The Pregnant Pause
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Decade N° 5: A Not-so-Average Blog on Middle Age
By Carrie McConkey
“Your blood work looks fine. You’re in menopause,” said the nurse at my new gynecologist’s office. The prior week had been my first annual checkup since Dr. McCollum, my beloved women’s physician, had retired.
The menopause message was old news — sort of — since a similar communication from my primary care doctor, nearly a year to the day before, had put me into a panic. I knew menopause was on the horizon, but how had it occurred so abruptly?
I had immediately made an appointment with Dr. McCollum for a consultation, tearfully trying to understand what felt like an unexpected leap in my biological journey.
Dr. McCollum gently explained that I was not menopausal — yet. I was still in the stage of perimenopause, in which menstruation becomes irregular and some common symptoms can occur such as hot flashes. He took me off the birth control pills that I’d taken since college, and instructed me to pay close attention to my already sporadic monthly cycle. When I had gone for an entire 12 months in succession without a period, I’d officially be in menopause.
As the new OB/GYN’s nurse and I finished our call, I reflected on the changes in my physical and mental state since that tender visit with Dr. McCollum. Leave it to me to experience non-traditional symptoms. Hot flashes? Nope. Maybe hot “moments”, but they only seemed to occur whenever I was wearing my new set of Ralph Lauren men’s style fleece pajamas. I chalked it up to non-breathable fabric. Cold flashes? You bet! I’d wake up shivering in the middle of the night. “Put on more clothes!” my friends would say. Alas, no amount of t-shirts, extra blankets, or even the Ralph Lauren polyester PJs could quell the chill that seemed to emanate from my spine.
I did, however, experience one undeniable symptom: depression. I couldn’t stop crying. One day I went through weeping jags that lasted for seven hours. I felt outside myself, emotionlessly observing; distanced.
I’m not completely sure that perimenopause was to blame; there was also the frustration of COVID, and the lack of exercise due to a still-healing foot surgery. But even as I gained enough mobility to attempt a core workout video, one day after about five minutes I just stopped, mid-ab crunch. I stood, rolled up my exercise mat and put it back into its case, and left the room. I just wasn’t interested. In an emotion-filled visit to my primary care doctor (which included me insisting that he NEVER, EVER retire), he put me on Wellbutrin.
I was emotionally stable enough to come off of the antidepressant in a few months, but my body kept experiencing biological changes. Ironically, I felt just as weird coming off the birth control pills as I did going on them all those years ago. And I had sensations that were disturbingly similar to what my friends described during their pregnancies.
Although I knew this wasn’t the case, I needed more information on this perimenopausal pilgrimage. Not having yet found a replacement gynecologist, I visited Dr. McCollum’s nurse practitioner. I did the routine weigh-in, blood pressure test, and then her RN quizzed me:
“What kind of birth control are you using?” she asked.
“None,” I replied.
“None?” she confirmed, a bit too urgently.
When the NP entered, she informed me that perimenopausal symptoms are as unique as the women who have them. “Every female could write a different book about what she has experienced, and they would all be correct,” she said. Then she added, “Why don’t we go ahead and take a pregnancy test, just to give you peace of mind?”
Okay. Wait. What?
Although I was concerned about the changes my body was experiencing, Dr. McCollum had assured me that there was a less than 1% chance that I could get pregnant. And frankly, my depression had not contributed to any extra horseplay around our household.
“Oh, no, that’s okay. I’m not really concerned about that,” I said.
We talked for a few minutes more, then she stood up to leave. “You can provide a urine sample, and the nurse will conduct a pregnancy test,” she said. “Then you won’t have to even worry about it.”
My husband John and I had decided fairly early in our marriage that we wouldn’t have kids. Although my feelings had wavered from time to time, and I’m sure his did, too, we both felt secure in our decision to live sans children. That being the case, I had never even taken a pregnancy test. The nurse practitioner’s insistence made me wonder if she was recommending this because she knew something I didn’t.
Taking the test wasn’t like what I had seen in the movies. No wandering through the aisles of a drugstore wondering if I should choose First Response or Clearblue. As I waited in the examination room, I thought of the episode of Sex and the City called “The Baby Shower”. Carrie Bradshaw’s period is late, and she contemplates having a child much earlier in life than she expected. I wondered whether it was a coincidence, or a sign, that I had just watched the rerun that week. Was I in the same boat, just rowing in a different direction?
The nurse bustled into the room with a rectangle-shaped object, shorter than the traditional pregnancy test I was used to seeing. I guessed that at the doctor’s office they only need the business end of the stick.
With an expectant look, she asked something along the lines of, “Which do you want it to be?”
The question caught me off guard, fitting in perfectly with the entire surreal experience. Hesitating, I imagined what John would think, knowing he would be an amazing dad no matter what his age. My friends and family might be amused, because, as I mentioned, I always like doing things differently. But, how did I feel about it? Good heavens, I had always said that if I was meant to have a baby, God would go against all birth control odds. I never considered Him conducting an age-defying miracle.
“No; I guess…?” It came out as a confused musing more than an answer.
“You’re not pregnant!” she replied.
“Okay. Wow. Well, this is a banner day for me,” I said. “My first pregnancy test, at age 51.”
“Ahhh! Do you want to keep it?”
At this rate, why not? She snapped off her glove, dropped the cassette inside like she was bagging a newly-purchased trinket at a boutique, and handed it to me.
As I left the exam room and walked past the other patients and registration desk staff, I felt as if everyone knew I had a used pregnancy test wrapped in a floppy rubber glove tucked inside my purse. I had been too embarrassed to ask the RN or nurse practitioner what had just happened; was it possible to be perimenopausal and pregnant? Turns out it is uncommon, but not unheard of.
When my new gynecologist’s nurse told me that I was, without a doubt, experiencing menopause, I confirmed with her that I could not become pregnant. No, the window had officially closed. This time, the news about “The Change of Life” felt welcomed. Next stop, postmenopause. I will be more mentally prepared for that.
And I guess I am officially getting old. I remember taking the latex gift-wrapped pregnancy test out of my purse after getting home, but now I forgot what I did with it…
