The narrator attends her yearly gynecological appointment with Dr. Mendoza, a naturopath and ob-gyn. In the waiting room, she reflects on the absurdity of three generations of women—a young pregnant woman, herself, and a woman in her seventies—sharing the same space, each unable to truly comprehend the other's experience. She briefly recalls the seventeen days after Sam's birth when two babies existed: the living one fighting in the NICU and the stillborn soul she continued to speak to in darkness. She tells Dr. Mendoza she suspects a cervical polyp causing irregular bleeding, but the doctor finds nothing. Instead, Dr. Mendoza diagnoses her with perimenopause based on her symptoms—insomnia, emotional volatility, irregular bleeding—and prescribes Estradiol cream and progesterone, explaining hormone replacement therapy.

Sitting in her car afterward, the narrator is stunned. She had used menopause as a cover story with Harris, and now it turns out to be real. She looks up menopause symptoms on WebMD and is alarmed to find "reduced libido" on the list. She calls Jordi and they examine a hormone graph together, noting how sharply estrogen drops compared to testosterone's gentle decline. The narrator feels a terrible bravery descend—the same submission she felt during Sam's traumatic birth—recognizing this as another ride she cannot get off. She reflects that Grandma Esther and Aunt Ruth were already falling off this hormonal cliff when they took their lives.

At home, the narrator tells Harris about the diagnosis over dinner, omitting the libido concerns. When she becomes emotional, Harris asks if he can help, and she whispers that there is nothing he can do. She then calls her mother to ask about her menopausal experience. Her mother reveals that a doctor removed her ovaries without her consent during a routine cyst surgery around the narrator's current age, plunging her into sudden menopause. Her mother claims it wasn't a big deal, and the narrator realizes she cannot get useful information from her.

The narrator turns to her friend Mary, who is postmenopausal. Mary confirms the narrator's fears, describing herself as now feeling "numb" and "dead down there," having lost her formerly body-rooted arousal entirely. Mary explains that without hormonal drive, sex becomes purely mental and requires constructing a narrative to avoid feeling violated. She suggests women should get a "rumspringa"—a year of freedom during perimenopause before the window closes—and mentions a mysterious "fork in the road" that postmenopausal women face, though she is called away before elaborating. The narrator immediately removes the rubber band from her wrist, realizing she should not be suppressing her desire but embracing its final surge.