I’m sure there are many things we don’t want to talk about. But the ‘thing’ I’m referring to is menopause. It’s not exactly a sexy subject. More often than not, it’s referred to as a kind of joke (Google ‘Menopause jokes’), oh the horror of a menopausal woman. And those of us who are going through it often try to pretend it’s not really happening, an embarrassed flap of hands when a hot flash occurs, Let’s move on. I don’t want to be a bother, I don’t want to be considered ‘past it’. Old. Et cetera.
Essentially there is a culture of silence regarding menopause: a report by the British Menopause Society found that half the women going through menopause haven’t visited a doctor, as many are ‘too embarrassed’. And yet the symptoms can, literally be catastrophic. I know, because they were for me. I’m writing this blog in the hopes it’s a small step to help break this silence.
I actually started menopause about 6 years ago. I experienced mild hot flashes (or ‘flushes’) – quite pleasant for someone who is usually cold, and I put on weight, which was a blessing as I’m underweight. The most debilitating symptom was breast pain, so extreme I had difficulty sleeping. I tried bio-identical progesterone bought from the USA, but it didn’t make any difference, and then symptoms slowly improved and I’d only have the occasional, mild hot flash.
About a year and a half ago, the hot flashes began to increase in number and intensity. At the time I was working with a herbalist to treat my 22 year-long chronic immune system dysfunction (possibly as a result of contracting South African Tick Bite fever). We were not sure in fact if the hot flashes were viral in nature or hormonal, as they were not responding to herbs that commonly help. I was also working with my GP and he was taking a slew of tests. I saw an infectious diseases specialist, an ENT specialist. No tests showed anything wrong. I asked about hormones, and he told me blood tests would just show I am post-menopausal.
By March of 2016, my symptoms had rendered me almost completely housebound. I’d have 8 – 14 hot flashes a day, a few at night. They did not last more than a few minutes, but for those minutes I was incapable of doing anything at all. Generally I’d have to lie down. Hot flashes were not just ‘sweats’, they were like having sudden onset jet lag, being dunked in far too hot bath and having a panic attack (racing heart rate, dizzy, pressure in my abdomen) — all at once. Sometimes I couldn’t even talk, or open my eyes. In between hot flashes I was OK. I’d begin to do a little work on my computer, and then, wham, another one would hit and I’d have to lie down on my office floor. Or I’d think , it would be nice to go out for a walk, and ten minutes into the walk, I’d have to hunker down on the sidewalk until the flash was over. I felt ambushed by my body, unable to function for any length of time.
I stopped going out. I stopped exercising. I got very depressed. I didn’t know what was going on. I tried other herbs. I tried cold packs. I tried to ‘think’ myself cool. I did deep breathing exercises. The hot flashes were worse after eating and so I thought perhaps I had histamine intolerance, and I radically changed my diet. I did experience an initial improvement, I think simply because I was eating better. And then the flashes just got worse, and worse.
I thought about trying bio-identical hormones again. I found a private doctor who would prescribe these. I mentioned it to my GP and he agreed it might be worth a shot. Neither of us mentioned “HRT”. I didn’t know much about this other than the muffled but clanging alarm bells. Didn’t it increase the risk of cancer? Although I had not researched the facts, it seemed clear HRT was NOT something to even consider. And clearly my GP thought the same thing.
So, in February this year, I booked an (expensive) appointment with the private doctor. Blood tests showed I had rock bottom levels of oestrogen, progesterone, testosterone and DHEA. I had expected the doctor to prescribe perhaps one or two transdermal creams, instead I she sent me away with 2 transdermal gels (testosterone and oestrogen), a vaginal suppository of estradiol and a micronized progesterone pill to take at night. I felt a little overwhelmed.
I felt even more overwhelmed when, after doing the research I should have done before making the appointment, I discovered bio-identical (or ‘body-identical’’ hormone therapy (BHRT) is actually not that different to taking HRT. There are still risks associated. I worried: was I doing a terrible thing to myself? I worried even more when after two weeks things just seemed to be getting worse. And then at the three-week mark, there was a sudden change. Instead of 14 hot flashes, I had 3 or 4. At the four-week mark, I had none.
Was I celebrating? Yes I was. And, what if I’d received treatment last March?
In the process of getting my blood tests I discovered there was a nurse at my GP practice who specialised in menopausal issues. The female NHS doctor who ordered the blood tests the private doctor needed – my regular GP was not available – who told me this, also told me in the past HRT was overprescribed, but now, due to the cancer scares, it’s under-prescribed. She told me there are now different kinds of HRT available on the NHS, better tolerated kinds. She told me that in fact in addition to alleviating symptoms, there are health benefits to HRT: it can increase bone density and some say it can protect one from Alzheimer’s.
I had already booked – and paid for – my appointment with the private doctor so I didn’t pursue getting treated at my GP practice.
Actually, once my catastrophic symptoms stopped, the first thing I felt was rage. Rage that I had not been given adequate information or care by my GP. I changed practices, and now have a female GP on the NHS who is prescribing BHRT (all available on the NHS…) and who is monitoring my progress and symptoms, so I don’t need to fork out buckets of money to a private doctor. I have also learned that starting BHRT or HRT earlier rather than later is safer, and increases the benefits to bone-density. It might have been better if I had started a year ago. Or even 6 years ago.
Perhaps if I had been more vocal about what was going on (I thought I had been), perhaps if I didn’t ‘present’ with a complex case, perhaps then my now ex-GP would have said, Have you thought of HRT? and talked me through the options. I don’t know. What I do know is that what I went through was entirely preventable, and that after a year of near total inactivity, I’m still very debilitated.
If you are a woman ‘of a certain age’ please don’t suffer in silence. If you are a man (or woman) who loves a woman ‘of a certain age’, help her find support. This is an excellent online forum on menopause and all things HRT / BHRT: Menopause Matters.