I should probably date this post as I am pretty sure my thoughts on the menopause are going to keep evolving as I get closer and closer to the end of being menopausal and become post menopausal.
But first of all, why this post today?
Well I watched, with interest, the documentary that Mariella Frostrup did on BBC1 last night. Menopause has been on my agenda for about six months now, and I have been using HRT for about three. The journey to this point has not been a straight forward one and is one that wasn’t even mentioned last night in the documentary, hence my wanting to write a post about it.
First of all, the documentary (if you have an even passing interest in this topic, or have a woman in her 40s in your life that means anything to you, please find it on iPlayer) was great as it touched on the subjects that a lot of people do know about, ie hot flushes. It then discussed at length how debilitating they can be. What it didn’t discuss though is that there are about 30 other symptoms, and that whilst hot flushes are the most well known, not every woman gets them. In fact Mariella herself said that she has only ever had two.
What Mariella did have though was a very understanding gynaecologist. One who was happy to monitor her hormone levels, send her for bone density tests and generally keep an eye on her.
This is NOT the experience of a single person I have talked to about this subject. Not one. In fact whenever I mention the menopause on social media I get a wave of comments telling they have struggled to get their GP to acknowledge they may be peri-menopausal / been refused HRT / told they are too young / ignored etc etc etc. The list goes on.
Over the past few years I have been to see my GP for all manner of ailments, and I have, to be fair, been tested for a number of illnesses. My thyroid was checked for instance (many of the symptoms of the menopause are very similar to those of an under active thyroid), as was my blood count (I was diagnosed as anaemic, and having a vitamin D deficiency) and I had an MRI for my headaches and saw a neurologist who could find nothing wrong. But on the whole I have been left to my own devices. Shoulders shrugged and I was told to just sort of get on with living with my symptoms. Or given pain killers (that didn’t work).
It was only when I picked up a book by Liz Earle that listed all the symptoms of menopause that the penny dropped. Or rather I burst into tears. There, close to the top of the list, were the words “monster headaches”. It then became clear to me that the reason why my headaches were not responding to pain medication were because they are hormonal.
And when I say “my headaches” I mean the headaches I get roughly 12 times a day. Sometimes more. Not just a mild ache, but a sudden onset “ouch I ate that ice cream too quickly and now I have brain freeze” headache. They cripple me. I have to stop what I am doing and count to ten. They do pass relatively quickly but I don’t know when they will happen and when they do, they hurt. Sometimes I want to cry.
Thankfully I am not working in an office so having to deal with those on a regular basis is not a major issue for me, unlike the poor lady last night who has had to reduce her hours at work because of her hot flushes. Yes I also have had them, but thankfully they have subsided somewhat since I started taking HRT. When they were at their worst over the summer, I was able to go and have a cold shower or spend five minutes in the large walk in fridges at Costco (I did this a lot).
But here is the thing, the headaches haven’t gone since I started HRT. And I have had no follow up on the HRT treatment. Handed a prescription for patches, and dismissed. I have no idea if the dose is right, I suspect it isn’t, and no real clue as to whether my GP will be able to help me alter them if I go back. Mariella takes one tablet at night, and uses oestrogen gel daily, it is only because of reading up on it that I know I can’t have gel because I still have periods, but no doctor has explained that to me.
Because so many GPs have no idea about the menopause. Many of them, most of them, are working on guidelines set down in the 60s and 70s and not being taught that things have changed.
The change has changed.
And that means that so many women are being short changed on how they are treated. Just look at the Menopause Doctor on Instagram. Her comments are FULL of women telling their stories about being ignored and fobbed off. Many of them told they are too young, or that a hormone test has come back as showing their oestrogen levels are within the normal range. My own GP said to me “well your blood test is inconslusive so you probably aren’t menopausal”. But I knew that NICE guidelines no longer recommend them for peri-menopausal women over 45 because hormone levels can vary from day to day.
Women everywhere these days are exhausted and beating themselves up about it. Wondering why they are so shattered, sometimes even when they have had a lazy weekend or a good nights sleep. They think it doesn’t add up. But it does. Exhaustion isn’t the same as being tired, and isn’t cured by a good night’s sleep. It can be caused by all manner of things, one of them the menopause and whilst a GP probably wouldn’t jump straight to that conclusion many women also won’t know that exhaustion is a symptom of the menopause.
What struck me about last night’s documentary is that I didn’t feel like it educated women, and the men in their life, about the symptoms, aside from hot flushes, that may be indicating the peri-menopause years are approaching. So here are the most common symptoms. I have over the past six months had a lot of them:
Memory lapses or brain fug
Loss of libido
Loss of confidence
Joint pain or general aches and pains
Cyclical breast pain
Drier or dull skin
If you have any number of those for a prolonged period of time I would seriously consider doing your homework and then going to see your GP. A really good book to start with is Liz Earle’s The Good Menopause Guide. (NB that is an affiliate link so if you do buy from there I will get a tiny commission) Packed with info on the symptoms, what HRT is, and lots of recipes it is a fab go to book to have by your side. I learned so much from it and it gave me the courage to see my GP and to stand up for myself (which is hard when you are sobbing at the same time).
The other thing that made me a bit cross about the programme last night is that Mariella made it look easy to see a gynaecologist to discuss her symptoms and her ongoing care. That has never been suggested to anybody I know. And if you want to see one privately on your medical insurance, forget it. No I mean it. Forget it. Menopause is not covered as one of the “accepted illnesses” by most insurers as it is a collection of symptoms and not what they deem to be a treatable condition.
No, I don’t get it either.
What that programme did make me think though is that there is still a long way to go with understanding and talking about this condition. We need to keep the debate going now so that the 80% of women who could be on HRT but aren’t know their options. Know that a study in 2002 linking it to breast cancer was flawed (you are more likely to get breast cancer if you are obese or drink than if you take HRT) and to know that they are not alone.
Photo courtesy of Unsplash