'Quasi Pause': The Medical Term I Invented for Blowout Bleeding Before Menopause

by Martina Clark

My name is Martina, and I have Quasi Pause. Yes, it's a thing. And no, despite the lilting rhyme, it isn't much fun. According to Dr. Google, it is an Italian phrase and if you add "senza" you have the full meaning — "Senza Quasi Pause" - which roughly translates to "Without Barely a Break" and that is what I have. And I'm not the only one.

My affliction, apparently, is common among 52-year-old blue-eyed blondes because I happen to know one other woman who, like me, is a 52-year-old blue-eyed blonde and she is also suffering from Quasi Pause. So, really, it is a thing. I have seen all the doctors and had all of the tests in all of the places and the results are in. Even if I may or may not have made up the name Quasi Pause, (by the way, I totally did) it's a thing and it is not unusual.

Quasi Pause is the opposite of menopause. A last hurrah of the lady parts. One final bender for the vajayjay. The period that WILL. NOT. STOP. It is a nightmare for pretty much everyone in a five-mile radius of my uterus. 

And the side-effects, oh, the side-effects. Bloating, nausea, weight gain, acne, irritability, regression-to-teenage-angst — you name it. The bloating, nausea, weight gain, and acne, of course, are caused by the hormonal need for menstruating women to eat crap. Dairy, desserts, Giant Chewy SweeTARTS... you get the picture.

I know this because for the recent four and a half hours that my body was not bleeding, I did not crave these things. I was sated with mundane items such as fruits and vegetables and meals appropriate for healthy grown-ups. And then, bang, hour five, cramps start up again and there I am, spending the evening with my best friends, Ben & Jerry.

Read more: When You're a Week Late and Middle-Aged

But seriously, this last blowout of bleeding before attaining the Holy Grail that is menopause is no joke. For me, the worst part — aside from the hassle of it all — is that I have all of the common symptoms such as lower back pain, unpredictable moods, tender mammo-units and so on. It is like being 12 all over again but for months at a time. Well, I suppose that technically I was already 12 for months at a time, approximately 12 of them, but at 52, it isn't something I'd particularly wanted to repeat. 

I say 12 because that's when all of this nonsense started for me. By 13 I'm sure I was used to it, but in the beginning it was all very confusing and back in the 1640s when I was a tween (OK, 1976) we didn't much discuss these things. A box of maxi-pads showed up in the bathroom, my oldest sister slipped me a copy of Our Bodies, Ourselves and I was pretty much on my own from there on out. I was too embarrassed to actually read it, but, like everyone else, I figured things out. That first year was very confusing, upsetting and painful, literally.

Now that I am 52, I feel like nothing should faze me except that there is this thing about how by 52, most women have started menopause and that means that their periods are a thing of the past. Distant past. Both of my sisters had caught hold of the golden ring, dumped their feminine products and were well on their way to night sweats and other fun activities by the time they were 50. 

Clearly, I am a late bloomer. But I am so very very very tired of it all. And you know who else is tired of it all? My partner. In our house, bleeding equals a kibosh on sex. Sometimes that kibosh is in place for as long as a month, sometimes two months, occasionally three. 

Firstly, the idea of sex when I am in pain is very unappealing. Secondly, it is kinda nasty, to me at least, to contemplate sex with all of those "extra fluids." But, above all, in my situation, it really isn't viable because I also have HIV. Bring that into the mix and avoiding any and all blood suddenly becomes the wisest choice.

My partner is incredibly patient about these things and, for that, I am eternally grateful. He only teased me once about approaching menopause and after I unlocked the door and let him out of the broom closet, he never brought it up again. But it isn't fun for him nor, do I imagine, is it fun for the partner of any woman going through these changes, which they have no way of either anticipating nor controlling.

My body has been behaving badly for nearly two years now but, apparently, that is not that uncommon. It seems, slowly, to be sorting itself out but I fear I still have some waiting to do. Meanwhile, I fantasize about the day in my future when I no longer have to worry about bleeding. There I'll be, sipping a tall glass of cold water infused with lemon and cucumber, fanning myself in my mumu as perspiration seeps from my pores. But, I won't be bleeding.

Read more: Congrats, It's Perimenopause! 20 Signs You're Becoming a Crone

The thing I hadn't contemplated, however, until very recently is the reality that unlike other women who can likely give up birth control, I will still always need to insist on condoms. We now know that when a person with HIV has an undetectable viral load — as is my case thanks to effective anti-retroviral therapy (fancy term for medications that work) — the risk of transmitting the virus to a sexual partner is virtually eliminated. 

I know this. I have worked on HIV for decades and I know the science. But my heart still can't take that chance because if anything happened to the person I love, I could never forgive myself. Clearly, he also has a say in this but I am still not sure I'd want to take that risk, no matter how small, even if he suggested it. And so, I will always and forever need to insist on a condom. 

There is also the fact that post-menopause, a woman has less natural lubrication and so tearing is more common. This means that post-menopausal women should also still use condoms unless she and her partner are both aware of their respective HIV-status and are making informed decisions. Certainly any women who start dating again in later years need to prevent HIV or other STIs by using condoms. 

Before all of these peri-menopausal shenanigans, I accepted the condoms because I pretended it was also for birth control. In fact, it was also for birth control and it has worked. But once the need to prevent an unwanted pregnancy is gone, the fact that I'll still need to use condoms is somehow bringing up all of those ugly feels from early diagnosis. 

All over again, 24 years later, I feel dirty. I feel like damaged goods. These feelings are just a few gently teared-up eye sockets, not the fountains of salty stuff they used to be, but it still sucks. And so, yet again, all these years later, I'm coping with the fact that I have HIV in a whole new way. And I hate it.

But, unlike when I first found out when I was just 28 years old, I no longer worry that I'll be dead in five years. In fact, I now have the luxury of looking back and knowing that despite what the doctors said then, simply because they did not know better, I am going to be here for a while. 

HIV is no longer considered a presumptive disability, as it was in 1992. Today we know that with medication, regular health care, and taking very good care of ourselves — as we all should do — that people with HIV have a normal life expectancy. At least in the United States, people with HIV should be planning for their futures and budgeting for retirement. 

So there you have it, my story of Quasi Pause. I should be starting menopause any day now but, until then, I am in this holding pattern of the period-from-hell. In the end, it is better than the alternative. I'm here, and that is what really matters. Now, please pass the Half-Baked, it's in the freezer on the left, just behind the Cherry Garcia.


Martina Clark is a freelance writer based in Brooklyn. She is also an occasional instructor, public health consultant, and singer. More of her writing can be found on Facebook or on her blog.