by Alexis Shotwell
Why yes, since you wonder, I am writing this short review at 4:13 in the morning because of perimenopause. Maybe you’re reading it in the middle of the night for the same reason! If so, I am here to tell you that the Heather Corinna’s new book What Fresh Hell is This? will make you feel better than you do right now, and you should get your (perhaps sweaty, cranky, bewildered) hands on a copy asap.
Written by a nonbinary, rad, smart, funny, sex-educator, this really is a game-changer in a field of books that try to be helpful and relevant but end up just recapitulating tired gender-binary, straight, fat-hating, ableist sexism. In place of so much that makes us sad, What Fresh Hell is This? offers practical, supportive, buffet-style advice for meeting perimenopause and menopause with kindness, feminism, and science.
The book starts with a great, short history of how messed up and sexist treatment of perimenopause and menopause have been in western medicine (easily skippable, as Corinna notes, if you just want to not think about annoying things). Then it gives a clear run-down on hormones, why they are complicated, and why their changing affects us so much. (I had no idea that there are four kinds of estrogen that bodies produce? One of which is only produced if you’re pregnant, and it is made by the fetus’s liver? How wild.) But in this part, Corinna begins their reframing of the assumed subject of perimenopause with an ease that feels casual and comfortable as you read it, although it is clearly a political decision enacted with rigor.
The “proper subject” of menopause is often implicitly imagined as a straight nondisabled white cis woman who has had kids and worries about getting fat, wrinkly, nonreproductive, and moody. Corinna writes for that woman, for sure, but she is not the central subject from which the rest of us deviate. So all throughout this book there are regular people who have had or do have uteruses and ovaries, and who enter menopause suddenly because of chemo or oophorectomy or hysterectomy, or using T, or other things.
There’s an excellent supplemental section at the end about how trans women and people with testicular systems experience menopause. Being disabled, queer, and nonbinary is not exceptionalised, and Corinna marks how racialization and poverty shape the conditions of life through which we enter menopause.
I just can’t express how relaxing it is to be able to read a book about perimenopause and not constantly brace for or read around heterosexuality, fat-shaming, and ableism, a book that acknowledges racism as a structuring condition of our lives.
But then mostly the book is just helpful about perimenopause. Corinna explains the whys and hows of various things that can happen: Vasomotor symptoms (hot flashes and night sweats), mood shifts and mental health upheavals, cognitive affects, chronic pain flares, and changes to digestion, skin, bleeding (of course), and sexuality.
The bulk of the book, which goes through various kinds of experiences people have with perimenopause is grounded, thoroughly researched, and measured. I learned a lot, including about things that I thought I had settled views upon, like about whether hormone therapies are good or bad. On that front, I didn’t know that the studies that convinced me that menopausal hormone therapy was harmful and bad didn’t actually focus on the people who might benefit most from short-term combined hormone therapy – they were done on people who were postmenopausal, on average 63 years old, and with an aim of preventing long-term health problems. And I didn’t know that testosterone can be used as part of a menopausal hormonal treatment plan.
Part of what’s so great about WFHIT? is the steadiness with which it explains that the transition to not bleeding will be personal and specific, but that we can still know things about it. And it has really good suggestions in a frame Corinna calls “Ya Basics” for thinking about managing stress, sleeping, moving our bodies, finding social support, and quitting smoking. They offer sometimes irritatingly helpful advice while acknowledging that it’s sometimes irritating to be offered helpful advice. But they’re still offering it and honestly they’re probably right.
Readers of this blog are probably like me, people who think about a lot of things and who feel like we know some stuff. It is so strange and nourishing to read a book that shows how much more stuff there is to know about something that anyone who has or has had a uterus and ovaries will go through. I feel almost embarrassed at how relieved and affirmed I feel, having read this book, and I recommend it to you. And I hope you get some non-sweaty sleep.
Bio: Teacher, writer, SF nerd, functional potter, queer, currently obsessed with doing handstands in middle age. Author of Against Purity: Living Ethically in Compromised Times and working on a book called Collecting Our People, about getting together to solve big problems in which we are complicit.