I'm 49 and in full-blown menopause. I went on hormone therapy to revive my sex life.

• I started going through menopause at age 46.
• I have many symptoms including low libido, joint pain, insomnia, and sweating a lot.

It seems unreal when I think about how perimenopause crept in quietly without too much fanfare in my late 30s and early 40s. It wasn't too bad — I had minor symptoms — but it was bearable.

Then all of a sudden, in 2018, after my menstrual cycle abruptly ended at 46, menopause became my living nightmare. It crept up and consumed me. I slid slowly into an abyss of unexplained joint pain, hot flashes, brain fog, exhaustion, a nonexistent libido, and depression.

I was living in a body I didn't recognize

If I could advise young women of anything, it would be to avoid menopause. But sadly, that's not a reality. Fatigue, night sweats, osteoporosis, hot flashes, sweating, insomnia, dryness, anxiety, irritability, low libido, moodiness, and vaginal dryness — that is my everyday reality with menopause.

All these symptoms converging at once meant my day-to-day life changed a lot. I was either in too much pain or too exhausted to work, socialize, or do much of anything. My world got smaller as I withdrew from activities and things I once enjoyed.

I was falling behind on work, missing deadlines, and going days without doing anything, as I usually used any energy reserves I could muster to deal with family-related issues. I tried to ensure that my husband and kids felt supported even as I grew worse each day.

I barely slept more than two or three hours a night, increasing my brain fog and fatigue. I was battling migraines daily and staring at a reflection in the mirror I didn't recognize. My body had turned on me and left me wondering whether I faced death or institutionalization first.

I feared becoming a statistic

My husband is nine years younger than me and still has a high libido. That was a massive plus during the peri phase because my libido was also in overdrive. The decline began once I hit menopause; my libido was almost nonexistent.

Painful intercourse can be a dealbreaker for many women, and vaginal dryness is a real issue. But I was determined for it not to break me.

I didn't want to be the discarded middle-aged wife whose younger husband decided that working through menopause was too much effort.

We still had sex regularly, as I was intent on keeping the dream alive despite my lack of arousal. I was willing and able, so I did. I still found my husband attractive and wanted to continue our robust sex life, so I used what little I had left in the tank to ensure we kept that connection going.

Enter, lube; all kinds of lube. We've tried them all with varying degrees of success. It took lots of trial and error to settle on one we both liked. Adding lube made it easier for me to transition into this new version of our sex life.

I decided it was time to take care of myself

In May 2022, I reached my breaking point. I realized that using any scrap of sanity or energy I had on others couldn't continue. It became unsustainable for me, my husband, our family, or our business.

I made an appointment with my doctor and my therapist to explore options. After lots of tears, tests, and bloodwork, I began taking bioidentical hormone-replacement therapy, or BHRT, at the end of June.

To say that the change has been life-giving is an understatement. I'm now a month along, and my symptoms have almost vanished. The most bothersome — like hot flashes and daily migraines — left immediately. The other symptoms — dryness, brain fog, lack of sleep, joint pain, and low energy — have steadily improved each day.

I don't know that BHRT is for everyone, but it was the right choice for me. The turmoil that menopause can create in a woman's life is scary. The fear of becoming a statistic is gone, and I have my life back and no longer worry about disappointing my family and friends.

Cindy Rodriguez Constable is a communication strategist, freelance journalist, and professional speaker. You can follow her here.