Menopause: It’s a journey not a destination

Featured article - 18 October 2022
By Suzanne Cottrell, SCIE Safeguarding audits manager

So, you may have gotten to a point in your life where you are finally feeling more settled in your relationships at home and your career, children are getting a little more independent and now you are finally looking forward to having a bit of ‘me time’. Maybe considering booking that spa weekend away that you and your girlfriends have been promising yourselves for the last decade, or taking up a hobby that has previously seemed unreachable with the pressures of everyday life, the bang…just at the point when you are wanting to spend some of that energy on yourself, you are all out getting up in the morning and you aren’t feeling quite right.

• World Menopause Day

So, what was it for you that made you think you could have received a visit from the delightful menopause fairy? Night sweats? tears?, hot flushes? These were the things that I heard talked about in hushed tones by my mother and her friends when I was a teen (poor Dad, pubescent daughter and menopausal wife – no wonder he took up daily fishing!). No, for me, Menopause wasn’t even on my radar, it happened to ‘old ladies’, I was a feisty, independent young woman! Well , maybe not so young any more, 48 but due to two lockdown birthdays which didn’t count, I was still convincing myself I was mid 40’s and nowhere near the big 50 or being anywhere that could be considered as ‘Old’!

No, for me it was joint pain, oh yes, alongside an increasing maniacal desire to murder my lovely laid back long term partner, for something as simple as leaving a pair of underpants half in and half out of the laundry basket. Joint pain that made it so difficult to get out of bed sometimes that I was setting my alarm earlier so I could crawl to the bathroom (that of course, is if I’d managed to get to sleep, the sound of wood pigeons at 04:00 was regularly featuring in my nocturnal pattern!) Brain fog was a personal favourite of my family, ‘get the thingamajig out of the whatsit’ for me please, whilst I vaguely pointed to the utility room and then looking back to blank faces. The Brain fog highlight that made me take some action was during a visit to the busy outdoor beach café when the family were waiting with the dogs at a table, I navigated back to them with two open trays of chips whilst having a Hitchcock moment with swooping birds that terrified me, ‘Get those blasted… get those awful… GET THOSE BEACH CHICKENS AWAY FROM ME!’

Now let me explain… In my head it was Seagulls… I’m sure I knew that they were Seagulls, but due to the delights of Brain fog, unfortunately that wasn’t what came out of my mouth…very loudly… sufficiently enough for all those seated outside and those in the considerable queue to turn round and look at me. There is nothing like making a total show of yourself to result in your family becoming instantly engrossed with their phones, presenting like they have never met you before.

So as you can imagine, when you see yourself behaving like this, its bound to knock some of the stuffing out of you, questions like, ‘how am I going to manage, I can’t give up work I’ve bills to pay!?’, ‘what if I say something ridiculous in a meeting?’, ‘how can I provide support and challenge to my team when I’m all out trying to get out of bed in the morning or to construct a sentence that makes sense to my family?!’.

It was around this time that I saw some posts from old school friends on social media who had watched a Channel 4 programme by Davina McCall - ‘Sex, Myths and Menopause’, featuring Dr Louise Newson, a GP and renowned menopause specialist who holds an Advanced Menopause Specialist certificate with Faculty of Sexual and Reproductive Healthcare and the British Menopause Society, who with Davina discussed a broad range of topics such as the role of oestrogen in our bodies, types of HRT, the huge need for more research, and the gaps in menopause care across the country. Still not convinced it was relevant to me, I watched anyway so at least I could comment on the conversations, not have FOMO! It was like a very scary but enlightening lightbulb moment, tick, tick, tick against all of the symptoms they were listing – oh gosh, I was officially old!

• Newson Health Menopause and Wellbeing Centre

But the fact is that women are not old when they are starting the menopause, or at least the perimenopause, a word I’d never even heard of prior to watching this programme. Symptoms of the perimenopause can often start at around 45 years of age, although there are many that start earlier than this, women, like myself, mask our symptoms in efforts to ‘just get on with it’. We are often too busy with life and work to pay it much attention, that whilst we feel we are very much struggling with the mental load, we carry on. Those of us that do seek help can often find that we are in a more informed position than the professionals we seek assistance from and are frequently offered anti-depressants or anxiety medications which may or may not alleviate some of the symptoms, doesn’t address the cause. In some cases we are asked to have a blood test to identify our estrogen levels, which is a highly inaccurate indication of menopause, as levels fluctuate widely during a 24 hour period, even amongst women in their 20s.

But help is out there, medical advances in terms of treatment have come on so much, there are masses of research that debunk the myth that HRT significantly increases the risk of cancers and it has now been identified that using HRT can be not only beneficial for your wellbeing but can also reduce your risk of Osteoporosis, which increases when your ovaries stop making oestrogen and your bones become thinner leading to a higher risk of osteoporosis, where your bones break more easily (useful when you are running away from Beach Chickens!).

But one of the most important things is to talk to those around you, your family, friends and colleagues. I asked my partner to peel himself away from Sky Sports and watch the programme and also to read up on some info directed at those poor things who have to live with us, he was surprisingly very receptive to it and now is no longer worried when I’m reading crime thrillers in bed at night, thinking I’m developing my skills on hiding bodies! It’s different for women today, talk to women of a similar age to you, I was amazed that in my three friendship groups, amounting to 17 different women, we had all been having similar symptoms in isolation, putting our heads down and carrying on, then falling into bed of a night, exhausted but unable to sleep! Our mum’s were often in the position that by their early 50’s, they had long paid off mortgages, and in some cases had careers that didn’t mean they were the main breadwinner in their homes, my mum whilst having a fantastic career, fell into the former category and was able to go part time before eventually retiring at 53. Unfortunately that’s not going to be an option for my friends or I, so we have to ensure we look after ourselves, both medically in terms of getting the right advice, and emotionally by discussing what we are going through with friends and family.

The Department of Health and Social Care announced in 2021 a new ambition to close the ‘gender health gap’ and that GPs should have ‘compulsory training’ in women’s health, including the menopause, when it made plans to publish a full Women’s Health Strategy, ‘that prioritises care on the basis of clinical need’. It stated it will name a health ambassador who will ‘raise the profile of women’s health, increase awareness about taboo topics and support the Government in implementing the strategy.’

ACAS advises employers that ‘Supporting and creating a positive and open environment between an employer and someone affected by the menopause can help prevent the person from:

• Losing confidence in their skills and abilities
• Feeling like they need to take time off work and hide the reasons for it
• Having increased mental health conditions such as stress, anxiety and depression
• Losing their job.

Workplaces are developing Menopause strategies recognising that for those experiencing symptoms it can be a difficult and stressful time. Everyone will experience the menopause differently and for some, symptoms can be quite severe and can affect people both physically and mentally.

In the UK, 15.52 million women aged 16+ were in employment in October to December 2021, according to the ONS UK Labour Market bulletin. This is up 153,000 from the year before. 9.68 million women were working full-time, while 5.84 million were working part-time. Women are remaining in employment longer than they have ever done before, increases in retirement age for women have supported this shift, along with women increasingly bearing the responsibility for a larger proportions of, or in some cases all household finances.

The one thing I have found that has been vital to my menopause journey is to maintain a good sense of humour, because if you can’t laugh at yourself, then its going to be more difficult. Remember, it’s a journey, not a destination, do your research, if the initial options don’t work for you, read up on and keep asking for others, remember that your needs will change as your journey continues and keep talking!