Perimenopause can bring unfamiliar and sometimes life-altering challenges, yet most of us will have the benefit of a pretty long time-horizon (sometimes years), to process the transition. But for Juilee Dandekar, a full hysterectomy at the age of 37 thrust her into a post-menopausal state about a decade earlier than the average Indian woman reaches menopause. Now 38 years old and approaching a year since experiencing surgical-onset menopause, Juilee (pronounced Zhu-e-lee) is establishing a new normal for her health and well-being, while using her voice (and social media platforms) to amplify and normalize the discussion about menopause among women across her native India.
“I wanted to start mapping my journey so that if tomorrow there’s somebody else going through the same experience, they have something to review and someone to reach out to. I wanted to share my story so they might better understand what is happening to them.”
A Long and Painful Struggle
Diagnosed with Stage IV endometriosis at age 37, Juilee struggled with dysmenorrhea (severe pain associated with menstruation) since starting her period at the age of 10. By the time her doctors recommended a total hysterectomy (i.e., removal of her uterus, cervix, ovaries, and fallopian tubes) in the fall of 2020, Juilee had already undergone three surgeries in years prior for endometriosis, fibroids, and diastasis recti – the latter after giving birth to her twin girls in 2016. While the surgeries gave her some relief, it was always short-lived and ultimately, the endometriosis grew back with a vengeance.
“Because endometriosis is an estrogen-dominant disease, my doctors explained that it would more than likely continue be a problem for me if my ovaries remained intact.”
With the removal of her ovaries, Juilee knew that she’d no longer be producing estrogen naturally, and as a result, would be faced with the early onset of menopause. So, she set out to prepare herself for what was to come. But to her disappointment and frustration, there was little to no educational information available on the effects and impact of surgical menopause. And the community of support for women navigating menopause was non-existent. Rather than be resigned to the status quo, Juilee decided to document her journey so that others wouldn’t have to go into surgery feeling unprepared and not knowing what to expect after their reproductive system has been removed.
Born and raised in India, and now living with her husband and five-year-old twin daughters in Mumbai, Juilee notes that discussions about women’s health issues, let alone menopause, are not common.
“There are still many antiquated rituals (and stigmas) around periods. For example, in some families, women do not enter the kitchen or cook during their periods. There is little discussion on periods, much less menopause, and so we have no idea what to expect.”
Although Juilee’s mother doesn’t recall her own menopause transition, like Juilee, she started her period early and has been supportive of her daughter throughout her struggles, including in this new stage of her life. Juilee also has a supportive friend group and is in the unusual circumstance of living and sharing this experience with her best friend who has also gone through surgical menopause.
As a mother to two girls, Juilee feels an obligation to open up the conversation about women’s reproductive health – from the onset of our periods to post-menopause – and everything in between. While she’s optimistic that her daughters won’t experience the same painful journey that she’s had to endure, she knows that they may struggle with dysmennorhea.
“I will never be dismissive about their pain. I’ll be a lot more conscious and educated about what is happening with them.”
Managing Menopause at 37
Juilee says that some of the conditions she’s experienced post-menopause haven’t been as bad as she expected. For example, the fatigue and her depressive episodes were significantly worse when she had endometriosis. But when it comes to the hot flashes, that’s a different story entirely.
“The hot flashes are pretty bad. I sweat profusely even in full air conditioning!”
She credits resuming a regular exercise routine shortly after her hysterectomy with helping her manage her psychological and emotional well-being. And though she says her metabolism has slowed down due to menopause, she has managed to restrict the weight gain to 2-3 pounds by practicing mindful eating. Rather that follow any special diet, she is mindful about the amount of oil, sugar and processed foods that she consumes.
While Juilee is optimistic about her quality-of-life post-menopause, she knows that her health journey is far from over. Because she’s no longer producing estrogen, she’s prone to more rapid muscle loss and at increased risk of osteoporosis and osteopenia.
“Doctor’s will often recommend HRT for post-menopausal women who are at particular risk for osteoporosis; however, my doctor doesn’t recommend traditional HRT for people with a history of endometriosis, as the estrogen can lead to a return of the condition.”
Juilee says that some endo specialists will recommend a synthetic form of hormone replacement therapy, “such as Livial.” Having worked in the pharmaceutical industry for several years and after researching every aspect of the drug, Juilee ultimately chose to start taking Livial after she started experiencing early symptoms of osteoarthritis. She has also taken a fitness-focused approach to enhancing her body’s response to early menopause, and understands the importance of incorporating muscle conditioning and strength-training into her regular routine. At the recommendation of her gynecologist, she also takes daily supplements (including Menopace, Omega-3s, and calcium) and has made other lifestyle changes to support this process.
She also has regular bone density scans to ensure that she’s maintaining her bone and muscle mass.
Creating a Platform for Indian Women to “Live Fearless”
In the US, the median age for reaching natural menopause is 51; however, Black and Latina women reach menopause at 49 — two years earlier than the national median age. Shockingly, a 2016 PAN India study by members of the Indian Menopause Society, showed that the average age of menopause of an Indian woman is 46.2 years – three-to-five years less than their Western counterparts.
Juilee wants to create more awareness and conversations around women and their health – especially as we age.
“So many women are not even conscious of what is happening to their body. They’re in their 40s and they don’t think, ‘I’m probably going through menopause and that’s why this is happening to me,’ because there’s no conversation around it… I want them to be more informed.”
Since starting her Instagram page (@LiveFearless.MenopauseIndia) in 2020, Juilee has had dozens of women reach out to ask questions related to her personal experience with her hysterectomy, and about menopause, in general. With more than 2K IG followers (and counting), she knows that there are a lot of women out there who do not have any support and go through a lot of mental anguish alone, with nowhere to turn.
“I really feel good when people write and ask me questions about this space. Because I’m going to be researching about this topic day-in and day-out anyways. What am I going to get out of keeping it just for me, right? So, I might as well share it with as many people as I can.”
To keep us with Juilee’s post-menopause journey, follow her at @LiveFearless.MenopauseIndia on Instagram and Facebook. LiveFearless is an initiative to educate, create awareness and conversations around Menopause. Its mission is to empower women to take charge of their health proactively, so they can live an independent and more fulfilling life beyond their 40s.