I was standing in my living room on a summer afternoon with my husband and four-year-old son. My left arm was tingling, I felt some pressure around my heart and it was beating in an irregular way. I thought I was having a heart attack. I was 46 years old.

I called my doctor to report my symptoms.

He asked if I had shortness of breath. I did not. He asked if I felt nauseas. I did not. He asked if I had pain anywhere else. I did not.

I told him that I had taken a three-mile run earlier that day and I felt fine. But now my left arm was tingling and my heart felt aflutter. I was scared.

After asking me more questions, my doctor told me that he didn’t think I was having a heart attack. He thought it might be anxiety.

Anxiety? I practiced yoga six days a week, meditated every morning, and always made self-care a priority. How could I be having anxiety?

Not long afterwards, I realized I was late on my period. One week late. Could I be pregnant? I didn’t remember having sex with my husband last month at a time that would match up, and anyway, we use protection. But I thought anything is possible. So I took a pregnancy test.

It was negative.

A few days later, to be sure, I went to the OB-GYN. My blood test showed I was actually quite the opposite of pregnant. I was in perimenopause. Peri-what?

I wasn’t familiar with this term. I only knew about menopause, which is something I thought women didn’t go through until they were at least 50. I’m only 46! What is she talking about?

The doctor informed me that I was pretty far into perimenopause. She said that my estrogen level was very low, and that this may account for the anxiety and fatigue I was feeling. She asked me if I was having night sweats or hot flashes. Thank goodness, I wasn’t.

As it happened, not long after that visit, I began to have night sweats. So much so that I would wake up almost nightly with soaking sheets and pajamas.

Then came the daytime hot flashes. Then foot cramping. Then mood swings. Then extreme fatigue.

I went back to the OB-GYN. She suggested that I try acupuncture. She said that acupuncture had been shown to help some women stabilize their perimenopausal symptoms. She gave me a recommendation for an acupuncturist. I made an appointment for the next day.

Whether it was the acupuncture, or the loving care of a compassionate, wise female doctor — or both — I’m not sure, but going to my weekly acupuncture appointments helped a lot. It helped stabilize my moods, reduce my night sweats, and gave me a little more energy. This made it possible for me to function.

My health insurance did not cover the acupuncture and I was aware how fortunate I was to be able to invest in this treatment. Not everyone has this option available to them. It made me think about how many women suffer through this phase of life without the proper support from the healthcare system.

One year later, at age 47, I was in full-fledged menopause. I hadn’t had my period in one year. (This is the official definition of menopause.) While acupuncture made it possible for me to function during this time, menopause started wreaking havoc again on my moods and energy level. I started experiencing lots of highs and lows, and mediums. Mostly, lows and mediums.

With my energy so depleted, I felt grumpy, strained and irritable a lot of the time. I struggled to stay on top of things—with my work, my marriage, motherhood and life in general. While my husband and son were patient with me, overall, I felt pretty lethargic and unhappy, and had no desire for sex.

Add to this, I had brain fog. There were many times I couldn’t remember a name or a word in a conversation with a friend, colleague, or most embarrassingly, a new acquaintance. This made me feel “dumb,” which certainly undermined my confidence.

I struggled to find words when writing and speaking. This was unnerving, considering my work is based on writing and speaking. I help women find their voice, but somehow I was losing mine. At times, I secretly wondered if I had early onset Alzheimer’s or dementia, but I didn’t mention this to anyone.

I suffered for a while in silence.

On top of all the physical disturbances, I was also grieving. I was grieving the loss of my period.

Ever since I first got my period in the 10th grade (yes, a little later than most), I enjoyed the sense of womanhood that came along with my cycle every month. I always felt a deep sense of strength, feminine mystery, and connection with other women each time I bled.

Now this was gone, and I never even had a warning! For over 30 years I bled on a regular cycle, and then one month, it stopped. And stopped forever. I never even got a chance to say goodbye.

My experience was rare. It’s more common for women to experience irregularities with their period for months or even years before their period stops.

At the same time I was grieving the loss of my period, I was also grieving the loss of my light-heartedness, joy and laughter. I felt my youthfulness and zest for life slipping away.

During this time, I did my best to stay balanced with my self-care practices, but even with those, menopause was taking its toll. I knew life could be better. So I went back to my OB-GYN.

Upon seeing her in the office, the first thing she told me was, “You look a lot older since I saw you last.” I felt shamed, but had to swallow it to move on with the appointment.

After talking through some options to improve my well-being, we agreed I was ready to start hormone therapy. I would begin with a very low dose of bioidenticals (plant-based, custom-compounded hormones) to minimize health risks associated with hormone therapy.

Within a month, I started to feel more stable again. My mood was improving, and I had more energy. I could also think and write more clearly. While I wasn’t necessarily a ball of laughter and joy, I was feeling a lot better. I was finally moving out of survival mode, and into living mode.

Six months or so down the road, I was still struggling with my libido. To work on this, I decided to read Pussy: A Reclamation by New York Times bestselling author Regena Thomashaeur, aka “Mama Gena.” I’d felt empowered by one of her earlier books about female power and pleasure, so I thought this one was worth a try.

Halfway into reading Pussy, a miracle happened.

