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Five thousand American women enter it every day. No, it's not a day spa. Nor is it an outpatient clinic for plastic surgery. And it's certainly not optional—although many options exist for dealing with it. It's menopause—often referred to as The Big M. Over the generations it's been called The Change of Life—for more reasons than one.

For many women, menopause comes abruptly, far sooner than 51, the average age of the body's natural cessation of menses—due to the 6,000 hysterectomies performed in the U.S. each year. For the rest of us, this unavoidable rite of passage often sneaks up after a six-month to ten-year hormonal time warp called perimenopause.

I know. I was blindsided by this roller coaster of baffling physical symptoms and emotions when I was in my 40s. If I'd been paying attention, I'd have realized some of my girlfriends already had entered perimenopause in their late 30s. A few even reached menopause—that point of no return where periods stop forever—before they were 40.

Since no physician had yet mentioned The M Word to me, I convinced myself what was going on in my mind and body was "all in my head"—a diagnosis often given to the younger woman who sees her family doctor for the first time with symptoms such as mine: teariness, tingling muscles, aching shoulders, racing heart, insomnia, anxiety, and forgetfulness.

Despite that hallmark forgetfulness, I clearly remember where I was when I finally realized what was happening to me. I'd just made a hasty exit from a Christian bookstore where I'd gone to find a book that might help me self-diagnose. I perused one on depression and promptly burst into tears. Too embarrassed to buy the book, I hurried out of the store before the clerk could see my puffy-red eyes.

"What on earth is wrong with me, Lord?" I wailed as I got in my car and desperately tuned into my favorite Christian radio station, hoping its upbeat music would sooth my jangled nerves.

Instead, a woman's soft, authoritative voice came into my car, systematically describing nearly all the symptoms I'd been asking doctor after doctor about with no results. I heard the one word no physician had yet diagnosed—one that would rock my world and set me free at the same time: menopause.

"What??!!" I wanted to scream back at the radio in denial. "Isn't that for old women? I'm just a kid in my 40s!"

The American College of Obstetricians and Gynecologists assures me I'm not alone. They report fewer than half of the women entering meno-years knows much about them.

As a result, many initially view the onset of perimenopause with that proverbial "deer in the headlights" look. Then, like me, they dig into ways to manage this time so aptly dubbed The Change. As I did, I discovered six steps crucial to adjusting to—and even embracing—The Big M.

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Caroline ter Mijtelen

September 14, 20076:51a

Thank you for your advises. I think I read this article just in time. Although I'm not going to buy a Harley I understand what this is about. God bless you Caroline ter Mijtelen, The Netherlands

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