Why the menopause should matter

I’ve just written something for World Menopause Day 2021 (Monday 18 October) for the Staff Intranet at work, and it got me reflecting on all kinds of things (I’ll publish the article here).

I presented an update on perimenopause and menopause for staff members (all staff, not just women, and for everyone who identifies as a woman) – just a kind of round-up of all the things I’ve picked up on through Social Media channels, newspaper and TV articles, even mentions on Netflix shows, along with some resources I’ve found whilst doing my own research. And it struck me, that suddenly the world seems to be recognising this major life-changing health issue which happens to half the population.

I guess it is 2021 so why shouldn’t menopause have its own day? I don’t think there’s anything to celebrate just yet, but the fact that it might get people talking is most certainly a giant step for womankind indeed!

I wanted to outline my own journey (I know, I’m not Davina McCall, so who cares, right?) but if it just helps one woman to help herself, then that’s good enough for me.

My journey started back in 2014 and when I look back, knowing what I know now, I realise that if I’d been equipped with the knowledge I have now, things might have been very different for me on my health journey. So, any woman who is reaching the age of 40, I would ask you to take note (quite literally) and keep account of what’s happening to your body so that you can reach out for help sooner than a lot of women. This is the beauty of knowledge. It really can help to inform the future.

So, 2014, I started to have some problems with digestion. I had been having dizzy spells on and off, but I was fit and healthy, had started running, was doing yoga and I’ve always been a hiker/walker with a pretty healthy diet. That same year, I had been to see my GP about pain in my hip, followed by pain in my left knee and was also suffering with urinary infections. Fair play to them, I had all the tests imaginable for these things (let me remind you):

Digestion problems (prescribed Lanzoprazole)

Knee pain (physiotherapy)

Hip/Back pain (chiropracter)

Urinary infections (internal examination/smear test)

Anxiety attacks (two specifically that I remember – I’ve never had a panic attack in my life, and the loss of control affected me enormously). Just a note, I never presented at the GP about these.

Dizzy spells (never went to the GP about these either). Usually when I was sitting down at work at a computer, thought it might be my eyesight, had my eyes tested regularly.

Migraines/headaches (usually lasting 24/48 hours – all consuming headaches that made me feel nauseous at times).

To put it into context I was 47 years old. With hindsight, and after lots of personal research, I realise that all of these things are symptoms of the perimenopause. I never gave it a thought. Like everyone else, I thought the menopause was hot flushes, goodbye to the periods, and hello freedom from contraception! Never in a million years did I associate these minor niggles with a more complex issue affecting my body – the depletion of a trio of vital hormones, eostrogen, progesterone and testosterone.

I’d been to a well-woman check at my GP surgery when I was 40 and perimenopause/menopause wasn’t mentioned once. They were concerned about my weight, diet, drinking alcohol, blood pressure and cholesterol. But no mention of something more substantial that could, at some stage, affect my health and wellbeing in quite a substantial way.

Also, I’d like to point out that I am of the generation that just puts up with things and I never go to the doctor generally. But all of these things were really affecting how I lived my life, how I exercised, how many times I had sex (mostly always having urinary infections following a healthy bout!) and now how I was eating.

I lost over a stone and a half with digestion problems that were never diagnosed. It seemed like suddenly my body was creating too much acid, food was being digested too quickly, and I was barely able to keep anything in. The medication has regulated this to some extent.

So from 2014 I seemed to clamber on a crazy merry-go-round of physical and mental debilitation.

Yes, I’m not a stupid woman. My very regular menstrual cycle was becoming irregular but I just thought that was the impending ‘change’ starting to happen. I wasn’t particularly worried or concerned about this because I’m not a reproductive female and am child-free and never could see the point in having periods. If anything, it was just inconvenient. But suddenly I’d be camping in the middle of a field in the middle of nowhere and ‘Hello, bloodbath! Who invited you?’ The heaviest, dirtiest bloodflow I’d ever encountered – having always had polite light flow at the same time every month, here was a horror story of gigantic proportions!

I wasn’t used to it. I wasn’t prepared. But I thought – yes, this must be the start of my periods leaving me and good riddance to all that. Go on, I thought, empty yourself out and be gone.

But then things really started to escalate. But just to sum up these extra symptoms for you:

Erratic menstrual cycle (missing periods, heavy periods, lots of stomach pain, cramps)

Increasingly worse headaches

So, without knowing it, I’ve already ticked off 9 of the symptoms of perimenopause and it’s only 2015. Over the next five years, I found that I was suffering from quite substantial memory loss, couldn’t remember names, couldn’t recall what I’d been thinking about only seconds before, the headaches were getting worse before and after my period was/had been due – even if they didn’t appear – and it wasn’t the kind of headache that could be killed by a normal painkiller. They didn’t touch the sides. I remember going to work with these headaches, working all day, not saying a word to anyone, barely able to see the screen some days and then, when they cleared, I would have to check everything I had done previously to make sure I hadn’t made any mistakes. Double the effort in the workplace.

