Why is menopausal such a loaded word?
Going through ‘the change’ is a fact of life for all women, often in midlife when they’re at the top of their game, but the connotations still conjure up images of madwomen in the attic.
Mythology has a lot to answer for, but it is certainly true that, for many, the symptoms and effects are extreme and distressing.
I went through a ‘medical menopause’ – when the process is hastened by another operation – at the age of 47 following a hysterectomy.
I’d known it was on the cards following a difficult birth with my son nine years earlier, but the hard conversation with my consultant was whether it would include the removal of my ovaries.
With ovarian cancer in mind, I decided to go ahead with it. The operation essentially catapulted me straight into menopause; since that meant my body would literally stop producing oestrogen overnight, I started HRT the next day.
A hysterectomy is a major operation and needs proper recovery time, so there was none of this back-to-work-in-two-weeks for me.
The most disconcerting side effects were disturbed sleep and night sweats
I took eight weeks off and spent six of these lying down, consuming Voltarol – the pain was possibly the biggest shock – and every episode of The West Wing.
My family and friends were wonderful, popping in with books and food and flowers, and I relied on them a great deal.
The Hyster Sisters website was also a crucial source of information and support during that time; their advice about resting helped me to recover in good time.
Once it was all over I was bouncing with good health, in no small measure because of the HRT.
But I was to come down to earth with a bump; in 2002 the Women’s Health Initiative Study found links between HRT and increased risks of breast cancer, garnering headlines all over the world.
That report has since been found to be less devastating than first feared, but back then, in common with thousands of other women, I instantly stopped taking the drug and wham-bam: I went through a ‘hard menopause.’
Suddenly I had no oestrogen at all.
The most disconcerting side effects were disturbed sleep and night sweats, waking up literally wrung out, with no discernible pattern to either.
When I was asked to work on a documentary called The Insiders’ Guide to the Menopause I jumped at the chance
I learned to be thankful for the nights when I had a good sleep, and kept – still keep – a notebook beside my bed to write things down so I didn’t fret about forgetting. The tumultuous nights have persisted, though to a lesser extent.
When I was asked to work on a documentary called The Insiders’ Guide to the Menopause I jumped at the chance.
When I told people what we were doing, it was as if the floodgates had opened. Story after story, symptom after symptom – people were overcome with relief at being able to finally open up about their experiences.
In conversation with senior female executives – including my own colleagues – I heard about their red-mist moments, when they could throw plates in an uncontrollable rage, that came out of nowhere, terrifying them and their family.
Often, these clever women didn’t make the connection between their plate-throwing and the menopause but in centuries past – right up to the 20th century – that behaviour landed women in institutions, dismissed as mad, bad and dangerous.
We were aiming for humour, testimony and science and I’m proud of the women who told me about their myriad symptoms; of how crushed they were beneath the weight of the stress they felt, while at the same time dealing with their career, children and ageing parents.
Often women do not realise that a loss of libido, weight gain, hair loss, joint pain and the horrifically-named vaginal atrophy – thinning of the vaginal walls caused by a drop in oestrogen levels – are all symptoms of the menopause; one couple I interviewed have gone back to what they term ‘teenage sex’ because penetrative sex is so uncomfortable.
Low mood is often part of the menopause, yet some women talked about being put on anti-depressants without a second thought
Menopause can also result after chemotherapy treatment for cancer, as if the cancer itself isn’t enough to deal with.
Low mood is often part of the menopause, yet some women talked about being put on anti-depressants without a second thought.
During the making of the programme I also got to know Dr Heather Currie, chair of the British Menopause Society and consultant obstetrician and gynaecologist at Dumfries and Galloway Royal Infirmary in Scotland, who runs the Menopause Matters website.
Discovering Heather was on HRT was an absolute eye-opener for me: she says the revised guidance is clear, that HRT only increases the risk of breast cancer if you are already predisposed.
As a result I am now back on a small dose of HRT, and I’d encourage others who dropped the drug as a result of that study to seek medical advice as to whether they should take it again.
The lack of oestrogen present post-menopause also contributes to osteoporosis, and I was taken aback after a bone density scan revealed I have osteopenia – pre-osteoporosis – in my hip.
I thought I was taking care to avoid it, playing a lot of tennis and working out with a personal trainer, but it turns out that isn’t enough. Restricting my alcohol intake and doing more weight-bearing exercises will help manage, though not alleviate, the problem.
Jennifer Saunders told me how she got through it: ‘With a large glass of champagne, naturally!’
There are many ways women deal with the menopause, from breathing techniques to CBT, but talking to each other and dealing in black humour can be a terrific tonic.
I interviewed Jennifer Saunders, who had her own cancer-induced menopause, and she’s pretty inspirational – she had to cope with alterations in her metabolism, changes to her skin and fluctuating energy levels.
I asked her how she got through it, to which her reply was: “With a large glass of champagne. Naturally!”
The subject has been covered with good humour by the likes of Absolutely Fabulous, Father Ted and Les Dawson, but what some women have to endure is far from funny, especially if menopause hits in their teens or 20s.
I wish the menopause was called something else – perhaps it should be ‘the liberation’.
The old-fashioned ideas so long associated with it should be banished to the attic and all the wonderful creativity, resilience and fun of the next stage of our lives celebrated.
Kirsty Wark was talking to Joan McFadden