I'm a Doctor, and the Only Way I Knew I Was in Menopause Was Because I Wanted to Kill My Husband.

I had a sneaking suspicion something was up with me when I walked in the house one day and looked at my husband…a man I love deeply…with utter contempt and thought to myself, Should I poison him? How can I make him go away?

My husband and I have a great marriage and two beautiful children. And that day, he hadn't said anything or even looked at me. I didn't want to be around my kids either; I felt annoyed by their mere presence in the house. (They were upstairs.) And all I could think was, Wow, I understand why animals eat their young and kill their partners.

I asked myself what exactly my family had done to deserve this kind of contempt. What did my husband do to inspire me to have a serious conversation with myself about whether I might be able to kill him (I wish I were joking!)? And the answer was shocking: He simply exists. I hated everyone in my house. It was as if I had a very severe case of PMS that would not go away. And that is ultimately what tipped me off to the fact that how I was feeling was about me, not them. It sent me down a path of self-inquiry over the next few months.I realized I was probably in perimenopause.

A few months after that low point of contemplating killing my husband, I started to put some puzzle pieces together. Considering I'm a doctor…and a gynecologist at that…you might think this particular puzzle wouldn't have been so tricky. But given how little we as a society talk about perimenopause and menopause…and the fact that it's not even taught in medical school or during a doctor's residency…it makes sense as to why it would've taken me a beat to figure it out.

I was in my mid 40s and hadn't been sleeping well. I was irritable all the time, even when absolutely nothing was going on to tip the balance toward misery. I'd also been dealing with hot flashes for a couple years…a big, flashing (literally!) sign of perimenopause, I realize, but I was still having a period. I was too young for menopause, right? Wrong! Perimenopause is the period of time leading up to the actual cessation of your period (read: menopause), and it can last up to 10 years. Considering the average age a woman hits menopause is 51, being in my late 30s put me solidly in the perimenopause window.

When I finally put this together, I was mortified. I felt truly embarrassed that I didn't figure out what was going on with me sooner.But then I got mad that it didn't even enter my consciousness that my symptoms had to do with my hormones. I could understand why we didn't cover all of these details in medical school; there's so much to cover. But why didn't we get an education about this incredibly tumultuous time in a woman's life during residency? How was it that I…a gynecologist!…didn't learn how to diagnose and treat perimenopausal women?

Luckily, I've learned a lot by being on my own perimenopause journey. Now, I'm committed to helping other women navigate what can be crazy-making times as well.

Here is some of my best, hard-won advice…stuff your mom, doctor, and friends probably haven't told you about life after around age 35:

Your sex life is going to change.

If intimacy issues surface for you at some point, they may be due to a number of different reasons. For example, your libido may be non-existent because sex hurts. If you fall into this camp, the good news is that this is fixable! Talk to your doctor about your symptoms. And if you feel embarrassed or like you're the anomaly, let me assure you that we've heard it all. There's a good chance you're experiencing something we hear women tell us all the time. There are other reasons you may not want sex, too. You may be totally overwhelmed by all of your responsibilities at home and at work and feel too tired to even think about sex. Maybe you feel like it's easier to just fake climax and have just enough sex to satisfy your partner. That won't exactly get you psyched for sex. It's important to talk about these issues as well…with your doctor, a therapist, and your partner.

Your brain will change, too.

Starting to feel like you woke up one morning and you're just not yourself? Here's the truth: As estrogen declines during perimenopause, your brain chemistry literally changes. While this has several different potential consequences (for example, research shows that estrogen's protective qualities protect our heart and brain health), the one that may feel like it's impacting your day-to-day is the fact that you actually feel like a different person. Maybe you used to be Type A and now you have trouble motivating to do anything, or you used to care deeply about what the people in your world thought of you and now you couldn't care less. When you realize that this drop in estrogen and change in brain chemistry that happens during perimenopause may be impacting you in big ways, it can help you go easier on yourself and remind you that now is not the time to make big, life-changing decisions without a lot of thought.

You have to educate yourself about perimenopause.

Sadly, this is not a situation where you can expect your doctor to fill you in on what's what. In fact, I think you need to be prepared for your own gynecologist to give you wrong advice. What this means is that it's crucial that you do some reading about the signs and symptoms of perimenopause and talk to other women about what they're going through. I'm the first one to admit that this needs to change! We, as a medical community, have to do better. But until that happens, you'll be better off if you embrace the fact that you must educate yourself about this incredibly important time in your life. And if you're not making progress with your current gynecologist, find another practitioner who is trained specifically to help you manage perimenopause! Yes, these doctors and other healthcare pros may be tough to find, but they're out there! The North American Menopause Society is a great place to start when it comes to referrals.

Talk to your friends, your partners, your daughters…everyone!…about your experience.

And talk about what's happening to you honestly. As in, I-knew-I-was-in-perimenopause-when-I-wanted-to-kill-my-husband honest. As much as you might be ashamed about thoughts you're having, or symptoms you're experiencing, it's important to share these things with the people closest to you. Tell your best friend you've had these crazy, irrational, but very real thoughts about poisoning your husband! Share with your husband how you feel irrationally irritable and ask him to give you just a little bit of space as you figure things out. (Maybe leave out the part about wanting him dead.) Share your perimenopause experience with your daughters and nieces, so they're in a better place than you were when they reach perimenopause. The more we share with each other, the more we'll start to de-stigmatize this time in a woman's life that impacts all of us.

Know that perimenopause can be a wake-up call to set you on a better, more empowered path.

I strongly believe that the more we pull the veil up around this important topic and start talking about it, the better off we'll all be. What's so fascinating about this time is that it feels like a crossroad: You're staring down your 40s, 50s, and beyond and it's a time where you may feel inspired to assess your life, your relationships, your work, and your goals. Are you where you want to be? What needs to shift for you to find more happiness? Yes, the hormonal changes you're experiencing may be driving these questions…but this time can also be part of a woman's spiritual evolution as well. Once you handle any symptoms that are making you miserable, it's an incredible chance to do some introspection about what the next chapter of your life might look like. When you think of it that way, perimenopause can stop feeling like something to dread and start feeling like an opportunity to go on a quest for a more fulfilling, satisfying life.

Similar to Dr. Arianna, you may be wondering where you are on your menopause journey. To help you find out, our friends at Kindra created this helpful Quiz. Click HERE.  

Plus, get 20% off all Kindra products with code SUNDAYPAPER20 at checkout. Click HERE.

Arianna Sholes-Douglas, MD, FACOG is the founder and medical director of Tula Wellness and Aesthetics. She has practiced medicine for 30 years and is board certified in Obstetrics and Gynecology and Maternal-Fetal Medicine. She earned her undergraduate degree at Washington University in St. Louis and her medical degree at Meharry Medical College. Her residency and maternal-fetal medicine fellowship were completed at Martin Luther King Medical Center and UCLA Medical Center, respectively. As a graduate of the University of Arizona's Integrative Medicine Fellowship, founded by Dr. Andrew Weil, Dr. Arianna combines her extensive knowledge in women's health with the field of integrative medicine.  She is the best-selling author of The Menopause Myth: What your mother, doctor and friends haven't shared about menopause. Dr. Arianna has dedicated much of her career to helping women through the stages of life that are largely neglected by most of the medical community: menopause and perimenopause. She is a passionate leader and a visionary in the field of sexual health and uses state of the art technology to treat women of all ages with sexual dysfunction.