I started to have waves of hot flushes, not massive ones like some people have described to me, but enough to feel embarrassed (and can I say, slightly ashamed?) when I was in meetings. I would wake up at night drenched in sweat. As the years went on, I would take a towel to bed with me. I bought a fan for my desk at work and a hand-held one to take to meetings. I used to joke about it with work colleagues, but actually I was kind of dying inside. Literally.

I knew that this was the menopause now but, a big believer in holistic medicine, I tried all kinds of things – Black Cohosh, Evening Primose Oil, Magnesium Oil – I changed my diet. But, and I’ll say this out loud, nothing supplements missing oestrogen, progesterone and testosterone like replacement hormone therapy. Yes, the natural supplements might take the edge off, but your body is made to perform with these vital hormones. These hormones are crucial for all kinds of things for women – not just to keep your menstrual cycle and reproductive capability moving – but for your bone health, your brain health and your overall wellbeing.

To be honest, I never gave Hormone Replacement Therapy (HRT) a thought because at the back of my mind I remembered it being taken off the shelves because of its link to breast cancer. I didn’t think it was an option. Never realised that the small research project that had first made the link had long since been discredited, but the medical profession had just never caught up. Certainly there hasn’t been enough research into this ‘woman’s’ health issue – male researchers were clearly too busy trying to produce Viagara for the blokes! So many women were taken off HRT at crucial times in their lives – and now we are seeing a massive increase in dementia in women and there could well be a hormonal link. So many things that were never explored, or never researched properly. And women being women, we suffer in silence and we put up with this.

I actually think I put up with my symptoms for seven years before the final straw that broke the camel’s back and that was the insomnia.

Anyone who knows me knows that sleep is very important to me. I’m a 9 hours a night girl. Suddenly I was waking up in the middle of the night and just couldn’t get back to sleep. It wasn’t always about night sweats. I just couldn’t sleep. And I can sleep anywhere. Trust me. I was exhausted. It was the middle of the pandemic and work was full-on and I was trying to survive on two or three hours (not good quality sleep) a night. I showed up. Never once did I speak to my manager and explain that the menopause was affecting me badly, my standards of work didn’t slip (I just had to double-check everything) and I marched on like a trooper, like many other women no doubt. What a cavalry we are!

I can see how insomnia can drive someone insane.

Also, at about this time, I started to feel a lack of JOY. I can’t really explain it and I’m a writer, so I can imagine how most women feel trying to communicate this to people. I just felt so EMPTY inside. Apart from the pandemic, my life is really good and I have no complaints. But I specifically remember sitting in a really beautiful pub garden, the sun going down, with my favourite cocktail in front of me and in the company of the most wonderful, energetic person and I knew that my eyes, my heart and my soul were DEAD. No enjoyment. I felt NOTHING. I knew, at that moment, that I just wasn’t myself.

Over a third of women who go to the GP with these kinds of symptoms are prescribed anti-depressants. I didn’t go to see my GP about this.

The demise was quite quick following that episode. I suddenly started to smell weird, my body odour was reminscent of a dusty old cemetery full of dead bodies. It didn’t matter how much perfume I wore, or how much I washed, this stench was not me and I didn’t recognise myself. It was like all the bits I knew and loved were falling off me, like an old, washed up rag doll.

I even lost all sensation in the nether regions. I’ve always enjoyed physical contact, but let me tell you, the Sahara Desert had nothing on me downstairs during this time. And I didn’t dry up, I know some women experience that. But like my mind, my sex drive was MISSING IN ACTION. I was running completely on EMPTY.

It was the middle of the pandemic. You know when you make excuses for yourself? I started to do that. I’d also had Covid quite badly, maybe it was that? I was really looking after myself, I’d stopped drinking, was eating healthily, was exercising. Nothing I did would help me sleep, nothing I tried would make me feel alive, like the woman I was, the woman I had been, the woman I missed and the woman I wanted to be in the future.

So let’s recap on the symptoms during that time:

Insomnia

Vaginal dryness/lack of sex drive

Brain fog

Lack of emotion/feeling/JOY

Dry skin/lack of moisture

During my daily walks I started listening to podcasts – one in particular called On My Last Eggs by Rachel New – about the menopause.

You know when you hear all the pennies dropping at once? Well, they were raining from heaven!

I was walking and shouting out ‘That’s me!’ ‘That’s me!’ ‘That’s me!’

And do you know what I felt? An overwhelming sense of relief. To hear other women talking openly about their experiences of a variety of different menopausal related issues, hearing that I wasn’t the only one, that I wasn’t the odd one out, that actually, this was an actual health issue that just wasn’t talked about and hadn’t been given any real focus by the medical profession.

Just some of the things I learned that shocked and outraged me. GPs don’t get any mandatory menopause training (they can do a short course if they choose to); HRT isn’t offered to women and medical professionals are still citing the outdated research from years ago with the links to breast cancer; marriages were breaking up and women were leaving the workplace in their droves because of their symptoms; there was no recognition of the menopause in the workplace and no legislation in place to cover women suffering as a result of it; testosterone can’t legally be prescribed to women even though it’s a hormone we produce that depletes as we get older … actually I could go on and on.

