As I walked into the exam room, Susan’s smile quickly turned to tears.

“What’s going on?” I asked, sitting down on a stool.

She let out a big sigh. “My life is great, I mean, really great. I’ve been dating a man for almost a year and he’s terrific. Work is great too–I made partner.” She looked away for a moment, then back at me with her eyes brimming with tears. “See this,” pointing at her eyes, “this happens all the time now.”

I’ve known Susan for years as a patient. I was always impressed, and a little envious, of her nonstop energy. Driven to be top in her field, she gave everything she had to her career. She embraced the challenges, thriving in her male-dominated work world, and found rich rewards in her chosen life.

“I cry at everything these days. I’m in the middle of a meeting, then someone pushes my buttons, which I normally can handle easily, and suddenly tears are welling up in my eyes. My boyfriend asks a simple question and I want to scream at him. It’s so embarrassing! Worse yet, I feel like I can’t control it. You have got to help me!”

“It’s like you’re going through a second puberty,” I told her with a smile.

“Exactly! I’m 52 and acting like a teenager! But how do I explain that to a bunch of men??”

What comes to mind for me are infinity mirrors you see at fun houses. They’re the ones that show you smaller and smaller reflections of yourself going into infinity. When you’re surrounded by those mirrors, it feels like the crazy turbulence they reflect will go on forever!

Recently, I had a mother and daughter see me for check ups. I saw the mother first. As I walked into her room, I found her fanning herself with a pamphlet from the shelf. “Oh my God! These hot flashes are horrible!” she greeted me. Her gown was wet from sweat.

She went on to tell me that her periods were erratic, and she was irritable and moody. She didn’t sleep well, waking up drenched in sweat throughout the night. “Sometimes I scream at my kids and husband for no reason.” She rattled on about scenarios where she felt out-of-control or acted impulsively.

From the “What the heck is going on with my body?” to “I can’t remember where I put my car keys” to “there are days I just want to whack everyone at work,” the end of a woman’s reproductive years can be an emotional, topsy turvy time.

For some, the hot flushes, night sweats, and interrupted sleep wreaks havoc on the daily. For others, more subtle changes are bothersome–dryer skin, saggy breasts, decreased energy level. Or it may be harder to take off those few extra pounds after the holidays, memory becomes a little foggy, and sex isn’t the same, possibly even painful.

And on a deeper front, there may be joy in not having a period anymore or hell in trying to manage volatile emotions or sadness in the closure of the reproductive years.

On a personal level, I found it a time to reflect about my mother and her transitions. I was finishing high school and starting college when her ovaries were probably shutting down, but true to her style, she didn’t comment or complain about how this affected her. She just went about her days like nothing different was going on with her body.

Even though I am different from my mother–more willing to share my emotions–I would guess my children would say the same about me during this time. I didn’t find myself complaining much at home, partly because working in this field gave me access to resources and knowledge to help me navigate my transition.

During Susan’s appointment, we discussed options to help her feel more in control of her body and hormonal changes. For someone who thrives on being in control, as Susan does, the unpredictable changes of menopause can be scary. So for her, acknowledging the changes she was experiencing and respecting her body were empowering to her. In the end, we decided to try to include one medical intervention in her plan to ease some of the physical changes for her.

I hoped she came away from her appointment with a renewed sense of self love, self patience and self acceptance. And, ultimately, to honor her wisdom and experience that brought her to this point in her life.

Andrea Eisenberg is a board certified obstetrician/gynecologist in the Metro Detroit area for the past 25 years. Through her many years in women’s health, she has shared in countless intimate moments of her patients, and shared in their joys, heartaches, secrets, losses and victories. In her writing, she captures the human side of medicine and what doctors think and feel in caring for patients. She has documented these stories on her blog, The Secret Life of an OB/GYN. She has been a contributor to Intima, A Journal of Narrative Medicine; Pulse, Voices From the Heart of Medicine, and The Examined Life Journal. Andrea is also a contributing author at BBN Times and a guest rotating blogger on KevinMD and Doximity. In addition, she was a writer for Doximity’s 2018-2019 Authors Program, and a medical reviewer for HealthCentral.com.