“Anything that can happen to a woman can happen to me.” – Muriel Rukeyser, Waterlily Fires

I’m 38, an age I never thought would feel the effects of aging, and yet, here I am, bloated, angry, some X pounds overweight, with lines jutting across my forehead and neck like I’m wearing a goddamn high school geometry quiz. I wonder if my dermatologist—before she injects the botox—has a protractor to measure and marvel over the pronounced exactitude of these angles. I mean, wow. It really is quite something. Someone has to.

This is the bully inside me talking. She wants to say a bit more before she’s done.

I have aubergine varicose veins that collect in cruel webs at the back of my knees and in random spots along my thighs, that, in another macabre twist, happen to be the color of limestone. And then there’s these new curves. I get out of the shower and look at my reflection and see the Vénus impudique, you know, that Paleolithic sculptural representation of a woman with bulging breasts, belly, thighs. She’s almost circular and completely anonymous, for her face isn’t present, save for horizontal ridges running across the countenance plane. Was this the chiseler’s artistic choice? Or was her face wiped away and distorted over the years?

Here’s the thing that strikes me most, despite all the other physical changes in my late 30s: my phantom breast syndrome. I got a prophylactic mastectomy to protect myself from the realities of having the BRCA2 gene mutation. Having this means around a 60% lifetime risk of breast cancer and a 15-30% lifetime risk of ovarian cancer. We know from the brave women like Anjelina Jolie, and her wonderful essay, the benefits of this medical choice. And now, even though I no longer have breast tissue, I feel that deep primordial discomfort where my breasts used to be. Any menstruating person knows this all too well—that rich, throbbing, tender-to-the-touch pain and sensitivity right before you bleed. There is no biological reason for me to still feel this. There is no breast tissue left to swell. And yet my body can’t let go. It must remind me.

I’ve had this pain since I was 10. So young to have a period, and yet, there I was one summer, noticing the first drop of blood staining my floral polyester pajamas. I had no idea—could not even predict—the rapid physical development that would soon follow, pushing me so prematurely and suddenly into womanhood.

Yes, I am grateful to be alive! I am grateful to have access to genetic testing that allows me to make the hard choices, to continue living, to have a body that is healthy and can move. I understand this is a deep privilege. And yet, and yet, I still feel the grief associated with this specific time of aging—this nowheresville between my reproductive years and full-on menopause. As the Mayo Clinic says, “Perimenopause means ‘around menopause’ and refers to the time during which your body makes the natural transition to menopause, marking the end of the reproductive years. Perimenopause is also called the menopausal transition. Women start perimenopause at different ages. You may notice signs of progression toward menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.”

To provide more color, within my group of friends, all women between the ages of 35-50, we’re experiencing these changes in myriad ways.

Let’s start with the vulvas. The changes to our desire and intimacy, that is who we love and how we love; the beginning of vaginal dryness, in which we’re instructed by OBGYNs to use tablets, creams, lubricants, or even insert Kegel balls before engaging in sexual activity; a weakened pelvic floor, which means peeing and laughing, peeing and coughing, peeing and walking, and even organ prolapse; changing periods, in regularity and flow, and I mean like suddenly bleeding through a tampon and right through our thick-as-camel-hide Levi’s jeans in the Trader Joe’s produce aisle.

Then, there’s the surgeries and speciality visits. The hypo- or hyper-thyroidism; the trans-vaginal ultrasounds (yes, exactly, it’s basically a medical dildo) to look for cysts or enlarged fibroids, or anything else that could be causing our sudden bloating or abdominal discomfort; the hysterectomies; the salpingectomies; the mammograms, with differing recommendations of when to start and how often based on family history and which doctor we consult. The interminable pap smears, which, for as long as we have cervixes, we’ll continue to get. The Botox; the peels; the lasers, the new face cream to try (necessary, no, but the pressure is pervasive).

And the cancer diagnoses. Breast cancer without family history, when we felt a lump and the first doctor said: “Look, I doubt it’s anything but let’s check it out anyway.” Cervical cancer. Thyroid cancer.

The careers. There’s leaving careers; changing careers; adjusting careers; the juggling of careers and child-rearing, which, in an overwhelming amount of cases, means single-handedly making the dentist appointments, doing the summer camp registrations in January before the spots fill up, facilitating all things that revolve around food in the household; organizing the pick-up/drop-off gymnastics; not forgetting to book that long-overdo wax before we have to appear in a bathing suit for our kid’s swim lesson because they’ll only be in the pool with us, the parent du jour; and, and, and… sorry, out of breath… all the other things we have to do before the sun goes down and we start to bleed from the eyes.

And then there’s the babies. The first babies, last babies, lost babies, definitively choosing not to have babies, or we’re so deep into exhausting fertility treatments to try for the love of all things holy to have a baby while we still can.

The divorces. The relationship changes because the partnership was never fully balanced in the first place and now, suddenly, there’s space to notice. Or because: see above.

Let’s talk about this. Let’s have these conversations as much as possible. We’re half the population. We’re too important not to.

I am both the little girl in floral polyester pajamas sitting in her room with a bulky pad hastily stuck to her underwear and the woman who made two other human beings (which also means two organs, lest we forget), who bears prominent scars from medical procedures, who has prideful flub, running around town with a Vénus impudique body. When the inner bully retreats, I think: That’s right, watch my big ol’ tush sway. Behold this body that has done so much.

I am crying, sweating, hustling, laughing, tired, and no, I don’t want to have sex tonight. At least not tonight. Maybe tomorrow. Yes, let’s try tomorrow. Tonight I want the privilege and space to just rest.

Writer and editor Anna Clarke Fiddler currently lives in Oakland, California, with her husband, two young children, and a giant Bernedoodle. She’s currently at work on her first novel, a ghost story set in Dublin in the 1960s.