I was outraged, but I was also exhausted. And there’s another thing that no-one talks about. As a society we are obsessed with youth and obsessed with staying young. I have no issue with women who want to tinker with their faces and look like a 20-something (even 20-somethings want to tinker with their faces and look like 20-somethings) – but as a more mature woman, it gets harder and harder to maintain your credibility in the workplace. Especially in PR and Comms when you’re surrounded by young things with all the ‘new’ ideas (not actually new ideas but you know how the roundabout goes round and the swings go up and down). Never mind that you’ve probably experienced everything there is to experience in your field, and you are wise, and have a lot of years behind you and in front of you, and lots of things to offer. In the workplace it’s about the new and the fresh.

No wonder mature women are reluctant to talk about menopause. It’s like signing your own death certificate. It’s like putting the Out of Date stamp on your forehead. It’s like saying, I’m sorry I just expired, and now I’m waiting in line for the Grim Reaper to pick me up. It’s like saying – I’m dried up now, so I should just bow out. At least, that’s what people think because they haven’t a clue about the reality of menopause and what it can do to a person. And I’m including most women in that.

So, I took control. I did a lot of research. Read a lot of books, listened to a lot of podcasts, assessed the situation, balanced it up in my head. And I made an appointment with the GP.

She sounded about my age (it was a telephone discussion) but she didn’t sound particularly sympathetic. I described my symptoms, my research and I asked to be considered for HRT. I think she knew it was pointless arguing (I’m lucky, I can articulate what I need and what I think, what about all those women who can’t?). She prescribed me three months of Novofem – a combination HRT oestrogen and progesterone.

I started to take it immediately.

It. Has. Transformed. My. Life.

I know it’s not for everyone, and I know everyone is different, and there are lots of things to take into consideration. But almost immediately, my sleep pattern was transformed, I began to smell more like my old self, my skin and hair felt much better, my sex drive returned in abundance, the headaches abated (I still get a cloudy head before a very light period every month) and I said a big hello to JOY in my life again. I honestly feel reborn. I feel like a new woman and the old woman I was all at the same time.

I hadn’t realised, because my perimenopause was such a long journey spanning 7 years, that my body and my mind had changed quite radically. I do hear about women waiting to get through perimenopause to the other side of menopause (a year after your last period apparently – no idea who made that one up to be fair) where they can celebrate being period-free but I worry about how missing those essential hormones is going to manifest in them as they get older. We need those hormones for our ongoing wellbeing. And yes the risk of cancer is there (but it’s there every time you have a glass of wine or a bacon sandwich) and I do think that there will be more treatments available in the future, there are already creams and gels, rather than pills.

I had my second consultation with the GP recently and it was like to talking to a new woman on the other end of the phone. She was clued up, had done her research and I’m being referred to our local Menopause Clinic (which has a massive waiting list) to trial the use of testosterone – the GP was interested in learning how to prescribe it herself! That’s a massive step forward for our practice. To be honest, I’ve bombarded them with all kinds of stuff from The Menopause Doctor, including links to free training for GPs, and I’ve complained about there being nothing on their website about the menopause or included in the well women checks at 40 or 50 for all their female patients.

And that’s what we need, you see. On World Menopause Day, we need women to find their voices. We need them to describe their own experiences so that we can form a much bigger picture, so that the canvas grows and grows and we can find solutions to an ever-growing problem. We are an ageing population and women are fabulous – not just young women, but ALL women, regardless of their age or whether they still bleed or not. We all bleed. But in different ways. We should want women to be fabulous for as long as they are alive and not just for as long as they can reproduce. Let’s be more forward thinking than that.

But for that to happen, we have to fight. Women have always had to fight for what they need or what they are entitled to, and this is looking like the fight of the century. We’re lucky we have some amazing ambassadors making all the right noises in all the right places, Dr Louise Newson, Dr Nighat Arif, Dr Annice Mukherjee, Kate Duffy, Behind the Woman.

But I would ask one thing, if you’ve read this and thought, like I did, ‘That’s Me!’ then ask for help, talk to your colleagues, your manager, your peers, your family. Make your voice heard.

It’s time to start making a fuss about a whole range of issues – and as the population gets older, and more and more women grow older (hopefully more wiser and more gracefully) we will have a very important part to play in society and we have years’ worth of valuable experience to offer in the workplace.

Don’t ever think that it’s your ambition to suffer in silence, to lose that most vital and crucial part of yourself and, most importantly, don’t feel that you’re alone.

If you look on Social Media today (World Menopause Day) you’ll see that you are one of a billion voices starting to be heard.

Let’s #makemenopausematter – sign this petition today!

Some useful resources

These are a few of the resources that I used when I was doing my research, when all of the weird symptoms I was experiencing suddenly started to make sense.

Menopause Doctor (Dr Louise Newson)

Instagram@menopause_doctor

Instagram@themenocharity

https://www.menopausedoctor.co.uk/

https://www.facebook.com/MyMenopauseDoctor/

Free app: Balance

On My Last Eggs

https://podcasts.apple.com/gb/podcast/on-my-last-eggs/id1547978378 (also available on Spotify and other audio outlets)

http://www.podfollow.com/eggs

https://www.facebook.com/groups/824685768327361/

Instagram@onmylasteggs

Behind the Woman