must beware of stimulants, as well. Illegal ones include cocaine and meth, of course, but also prescriptions, such as Ritalin and Concerta. Even some over-the-counter asthma medications have a stimulating effect. There is even some controversy in twelve-step circles over the use of so-called “energy drinks,” or excessive caffeine consumption.
We also want to be careful even as we face the good news of better medicine. Aging bodies can lead to new hips, new knees, and back surgeries. And those often come with the need for temporary use of serious pain medications. We have all known people in long-term recovery who have been led to relapse by correctly and legitimately prescribed pain medication, so this is an area for special care. When we face a surgery or treatment that does require pain management we need to tell everyone ahead of time. Tell your doctors, recovery friends, sponsor, and family members before the surgery. Make a plan so that it’s okay for them to check on you when you are using the prescribed medications.
But not all medications are prescribed. We also want to be careful with remedies we buy in the drugstore or at the health food store. A popular tea called kombucha is a true health aid for many people with digestive problems. It’s sold in health food stores. But we have to be careful. Kombucha is a fermented beverage. It contains alcohol. That’s one example.
A joke I heard recently with an implied warning goes like this: “Be careful with Geritol and NyQuil; there’s a reason they come with a shot glass.” Yes, those are but two of many over-the-counter medicines that contain a high percentage of alcohol. Read labels, and avoid ingesting even a small percentage of alcohol; even if your drug of choice was marijuana, why risk relapsing over a shot of 50-proof NyQuil?
MENOPAUSE
Women who stay in recovery for a long time will have to face perimenopause and menopause exactly like women who are not in recovery. Yes, real life again. But women in recovery have a few special considerations. For a woman in recovery, menopause can be a time of additional vulnerability.
One of my early sponsors joked about recovering women and menopause saying, “The hormonal swings of menopause can make you feel like you are drunk, and if you have ever been drunk, then you know that the best way to fix that is to have another drink.” So we want to be careful as those midlife hormonal changes begin.
Some of the physiological changes for midlife women include loss of muscle mass, changing levels of sex hormones like estrogen and progesterone, and a dropping metabolic rate. Again, these are all pretty normal occurrences, but the consequences and how we feel about them can impact our recovery.
A study from the University of Colorado suggests that over the roughly ten-year period of perimenopause through menopause, about 50 percent of women will gain ten to fifteen pounds because of their lowered metabolic rate. It’s safe to say that few women are happy about gaining weight and for most women, both in and out of recovery, that brings feelings of being unattractive, less desirable, and getting old that can jeopardize our sense of well-being.
Menopause raises medication and health questions. Night sweats, insomnia, mood swings, and libido changes all have a physiological basis, but they have emotional and behavioral manifestations, too.
Tabitha Kane, a gynecologist in Albany, New York, confirms, “Most women will see a decrease in libido and they will experience vaginal dryness. The insomnia can be really significant, with resultant irritability. It’s a stressful time for any woman. There is a general increase in irritability. Divorces occur.”
Concentration and memory can be a problem too, which, for women whose self-image is tied to their professional functioning, is especially hard. “They will take a hit there too,” says Dr. Kane. And anxiety can increase. “Some women feel like they’re going a little crazy.” So with all those factors combined, menopause can significantly affect our relationships and self-image.
Several doctors have confirmed that women who have no history of depression could have more than twice the risk of depression during the menopausal transition. “Yes, this does resolve soon after menopause, but for some women that ‘transition’ can take a couple of years,” according to Dr. Kane.
So how do we sort out our behavior as we are going through menopause? You’ve heard the jokes:
“Question: What is the difference between a terrorist and a woman in menopause?”
Answer: “You can negotiate with a terrorist.”
Yes, it’s funny because there’s an element of truth.
For a woman in recovery who is trying to be self-aware and mindful of her behavior and her communication—how can she know if her less-than-desirable behavior is evidence of a character defect or the result of declining estrogen?
We have to be mindful at this time because we could either use menopause as an excuse not to take responsibility for our behavior or we could be tempted to try a chemical remedy for our sadness or our anger. We might recall and start to romanticize the ways that wine, marijuana, donuts, or the attention of a new man made us feel better in the past. And yet, we also need to know when professional medical attention and even prescription medications are the right next step.
WHICH BRINGS US TO SEX
For many women it was something in the sexual sphere that got us into recovery. It was either too much or too little, and often it was with the wrong people. Better sex and better attitudes toward sex may be a marker of how far we’ve come. Pre-recovery, we may have had sex with too many people or the wrong person, or sex was bad because we were numbed out or we didn’t have enough sense of self to ask for what we needed.
Even in early recovery we may still have done it with the wrong people—that cute newcomer in our home group or the married guy who was thirteenth-stepping us. But the good news is that as we get better in recovery, our sex life can get better too.
When I was twenty years old I knew so little about sex. When I was twenty-five I thought I knew some things but I still didn’t know enough. At thirty I was learning how to give pleasure, but it took almost ten more years to learn how to receive it. And surprisingly, sex does get better with age.
Yes, I always knew that “older” people had sex. When I was thirty-three years old, my seventy-year-old mother, who had been widowed many years, was newly remarried. She told me that she and her second husband, Don, had sex almost every day. I thought, Good for her, but I also secretly thought, How good could sex really be at their ages? Now I know. And I’m sorry I laughed at the people who told me that sex gets better as you age. I didn’t know. But now I do.
At fifty-nine, my sex life is better than I ever imagined. Yes, I wish my skin was smoother and I wish I was firmer, but I now know more about how to give and receive pleasure. Having confidence is part of it—that comes with recovery too—as is learning what works, and being fearless about trying things, and then trying them again.
This is a gift of recovery we don’t talk about much in meetings, not even in women-only meetings. But I have learned about my sexual needs and how to meet them. And even that has been a process over years of recovery.
In my pre-recovery and early recovery years all of my character defects applied to my sexual behavior and my sexual sensibility, just as they did to my workplace and social behaviors: I was a people-pleaser, not always honest with others and rarely honest with myself. I didn’t know myself well enough to be honest.
In those days before recovery, I managed my fear or anxiety with alcohol or other drugs or food, and I was alternately obsessed with my body or wildly out of touch with it—so truly experiencing the sensual didn’t have much of a chance.
But I was always an athlete—runner, gymnast, swimmer—so I knew something of the body’s mechanics; hence, I learned sex mechanically too, and as a codependent I read every article about how to please men. I knew how to seduce without ever feeling seductive. Yeah, I faked frequently.
In those days before recovery, I managed my fear or anxiety with alcohol or other