“Entering it early is not as rare as you might think.” Her white-coated shoulders lift and fall. “Some women start at your age and stay in this pre-menopausal state for years. For some, it goes much faster. I have patients who started in their late twenties.”

“What does this mean? W-what are you telling me?”

“How many periods have you missed?”

“Um…four. I…my periods have done that in times of stress before. Skipped. I just finished an election. I attributed it to that.”

“Any hot flushes?”

“N-not that I’ve noticed, no.”

But did I not notice? I’ve “felt hot” several times, but you feel hot sometimes. I would never have assumed feeling hotter than everyone else in the room or fanning on a day that wasn’t especially warm meant hot flashes.

“Weight gain?” Dr. Granden probes.

I release a shaky breath. “Yeah. I do seem to be putting on a few pounds. Again, I assumed stress.”

“What about insomnia? Mood swings? Vaginal dryness? Decreased sexual appetite?”

“Well, I’m a vampire, so I never sleep, but I guess? Maybe? As for mood swings, like I said, I’m coming off a campaign, so for a year and a half I basically fluctuate between Linda Blair and being a twelve-year-old rocking in the corner.” I shrug. “We’d have to ask my assistant if I’ve been more of a bitch than usual.”

Dr. Granden’s lips quirk a little, but her eyes remain serious. “And the sexual appetite?”

“I think my appetite has been consistent. I may as well sleep with my vibrator under my pillow.” I snort. “Satisfaction is another matter. Between you and me, doc, these fellas out here just ain’t doing it right.”

We chuckle, and I realize I needed that. Just something to lift this heavy weight from my chest. My whole adult life I’ve prided myself on the focus, the drive, the discipline required to reach my goals. The future was a plan I executed. Now the future, my future—at least one aspect of it—just spun out of focus.

Out of my control.

“Wait,” I say, assembling the implications of what she’s saying as the shock starts wearing off. “If I don’t have a period, does that mean I can’t have kids? Is that what you’re saying?”

“Not necessarily, but the FSH level is significantly higher in your blood than typical.”

“FSH?”

“Follicle-stimulating hormone. Your brain makes more of it as your ovaries produce fewer eggs.”

“Follicle, huh?” I laugh humorlessly. “My ovaries have hair?”

She smiles, the tight line of her mouth easing some. “Not exactly. An increase in FSH alone wouldn’t be enough, but coupled with the missed periods and other symptoms you report, and the tests we’ve done to eliminate what it isn’t, the picture begins to become more clear.”

Ovaries. Eggs. Hormones. Babies.