A new Indian book on perimenopause. Unusual news, I thought, and ordered a copy. Shonali Sabherwal, a macrobiotic nutritionist and gut expert, and Dr Nozer Sherier, one of Mumbai’s most well-known gynaecologists with practices in three leading hospitals, have a bible in Finding Your Balance: Your 360 Degree Guide to Perimenopause and Beyond (Penguin, 427 pages, Rs399) for women in their 40s and marching to their 50s and menopause years.
The time to talk openly about perimenopause is just about right. The entrepreneurial dream that has found inspiration, support and money in the past decade around the world is the Fem Tech start-up dream—tech-based start-up solutions related to reproductive, sexual, maternal and gynaecological health, founded largely by women. Bengaluru-based FemTech India, a one-stop platform for all things fem tech in India, estimates that the industry will be worth more than 100 million dollars by 2025.
This book will go down well with a generation used to menstrual cups, ovulation apps and health bots. It does break some new ground. It is an expert, comprehensible addition to what Instagram can offer as advice on perimenopause. Your therapist is no radical if you are in your 40s—man or woman or anyone from the gender spectrum—and they don’t explain to you that the peerless, won’t-cow-down anxiety you feel on most days may be feeding from perimenopausal disturbance in your hormones. But the book does something important: It differentiates perimenopause from menopause, which many women and men have not yet had the chance to understand. Conversations around periods and menopause tend to be either feminist battle points or pure medical science.
Full disclosure: Dr Sheriar treated me for debilitating endometriosis in the early 2000s when I was looking for the best way forward from a ghastly diagnosis of Stage 3 endometriosis, which, I was told was going to stay until I would hit menopause. Endometriosis is a condition in which tissue that resembles the uterus lining grows outside the uterus - it may lead to especially painful periods and difficulty conceiving.
The universe propped me differently, of course, and that’s another piece. Based on the few years that I consulted with Dr Sheriar, I know he is a doctor to be trusted with knowledge, wisdom and the vibe of an ancient healer. He explains in the book, “You are said to have reached menopause when you have no periods for twelve months with the absence of any medical problems. This occurs when you have used up all or almost all the egg (oocyte) containing follicles in your ovaries, resulting in a dramatic fall in oestrogen levels, medically described as hypoestrogenism. The transition process and the time immediately before and after menopause is referred to as the perimenopause or the climacteric.”
Climacteric literally means a critical period or event. True, if we were to treat the hormonal vicissitudes of the 40s and 50s as “climacteric”, we’d probably feel and look much healthier than we do.
Based on her own years of research and practice, Sabherwal offers some easily achievable dietary and lifestyle changes to beat perimenopause and feel the best we can feel at this age. Besides hormone replacement therapy, which is a widely used medical regime—with their share of positives and negatives—this book is big on holistic changes like cooling our bodies consistently, every day with effort whether through breath work or what we eat. As with most hormonal or chronic health conditions, being on top of perimenopause and menopause demands deep-rooted changes and the discipline to sustain them, and both experts in this book have the best advice you could find.
Before you decide this book is full of prescriptions, I’ll stop giving more of it away. It’s a breeze to read, and nothing else has gotten closer to explaining what happens to us when we hit middle age—when everything from professional goals, relationships and friendships to managing parent care and braving teenage storms makes us forget some part of our elemental selves. You’d know how simple things that can embalm the hottest of messes.
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