I had to make a podcast to finally hear the truth about menopause
“I’ve got another urine infection”, I said, plonking myself down in the GP’s chair, rolling my eyes as if this had been brought on by some silly mistake I’d made. “It seems to happen after every time I have sex, and actually, it hurts a bit to have sex these days, too.”
My general practitioner (GP) looked sympathetic: head tilted slightly, eyebrows knitted together in concern. “A lot of women your age find this, often it’s new relationships, and they are having more sex than maybe they had been recently. Make sure you use plenty of lube, and don’t forget to go to the toilet straight after sex. Here’s some antibiotics, have a nice day.”
I was 51, the average age for a woman in the United Kingdom to experience menopause, but I didn’t know this then. Menopause wasn’t even on my radar because a) I was still having regular, heavy periods and b) I’d never had a hot flash, and all I knew about menopause was the cessation of menstruation and the occurrence of hot flashes.
Although my GP referenced my age, she (a woman of around 60) didn’t mention menopause in the consultation, and I had never heard the term perimenopause at this point.
When did all this happen? In the 1970s or 80s, perhaps? No. Four years ago, in 2017.
We’ll get back to my menopause story, or journey, or battle, however you want to label it, shortly, but let’s just stay with those numbers a moment. How is it that, in the 21st century, something that will affect more than half of the population, if they live to see it, is so under-discussed? That lack of conversation is across the board, between mothers and children, husbands and wives, even between close female friends.
No one talks about menopause, or they didn’t seem to in 2017. But more worryingly, medical professionals aren’t talking about it either, to each other or to us.
When I turned 50, I was invited for a breast scan as a matter of course, I get biannual invites to have a cervical smear, both of which I am extremely grateful for, but where was my leaflet at, say, 45 that outlined some of the symptoms of perimenopause and invited me to make an appointment with my GP if I thought I might be suffering some of them?
If you’re reading this and thinking, “Huh? What are the symptoms of menopause?” you are not alone. Let me fill you in on my favorite little-known symptoms that can freak women out because they have no idea that these are menopause-related:
Vaginal dryness: Your natural lubrication is maintained by estrogen, so as that dries up, so does your vagina. This can cause pain and discomfort, particularly during sex, and it also affects the urethra, hence my endless urinary tract infections (UTIs).
Itchy skin: This is the third symptom that took me to the doctor, after my UTIs and sore vagina. Low estrogen levels can also lead to low collagen levels, which leads to thin, dry, itchy skin. I now have to take an antihistamine daily so I can get any peace from this or any sleep. And talking of sleep …
Insomnia: Because of all the changes going on in your body, as well as the other menopausal symptoms, you may also experience disrupted sleep, a symptom that I had put down to just becoming “more of a worrier.”
Panic disorder: Menopausal women are more susceptible to panic attacks than almost anyone else. Can you believe that? I’m lucky that I haven’t actually had a panic attack, but in my 50s, for the first time in my life, I became anxious.
I felt a heavy weight on my chest that wouldn’t go away, an impending sense of doom that I’d never known before, and I became terrified of driving. The year before, I’d driven around Europe alone for 9 weeks, totally unfazed, but now I could hardly go to the shops.
Tingling extremities: It’s not overly common, but a tingling sensation can appear in any part of the body. This is usually in the feet, hands, arms, and legs. I had this, and I thought I was deficient in B12, I wasn’t. I was tested for and diagnosed with carpal tunnel syndrome, which is, surprise, surprise, very common in middle-aged women.
Memory lapses: I’ve lost count of the number of women I’ve heard say, “I thought I had early onset dementia.” You can forget what you’re talking about right in the middle of a conversation, you lose all your nouns, and you have to write everything down — at a point in your life when you are usually on top of your game. It’s terrifying.
Dizzy spells: Vertigo and feeling dizzy during menopause are thought to be caused by the drop in estrogen. I get dizzy when I lie down in bed at night, which makes me laugh because it seems ridiculous. But a close friend of mine developed crippling vertigo that first showed itself on a chairlift up a mountain at a ski resort. Not a fun day at all.
Allergies: While you may never have had a problem with certain things before, you may notice allergies or intolerances during or after menopause. For a lot of women, this means goodbye to wine and caffeine.
Irregular periods: After my trip to the GP with my problematic vagina/urethra, I went on to develop erratic, heavy bleeding. My doctor — who still didn’t mention perimenopause or menopause but did say she was worried “because of my age” — sent me to a gynecologist.
I had internal and external ultrasound scans and a colposcopy to look at my cervix and was diagnosed with endometritis. (No, I’d never heard of it either, it’s an infection of the womb.)
I was offered nothing for the infection, but it was suggested that I have a Mirena coil fitted to help with the heavy bleeding, and, for the first time, when I was aged 53 and a half, the word perimenopause was mentioned, hurrah!
This was 2.5 years after I first went to the doctor’s with “women’s problems,” and 2.5 years after the average age for a woman to hit menopause.
That was 1.5 years ago, and thanks to the coil, I now have no periods, which is amazing, but it does mean that I won’t know when I actually hit menopause. The definition of having entered menopause is not having had a period for 12 months, it’s as scientific as that!
Some of my other symptoms have also eased — possibly due to the progesterone I’m getting from the coil, possibly not. And in this space, this calm place of not bleeding into restaurant seats, being able to drive without freaking out, getting a bit more sleep, having a happy vagina, remembering my own kid’s names, and not itching ALL OVER, ALL THE TIME, I started reflecting about this whole business.
Then I got a bit annoyed, which turned into being really quite angry about the lack of information and conversation. Why didn’t my GP mention menopause, when she had so many opportunities, and I had so many symptoms?!
It was this anger and frustration about the silence around menopause that drove me to make On My Last Eggs, a podcast about perimenopause, to open up the conversation and to help women feel that they are not alone, not going mad, and not dying (I defy you to have your heart go into arrhythmia and not think you’re dying).
But actually, I’m even angrier now, having interviewed so many women and learned so much. I now know about the millions of dollars lost in business because of women in the workplace affected by menopause, about the relationships that end because a woman’s personality changes or she can’t have sex anymore, due to the pain.
I’ve heard about the added pressure when you have a menopausal mother bringing up teenagers (light the blue touchpaper and stand well back!), never mind the health implications of the cessation of estrogen: osteoporosis and an increased risk of heart disease.
On top of all of that, thanks to one study done in the 1990s, there’s a deep-seated fear of hormone replacement therapy among both doctors and women, leading to it often not even being considered as a treatment.
Two guests on the podcast, out of only 15, were suicidal. Both came extremely close to taking their own lives due to their symptoms.
So I ask two things of you. If you’re a woman in your 40s, read up on this juggernaut that’s coming your way, so that when it does, you’ll know how to ask for the help you need. Also, I ask that you have one conversation about menopause with someone in the next month.
Maybe ask your boss if they have a menopause policy in place (and please take a photo for me of the look on their face). You could ask your mum at what age she went through menopause, and what her symptoms were. Or chat to a friend or partner about it.
And if you want to hear some honest, informative, and funny conversations about menopause and perimenopause to get you started, please listen to On My Last Eggs.