No Two Women are the Same and Neither is Their Menopause
One of the biggest revelations for me, when I started to learn more about the menopause, was just how diverse the range of symptoms are and how every woman experiences them in her own, truly unique, way.
The actual number of different symptoms seems to vary depending upon which book or report you read, but I think it’s pretty safe to say that there are at least 35 well documented symptoms and there could well be many more.
This can cause problems when it comes to pinpointing the cause of the symptoms. Especially the psychological ones such as increased anxiety, poor concentration, low mood and depression. Often women are misdiagnosed and wrongly prescribed Selective Serotonin Reuptake Inhibitors (SSRIs) such as Prozac.
According to The British Menopause Society report by J Studd dated Jul 17, reproductive depression (depression with a hormonal cause rather than a psychiatric one) responds better to hormone treatment than to antidepressants, and yet many women are still being prescribed SSRIs.
In many cases women presenting in their early to mid-40s with well documented symptoms are dismissed by their GP as being too young to be menopausal. The average age for a woman to reach menopause (the date 12 months after her last menstrual period) in the UK is 51 but perimenopause can start up to 10 years beforehand. Therefore it’s clear that the women presenting could, very well, have symptoms related to perimenopause.
I’ve brought together 4 different women who have kindly shared their own stories of perimenopause and menopause in an attempt to illustrate that women truly do have a unique experience.
I was diagnosed as being in menopause at the relatively early age of forty-two. I had only stopped taking the pill less than two years earlier, and had been experiencing irregular and sometimes very painful periods. My sister suggested endometriosis (correct) and my mother suggested menopause (she was diagnosed at 43). Also correct. I burst into tears, much to the discomfiture of my rather awkward doctor. I don’t think he had any idea why. I didn’t want any more children, but I think the idea that a certain part of my life was over, was quite overwhelming.
He suggested HRT and, after some thought, I agreed. I had no contra-indications and nothing in my family medical history which would raise any red flags. I had been taking the contraceptive pill on and off (I had two children) since I was nineteen with no problems except regular, lighter, less painful periods. But I have low bone density (probably genetic) and the likely impact of an early menopause on my bones was a concern. So I took HRT for years until I was well into my fifties. I did consider taking it permanently, but I couldn’t justify the cost. The endometriosis stopped, as did the occasional ‘warm’ feeling; these were my only menopause symptoms. By the way, I still get the ‘warm’ feelings and I’m now 68!
I know how lucky I am to have had such a straightforward menopause, and I know that it’s not like this for everyone. But it does happen, and I hope it happens for you.’
At the age of 46, I suddenly started getting migraines and horrific mood swings every month. I had suffered from migraines periodically over the years and they were always stress induced but this felt like something new. I had not suffered with mood swings since being a teenager but this wasn’t the kind of “turning back the clock” experience I wanted!
It took a couple of months to realise they were happening every month at about the same time and they were getting steadily more debilitating.
I changed back to my usual contraceptive pill (having been prescribed a different one by a new doctor as mine was out of stock) and this seemed to reduce the regularity and ferocity for a while but it didn’t last. In the meantime I had started taking evening primrose oil to combat the mood swings – wonderful stuff for me and I still take it daily for everybody’s’ sanity!
About eight months ago, I started to notice a couple of other symptoms; the occasional hot flush and brain fog – oh the struggle to actually form the words I had in my head!
So, recently I decided to book an appointment with a GP to discuss options.
I didn’t want to come off the pill (until I have to) but the migraines have got to the stage where I lose 3 to 4 days a month unable to do anything at all and I am getting pretty hacked off with my lack of word recall. I have to admit that I did ask for a female GP and she was very pragmatic. She listened to my issues (although in true brain fog fashion I forgot to mention the brain fog, leaving the list I had prepared in my handbag…!) and discussed various options. We agreed that HRT probably wasn’t necessary at this stage as my combined pill is probably masking some of the symptoms.
I am now in receipt of a prescription of progestogen only pill (POP) which I start taking on Friday with the directive that “ we are just waiting for trouble to start after that”! On the plus side, she did seem to think that it may help regulate the hormonal changes each month, hopefully having a positive impact on my migraine habit.
My take aways so far, having spoken to many women who are at this stage of life, my mum and read lots of helpful literature are:
Eat well, move lots, sleep lots, do more of what makes you happy, be aware of your body and don’t be afraid to ask for help.
I have no idea what path my journey will take going forward, only time will tell – watch this space!
I’m sure I was peri-menopausal a lot earlier than I realised, and I so wish there was better information available out there, it is improving but there is still too much that is confusing and misleading.