One morning, I woke up and went to the bathroom for my usual morning routine. And guess what? Lo and behold there was some blood. Instead of being scared, thinking something must be wrong, I knew instinctively that this was my period coming back to give me a chance to thank her, honor her, and say an official good-bye.

This, I did. And I have never bled since. (Yes, I know this sounds a bit mystical. It was!) 

This experience made me realize how important it is for women to have some kind of ritual to help us cross this menopausal threshold and honor it as sacred — not as something that devalues us because we are now “older women.”

Every woman will go through menopause if she lives long enough, but most women aren’t educated about this important life transition. I certainly wasn’t — leaving me feeling blind-sided, lonely and disempowered.

According to the North American Menopause Society, by 2025, over one billion women around the world will be post-menopausal. That’s a very big number. Yet still there is a culture of silence around menopause.

According to Dr. Aviva Romm, Yale-trained physician, women’s health expert, and author of the newly released Hormone Intelligence, many women hold back and don’t disclose their menopause or menopausal symptoms because they feel ashamed and like there’s something wrong with them.

“I think for women in the wellness space, there can be a lot of expectation that you do the right diet, you do the right yoga, you do the right this, you think the right thoughts, etc. And it’s all fixed,” she said in an interview on the Glo podcast.

“Of course, that stuff really helps. But there can be added shame and confusion for women in the wellness space who are doing all those things, and they’re struggling.”

Exhibit A: It’s taken me four years to write about my experience with menopause, and I’m a writer on women’s issues! Add to this, I’ve even been afraid to talk to some of my closest friends about menopause.

After hearing Dr. Romm interviewed on the Glo podcast, I felt better knowing I wasn’t alone.

Dr. Jen Gunther, obstetrician, gynecologist, and author of The Menopause Manifesto, advocates for women being better informed. “Women deserve to experience these changes in their bodies equipped with facts and free of fear, shame or secrecy,” she said in a guest essay last spring in the New York Times.

One problem with this goal is that most doctors receive little training on the topic of menopause.

Earlier this year, the medical director for the North American Menopause Society, Dr. Stephanie S. Faubion, was interviewed by the New York Times about menopause. In the interview, she revealed that when her organization surveyed residency programs across internal medicine, family medicine and gynecology residents, the results showed they had “maybe one or two total hours of education about menopause.”

Furthermore, about 20 percent said they’d had no menopause education, and only about 7 percent said they felt prepared to treat menopausal women. This clearly needs to change.

I had firsthand experience with this during a preliminary exam with the nurse at my OB-GYN. Per usual in women’s health, she asked me when was my last period. I told her, “It’s been more than a year-and a-half. I’m in menopause.” She shook her head in despair and said, “You’re too young to be in menopause!” I was 47.

It turns out that most women begin perimenopause between the ages of 45 and 54, but I didn’t know that at the time. Having that knowledge sure would have helped me feel better about the transition. Instead of feeling like something was wrong with me, and that I needed to hide it even from some of my closest friends, I could have had more open conversations about it and felt more supported.

I have since left my OB-GYN for a new one. Sadly, I can’t say that I’m getting the proper support there either.

While menopause affects our physical health, mental health and emotional health, it also affects our finances.

“There are women who drop out of the work force or cut back on work hours because of menopause symptoms like hot flashes. On average, women spend over $2,000 per year on excess health care expenditures related to symptoms,” says Dr. Faubion.

That’s been my experience. Acupuncture is costly. Replacement hormones are costly. Add to this, missing work because of debilitating symptoms is very costly.

I often wonder … What if women were more educated about menopause? What if we spoke more freely about it in our public conversation as a natural cycle of life? What if we honored the transition as a sacred passage to our wise women years?

And what if doctors were trained to look at menopause as an ongoing and very important aspect of women’s health? How might that change how we go through menopause and how we feel about ourselves in the process?

I’m 50 years old now, and I finally feel brave enough to write about menopause. I’m writing about it because I don’t want other women to feel isolated, lonely or ashamed the way I did when I was going through the menopausal transition. I want to de-stigmatize menopause and put an end to the culture of silence around it so women can get the support and medical care that we need (without it draining our bank account).

I’ve been told by women friends 10 and 15 years ahead of me that it only gets better from here. They say they feel freer, more confident, less concerned about what other people think of them, more true to who they are, and liberated from social constraints that held them back in the past.

These women are letting go of patriarchal expectations and have embraced menopause as a rite of passage — an initiation into newfound wisdom and power. They no longer look outside to experts for authority, but trust their own wisdom and expertise. They are at the height of their position and influence, and they are asking themselves, How can I make the most impact?

Instead of looking at menopause as the end of something, I’m starting to see it as the beginning of something new and exciting — a significant life transition that empowers women to have a huge positive impact in our world.

Let’s say good-bye to the patriarchal silencing and shaming surrounding menopause and take back this sacred rite of passage. Will you join me?

Tabby Biddle, M.S. Ed., founder of TAB Media, works at the intersection of women’s leadership, feminine spirituality and social change. She is the co-founder of 50 Women Can Change the World in Media & Entertainment, the bestselling author of Find Your Voice: A Woman’s Call to Action, and an internationally celebrated women’s leadership coach, educator and group facilitator for her unique approach to activating women’s leadership. Her new group, the Divine Feminine Writer’s Group, is launching now. Learn more.