I was pretty sure what it entailed. It was boring, trivial, sentimental, stultifying, gross. Most of all, it didn’t have anything to do with being an artist. I wasn’t entirely wrong: it didn’t have anything to do with being a certain sort of celebrated male artist, which was the kind of artist I already knew I wanted to be—the kind with the most badges.
The actual experience of motherhood scuttled my arrogant assumptions. When my son was born, I crossed the divide and was permanently humbled. Now I look ahead to another rite of passage, and wonder what further education is coming. It is hard for me, still perimenopausal, to imagine a life in which sexual release is no longer a pressing need, in which that thunderclap isn’t part of the general weather.
In my early forties, when I started to experience the occasional burning-hot neck and ears, I combed the best-selling books about menopause for useful information, and found nothing. In “The Silent Passage,” from 1992, Gail Sheehy advocates hormone-replacement treatment, and strikes a note of empowerment: “WOMEN DON’T HAVE HOT FLASHES THEY HAVE POWER SURGES!”
For a while I read and reread Mary Ruefle’s “Pause,” a sparkle of an essay, from 2015, which gleams with honesty, if not optimism:
And I took some comfort from Doris Lessing, who called growing old “one of the most valuable experiences that I personally have ever had. A whole dimension of life slides away, and you realize that what, in fact, you’ve been using to get attention, or command attention, has been what you look like.”
I read all this, and I want to read more, but I also know that I won’t really understand it until my body and I cross over, too.
Passage into midlife is both a liberation from and a loss of youthful energy—energy that is wild and ambitious, unrooted and unafraid, energy that knows only to express itself as progress. Maybe, after this transition, your energy can take root. Maybe your fear—that if you don’t force yourself inexorably forward you’ll fail and die—will go away. But life transitions don’t confer perfect amnesia; like anyone, I drag my previous selves behind me.
Recently, at a restaurant with my family, I observed my son scrawling away at the paper placemat with his crayons, rapt, unfettered by his body, and I also observed a young man and a young woman at a nearby table. The woman wore lipstick and nail polish and a little pink cardigan, and, as she talked to the man, she kept arranging herself, adjusting her hair and dabbing at her eyeliner and rubbing her shiny lips together and shifting in her chair, as if she were the stylist arranging a bouquet for a photo shoot, but of course she was also the bouquet. Her discomfort hung around her like a cloud of too-strong perfume. Watching her, I realized that I felt more like my son than like her. I felt both grateful and a little mournful that someday I might not ever have to feel like her again.
To face a future of sexual irrelevance—and often disgust—is the surface experience of menopause; the more profound experience is to approach oblivion and endure its education. For Steinke, the sexual and existential changes are inseparable. “With every flash, my psyche is pushed to grasp what it does not want to let itself know: that it is not immortal.” Steinke’s hot flashes sometimes seem to originate outside her body, roaring forth to overwhelm—and thereby to teach. She compares them to religious conversion, “an experience of divinity unmediated by doctrine, hymns, or prayers,” things deployed “to protect individuals from the full scourging force of the godhead.”
Steinke has written before about her quest to reconcile physical embodiment and lived spirituality (her 2007 memoir, “Easter Everywhere,” is an account of the evolution of her religious faith), but it is the passive act of aging, not any willful striving, that at last brings her to a truly fundamental experience: “For decades I’ve tried, mostly unsuccessfully, to get out of the way so the force of the universe could use me as a conduit. Only recently, with the onset of menopause and the breakdown of my former identity, do I finally feel I am making a little progress.” Burnished by the flashes, stripped of the physical markers of youth, the menopausal woman shares some of the purifying experiences of penitence and spiritual preparation.
In the book’s final chapter, Steinke writes, “As a younger woman, I was led by my biology; now I’ll let the spirit tug me along.” But it’s rough thinking to equate “spirit” with all things other than the wild, hormone-fuelled pursuit of penetrative sex. And this is not the whole conclusion that the best of this book has led us to; “Flash Count Diary” spends most of its pages documenting the kinship of bodies and metaphysics. One of its most memorable scenes is a dramatic performance of this very kinship—the blurring of bodies and souls. A neuroscientist sets up an infrared camera in a room full of perimenopausal and menopausal nuns to observe the “halo effect,” in which hot flashes spread from one woman to the next—a living metaphor for the Holy Spirit.
After menopause, Steinke anticipates returning to the fierce young girl she once was. Her mother is dead, her spouse is alive and well, her daughter is out of the house and accounted for. Her filial and parental responsibilities are at an all-time low, and she has the chance, at last, to retake the role of protagonist of her own life. Just as the Incredible Hulk stood in for the menopausal woman, now an innocent child stands in for the postmenopausal one. Maybe someday these images will be replaced in the culture by images of actual women.
I hope that Steinke’s book, which I consumed hungrily, will encourage a wave of work by and about women undergoing what is, quite literally, a once-in-a-lifetime experience. Steinke makes the case that the inexorable slide away from fertility is a rebirth of agency, and her book is the fruit of the very creativity it describes. Like bildungsromans, birth stories, and jisei (Japanese death poems), such books could form a literary genre. And perhaps the interest of doctors will follow the interest of readers. Imagine a doctor asking a woman how her body feels six months after a hysterectomy. My own answer: almost back to normal on all counts, which is to say that the event, like all major events, has receded but left its mark.
Since the hysterectomy, my aging seems to have accelerated. While shopping with my son, who has once again outgrown all his clothes overnight, I’m shocked by the rumpled old woman in the mirror. Then I’m shocked that such a tired cliché has actually come to pass, and that it nonetheless feels so sharply disorienting, like an elaborate prank. I want to share the marvellous ruse with someone, but what can I say, that an exhausted woman in her forties appears as such? Steinke’s silver lining: “Since I’ve stopped my struggle to be beautiful, I am overtaken by beauty more often.” This statement sounds simplistic to me, but maybe I’m in no place to judge it yet. Maybe that shift truly is as simple and thrilling as the appearance of an old woman in the mirror, staring knowingly back at me. ♦
