The Menopause Chronicles, Part 2
october is menopause awareness month, so in each week we will be publishing content to help navigate and normalise menopause
I’ve been on HRT for almost a year now, ever since I walked into my doctor’s surgery and told her I thought I was losing my mind. It transpired that, of course, I wasn’t in the throes of early-onset dementia, as a rudimentary Google search had suggested. No, I was in fact in the throes of the far more predictable perimenopause.
Except that’s the thing - I hadn’t predicted it. I don’t know about you, but I didn’t know anything about it. I was 45 at the time, and I thought menopause was something coming for future me - perhaps in 10 years time. Peri peri is sauce at Nandos. Perimenopause? Nope, don’t know her.
The prefix ‘peri’ means ‘around, near, surrounding or enclosing’. It comes from the Greek word peri for about, near or around. So, ‘around menopause’ or better yet ‘near menopause’. Makes sense now, doesn’t it! If we’d only been taught that, we would know to watch out for it.
But here we are. And there I was in the doctor’s surgery talking about how I kept forgetting things and couldn’t think of words. The major indicator that made me make the appointment was when I told my daughter to put on her ‘radiator’ one morning on the way to school. She looked at me with her open, honest eyes and said, ‘what mum?’. ‘Coat! I mean coat!’ I said to her as I rushed us all into the car and drove to school, slightly worrying about myself.
I found too, that I couldn’t remember details of recent times, like what I did the week before, or what we ever had for dinner, had watched on TV and such. It was when I realised I was forgetting entire conversations with people, that I called the doctor’s office. The conversations would come back to me after a while of mining my mind, but I struggled so much to recall detail and it was making me stressed out.
I am lucky to have a wonderful doctor, Rachel Mackey of the Women’s Health Clinic in Dun Laoghaire, who is a menopause specialist, so I found myself sitting nervously opposite her telling her all this and she began asking other questions. How was my sleep? Rubbish - I’m too hot. How is my energy? Rubbish - too tired. How is my state of mind? Rubbish - feel flat and low, but there’s a global pandemic, I’m tired, I’m worried about my kids, I’m homeschooling, my mum has cancer, we had to move house as our landlord was selling up...
I told her I couldn’t differentiate how I was feeling from the fact the world felt like it was burning down (it was - it was October 2020). I told her I felt anxious and sad but that I was sure it was just lockdown woes. And surely I now had to add dementia to my list of worries now. I felt immediately emotional and fought back tears. She saw them though.
And then she said, Ellie, how about trying some HRT?
I consider that the threshold in my life that I am so very glad I walked over.
She explained to me all about perimenopause - that it is the stage before menopause that can affect women in their early 40’s. In some cases even earlier. It is the time when oestrogen levels begin to falter and fall, leaving behind any number of the 34 known symptoms, with the most recognisable being low mood, fatigue, forgetfulness, flushes, weight gain, low libido, loss of confidence and period changes.
When I spoke to my friends who are over 40 and under 50 after I spent time learning about it, many of them cited at least three of these symptoms. Many of them also claimed complete ignorance about it. We all cried ‘why aren’t we taught this at school?!’ Why indeed.
After I was given the prescription for oestrogen gel, I delayed a month before actually going to the pharmacy to get it - I can’t really explain why - I think it was because I didn’t feel emotionally or intellectually ready to be on HRT, or ‘be on HRT’ as was my immature understanding of it at that time. I don’t know - something felt final about it and I wasn’t ready. So I continued to feel like absolute shit for another month unnecessarily.
But after a few weeks of a lot of reading up on it and studying the wonderful resources so generously given by Dr Louise Newson, Dr Naomi Potter, The Harley Street At Home Menopause Group on Facebook, Diane Danzebrink, Liz Earle and Ireland’s own Wellness Warrior, Catherine O’Keeffe, Dr Deirdre Lundy and Dr Mary Ryan, I felt ready. And so I began. And haven’t looked back.
THE HORMONES FOR ME
The purpose of hormone replacement therapy is to rebalance and readjust our hormone levels as we transition through menopause, thus avoiding a crash that incapacitates us and makes us question our sanity, and suffer physically and emotionally. Oestrogen is the hormone that maintains the bloom of youth. As we decrease the production of it in our ovaries, the absence of physical bloom can cause dry skin, vaginal atrophy and our hair to thin. And the rest.
HRT had some bad press a few years ago when it was thought that it might increase the risk of breast cancer. The trial that flagged such concerns was called The Women’s Health Initiative and took place in 2002. But it studied women who are older - in their 60s - and featured a type of HRT that is not prescribed anymore. The authors of the trial since admitted their work has been largely misinterpreted.
HRT is a carefully considered mix of hormones that work together in synergy. For me, I began with intra-uterine progesterone via the Mirena coil and I started oestrogen by using Oestrogel - a gel rubbed on my arms twice daily. It took a few weeks before I noticed a difference, but a difference certainly arrived. I felt clearer, more light. I had energy back too. You often read about women feeling as though they have their life back. I felt that.
As the past year has gone on, I have kept in touch with my doctor and had blood tests and ongoing conversations in order to be sure to stay on track. She has since added testosterone to my regime as I felt my energy levels were sliding and my libido and general mojo had gone AWOL. More recently I have moved from Oestogel to Lenzetto oestrogen spray as I felt the gel wasn’t absorbing as well as it once did. Since doing that I feel back on track one more.
The thing is though, this is the plan prescribed for me by the careful consideration of my doctor, after my researching and deciding it was the course of action to take for me and how I am feeling. HRT is not for everyone, for many reasons. Maybe you want to have a natural menopause and to support yourself naturally and holistically, maybe hormone therapy doesn’t suit you physiologically, maybe it’s just not what you want right now, but may do in the future.
All of which is each woman’s choice to make. All of which is a part of a woman’s individual health and wellbeing story. But what is really important is that you know what’s happening to you, that you know what to expect and how to advocate for yourself in either a doctor’s surgery, in the workplace and in your personal relationships (because the changes there can be massive).
You’ll have been living under a rock, or on a deserted island with no wifi (sounds quite nice), up to now if you’re unaware that, in 2021, menopause is having a moment. And that the moment has grown woman by woman, to become a movement. There are so many great resources out there to help you understand and find your way. There is so much support, don’t ever feel alone.
A year ago, when my symptoms were squashing me I felt like that would be how my life would stay and it wasn’t. My advice is to read as much as you can, go to your doctor, join communities, learn from and gather around other women. Talk to each other. Talk, talk, talk.
Hold each other up.
Start with the doctor.
And don’t be afraid.
by Ellie Balfe, October 2021
p.s.
Here on Heyday, via our regular menopause content, we aim to support, educate and enlighten each other as we approach menopause. Featuring medical experts, physical health and mental wellbeing practitioners as well as various writers chronicling their journeys, we’re going to open this conversation right up. If you have a menopause story to share, opinion or expertise to offer, feel free to get in touch.
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