A few months ago, I was up at the chemist filling my script for progesterone, one of my HRT meds. (That’s Hormone Replacement Therapy, for any readers whose reproductive system isn’t having a decade-long closing down sale. And mazel tov, you juicy bitch!)
The pharmacist was confused by the instructions that invited me to insert the pills into my downstairs lounge.
‘These are supposed to be taken by mouth,’ she said, concerned. ‘And not’ - she used two fingers here in a vigorous demonstration of ‘up the clacker’.
The chemist was not as busy as it gets on, say, the intersection of flu season and pension day, but it was populated. Customers idly watched on.
‘Yes,’ I said. ‘It’s an unconventional method. But, you know. It’s what the kids are doing now.’
‘Its just that these are pills,’ she said. ‘Oral pills. Not meant to be -’
The fingers again. Anxious this time as she jabbed upwards. The crowd winced.
‘I’m wondering if I should call the doctor and check?’ she asked.
It was hard to imagine how a GP would prescribe pills and ‘accidentally’ issue instructions to put them in the vagina.
‘The directions are correct,’ I said. ‘It’s an off-list method but I’ve done it before.’
‘Oh, if you’ve done it before,’ she said with relief. ‘OK. I’ll leave it.’
I don’t make a habit of it, I wished I could tell the spectators, in case they were getting the impression that I looked at my facial scrub or my lamb chops and wondered if they’d serve me better inside my underpants.
The up-clacker method, well known in gynaecological circles as an effective way to localise the effects of progesterone to those whose bodies don’t go well on it, does work better - my dizziness decreases, my symptoms are muted - but even so, the 12 days I have to take progesterone every month really suck.
HRT has been very beneficial for me. The cheeky little cocktail of oestrogen and testosterone is great, but there’s one hormone that drags me through the mill, and that’s progesterone. This is the hormone that prevents the lining of the womb from getting too thick, and reduces the risk of uterine cancer. People who have a uterus need progesterone. Goddamit.
For 12 days of 28, this is my brain on progesterone.
The work of keeping all this internal means travelling through the world like this.
I’m having a tough 2024, especially at 3am every morning, when my worries cycle through my brain, one after the other, like a supermarket conveyer belt beeping as it processes each nugget of stress. Child A! Child B! Child C! Elderly parent! Cost of living! Sometimes random ones come through like a special offer on tissues or dog toys: climate collapse! crumbling of body! Great Pacific Garbage Patch!
In my last, particularly bad, progesterone cycle, where the hormones intersected with grief and overwhelm, I struggled to rally or regulate. I felt desiccated and waterlogged at once, a lump of meat dragging itself around, my body aching, my mind anxious and my heart sad. Good times!
Thing is, I’m not alone. For lots of people, progesterone is great; some describe it as like a natural sedative, because it can increase the production of GABA, a neurotransmitter that promotes sleep. It also, for some, induces relaxation and well-being. Must be nice (she says, breaking a tooth smiling.)
You see, progesterone intolerance is very common, although gender bias, lack of funding in women’s health and medical misogyny means that research and understanding of it, and of perimenopause and HRT overall, is shockingly lacking. How can 20-25% of the people with a uterus be progesterone intolerant but the medical management of it be so sparse that GP’s have to prescribe off-list workarounds of medication that risk middle aged women developing reputations as a local pervert?
I was perusing a Reddit thread for tips the other day when Child A came in from her caravan. I ranted at her for a bit about how on a discussion between people struggling with progesterone side-effects, there’s always some Betty who pops up to say that actually, she loves progesterone and she feels better on it than ever before. Tab interrupted to ask me why I had two long scratches along my arm.
‘I don’t know!’ I said wildly. ‘It’s weird, right? I don’t know where they came from!’
Tab gave me the careful grimace her father and my friend Lucy did when I gave this explanation for my mystery injury, like they are treating me slightly like a package that might explode.
‘You look like you’ve been in a secret fight club, Mum,’ Tab said. ‘Progesterone Fight Club.’
‘I’m listening,’ I said, turning in my chair and re-adjusting the hot water bottle on my sore hip.
‘It’s a secret club for peri-menopausal women to beat each other up and work out all the rage and irritation they have to keep contained in normal life.’
‘Yes!’ I said. ‘And when the energy starts to flag there’s one women in the corner who says that she’s never had any problem with progesterone.’
‘I feel full of life and vitality!’ said Tab. ‘My husband thinks I’m more attractive than I’ve ever been! I just love people!’
‘We all look at her with rage and the fight takes on a whole new energy,’ I said.
Progesterone is a bad hormone for me but my comedian Tab is always an excellent prescription.
This morning, a sinking feeling as I approach the progesterone part of my cycle. Time to hide all sharp objects and tell the dog to assume the brace position. This one goes out to all those Mums with mental struggles of any kind; who still carry the burden of care. I see you trying. I see you trying so hard.
At it’s heart, this is a system problem. We should have a greater understanding of perimenopause, the profound medical shift that affects half our population, and we should recognise that this population contains many of the carers whose work acts as a supporting beam propping up the wellbeing of our entire society.
Comrades, wish me well with my daily… procedures.
And if we see each other in the street, approach with caution. I have probably just about had enough of your shit today.
Bringing me joy
The glimmers still exist. Smallest child and I are practising this dance.
Girls and I watched Nobody Wants This on Netflix and absolutely loved it, and we’re also in a phase of surrealist collage. Hard recommend: a pile of op-shop magazines, scissors and glue. Community season 1 rewatch. Ignore the mess.
Process Notes
The book drags on, at the moment like quicksand through the hourglass. I’m questioning everything. But I’m showing up at the page. This week, the social model of disability, the community life of ants and the Grease 2 soundtrack.
In October, I’ll be speaking at the Berry Writers Festival - hope you can join Ariane, Nina, Tori and I in what I know will be a funny, candid and vulnerable conversation.
If you are a new mum or know one, direct them to Jodi’s new Substack Dear New Mum: the best gift you could offer.
Thoughts and prayers for my progesterone sisters. If you feel the urge to write and tell me that P has actually been amazing for you, perhaps consider putting a fork up your arse instead? Thanks!
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