Since about age 45 I began suffering from increasing anxiety, recurring depression, stress, brain fog and overwhelm, lower libido and low mood. I think the brain fog and overwhelm was the worst as I just couldn’t multi task anymore and being able to run my day to day home admin as well as help out with my husband’s business was a constant challenge.
I eventually realised when I was turning 50 that this wasn’t just another period of depression and stress, it was actually menopause and I needed to try and find help. I wasted a lot of money avoiding goIng on HRT – having read all the negative press – and not wanting to be judged by others for deciding to take HRT.
I tried exercise and nutrition, I tried a private GP and bio-identical hormones from a compounding pharmacy. Eventually I sought proper help from my specialist menopause GP but it was a slow journey. I was very sensitive to the progesterone, but she was unable to prescribe outside of the NICE guidelines. So, after doing my own research I went To see a private specialist in London and finally got the right combination of HRT in the right doses for me. I am on body identical HRT and apart from testosterone this can be prescribed on the NHS now thus reducing the cost of private prescriptions.
I would say to any other 45+ women – don’t hesitate – trust your instinct and get help earlier. Read books and do your research but HRT is not the horror we have been led to believe and it can be life-changing. It was for me!
Michelle Green – Blogger Fifty & Fab
I am 48 years young and I have been experiencing what my GP calls perimenopause for 8 years now. I experience all of the fabulously frustrating symptoms of menopause with the added gift of the unpredictable and uncontrollable period.
My journey began with night sweats and insomnia and has travelled the full spectrum from unwanted facial hair to vaginal dryness. I have days with the help of meditation and yoga that I feel like my normal self but others where I feel like I am riding a train of emotions that could jump the tracks at any moment.
I have had some amazing GPs and specialists along this magical messy journey as well as one that made me feel responsible for my own personal suffering.
I am a plus size woman and I have had a doctor blame me and my inability to lose weight as the reason for my epic periods. Periods so bad that they lasted almost 4 months and landed me in the hospital twice.
Thanks to an amazing set of doctors and a few medical procedures we have addressed the problem and fingers crossed will keep things in check until I cross the magical finish line and am officially in menopause.
I have some time yet until that happens officially but, what I can say, is the two things that have made this journey manageable is support and determination. Reach out to your family, friends, Facebook communities… find a tribe that can give you tips, tools and listen to you during your dark and twisty moments. Dig deep within and grab every ounce of determination you have to advocate for yourself with GP’s until you feel heard and get the answers you need. Try everything… alternative treatments like supplements, massage, Reiki, Gong baths they help in ways that can’t be measured.
Lastly practice self-care like your life depends on it you know what you need, you just need to get quiet enough to hear your inner voice.
WHAT IS YOUR PERSONAL MENOPAUSE PHILOSOPHY?
Just as there is no one size fits all menopause, there are no one size fits all treatments. We all have our own personal philosophy on how we would prefer to manage our symptoms. Some choose to go down the hormone replacement route, some opt for natural, herbal remedies or alternative therapies. Often lifestyle changes can help to reduce the severity of symptoms. Some women find talking therapies such a Cognitive Behavioural Therapy effective.
Whatever philosophy you have for dealing with your menopause symptoms my advice is to do your research. Get help from reputable sources such as The British Menopause Society. Seek out specialist menopause clinics (you can ask for a referral from your GP if you don’t feel you’re getting the support you want).
There is very strong evidence to show that the demonization of HRT over the last 15 or so years was based on highly flawed interpretation of data gathered for the Women’s Health Initiative study, and yet many medical practitioners are still advising and prescribing based on outdated information. If you’re choosing to avoid HRT based on fear of the risks, you may want to think again. I would highly recommend a book called Oestrogen Matters by Dr Avrum Bluming and Carol Tavris which offers a very strong argument in favour of supplementing with oestrogen.
The NICE Guidelines for the Diagnosis and Management of the Menopause were published by the National Institute for Health and Care Excellence on 12th Nov 2015 and have since been updated. These are the guidelines that GPs should be following, however some are either choosing not to or are unaware of their existence.
Taking time to understand how you would like to manage your menopause begins with becoming aware of how your symptoms are affecting you, which are the most severe and what impact they are having on quality of life. Next is deciding how you want to proceed, based on fact rather than fear and this means gathering up to date information from reputable sources.
If you’d like a copy of my Menopause Action Planning Sheet to help you clarify your personal menopause philosophy fill in the form below and I’ll send it through as a printable PDF. You can use the planning sheet to help prepare to speak to your GP or medical practitioner to help ensure you get the outcome that is right for you.
Finally, I’d love you to share your personal menopause story in the comments below.