Women used to have to give up their jobs in Ireland once they got married – did you know that? Periods were taboo and god forbid you fed your child in public the way nature intended. As depressing as all that sounds, all is not lost. We are slowly emerging from the dark ages (we have a long way to go though) and that begs the question as to why NOBODY talks about menopause! Is it a secret? Are we trying to keep women in the dark about this perfectly natural phenomenon? Truth is, if you aren’t aware, it can be lonely and a little scary.
Leaving certificate biology;
- life cycle of a tadpole (to frog)
- 2D representation of cardiac anatomy (which, might I add, paints an inherently incorrect picture of myocardial positioning within the chest cavity)
- The male testes
- Female menstrual cycle
- ………..aaaaand, thats a wrap lads! Nothing else to see here!
So, are we saying that the only valuable aspect of the female hormonal cycle is the part where she can produce an heir? Nobody thought it might be a good idea to teach us about the enormous physical, mental and emotional upheaval that occurs just around the time our bodies decide that reproduction is no longer a viable option? Sure, I suppose its best to keep us birds on our toes by throwing a bit of menopause at us just as we are figuring shit out for ourselves!
Feeling Kind Of Angry
I’m a feminist – not the man hating kind. For the record, I adore men! But I’m the kind that acknowledges the fact that women have culturally and societally been treated like second class citizens the world over since the beginning of time.
I understand why things like periods and menopause are not part of daily conversation with the guy making my coffee in starbucks! I get it! But why have we had the period conversation at school, the ‘how not to get pregnant when you’re 15’ conversation and not had the ‘menopause will change your life’ conversation? Is that still deemed too taboo? Or is it that nobody knows or cares enough about it to consider it an important discussion point? I’m feeling kind of angry because I got landed in the middle of full blown menopause and I don’t have a clue what’s going on.
Menopause and Perception
I don’t think I’m wrong when I say that the word menopause brings a number of thoughts of crazy women to mind ( I can say this because I apparently am one). It’s like when you watch TV normally and you can watch the best character fall off a cliff and die and you feel a little sad. Then, 3 days later, you catch the last 8 seconds of an ad for feeding kids in Africa and you spend the following 3 hours crying hysterically under a blanket on the couch. Now, multiply that level of “I feel completely outside of my own mind and body” by about 23 and you are nearly at where I was before I caught up to the fact that I was menopausal. I can only imagine what others would think of me if they got a glimpse of me on those days. However,
Me & Menopause
6 months of low dose chemotherapy and high dose steroids was a last ditch attempt to shock my immune system into leaving my kidneys alone. End stage kidney disease is no fun! I was warned that this may effect my ovaries, but I had to try. I blew up like a balloon and had perpetual low grade nausea for the duration of my treatment. It didn’t work and I eventually required dialysis and a kidney transplant. Also, my ovaries crashed and I went into premature menopause (nice one higher power!)
I Was Driving In My Car….
The first symptom I experienced was tiredness mixed with a large dose of insomnia. We haven’t even gotten to the fun part! I would be exhausted by 6pm but when I would go to bed, I would lie awake, my restless legs dancing a jig under the covers (nowhere near as fun as it sounds) and I would stare at the ceiling for hours.
About a month after these symptoms began, I was driving through town with the kids. I found myself obsessively checking the faces of the drivers in the cars coming towards me. I wasn’t watching the road at all. Once we arrived at home, the kids went inside and I sat in the garden bracing myself for the full blown panic attack that was coming. I had a panic attack once before in my whole life and it was, I believe, chemically mediated to an extent (that story will come later). I was sweating, my heart was racing and I couldn’t catch my breath.
I felt like I was completely losing it. I picked a handful of grass and slowly let blade by blade fall through my fingers. As I counted them, my breathing slowed and I began to relax. I didn’t know whether to book a mental health check or just sit in the grass and cry. I’m not sure what clicked, but I suddenly had a moment of clarity. I remembered having hot flushes before I started dialysis (periods often stop in women with end stage renal failure). This felt similar and I decided to visit my GP for a blood test.
List Of My Menopause Symptoms
- Panic Attacks like the one described above
- Almost panic attacks – heart racing, hands clammy, feeling worried for no reason
- Hot Flushes – like…. not warm – Hot. Take all your clothes off NOW, hot!
- Goosebumps – like hairs standing up on the back of my neck. These were horrible and seriously triggered my fight or flight response. My body would feel suddenly cold and all the hairs would stand up on my arms.
- GI upset – my stomach was in knots. I couldn’t go, I was going 3 times a day….sorry for TMI but this had me on the edge!
- Headaches – big, Shandon Bells* headaches
- Restless legs. If you have ever done a horribly heavy leg session or run a marathon, its the feeling of unease and twitchiness in the legs like that. You can’t get comfortable and can’t stay still
- Sleeplessness. I was exhausted, would go to bed early, then nothing! Wide awake for 2-3 hours.
- Skin Break Outs – back to being a teenager! Serious blow to confidence
- Dry Skin – no moisturiser was good enough and I started to resemble a bit of a prune! Huge usage of filters on social media required!
What Fiona Did Next
I met with my GP. She was very kind and understanding. My options were as follows:
- Just live with it. The symptoms would gradually resolve over time and I would be post menopausal eventually. Some fly through it in the course of a few months, however, for others, it can take years.
- Begin Hormone Replacement Therapy (HRT).
She took bloods and I explained that I had an appointment with my endocrinologist the following week and would discuss with him. My blood results showed that I was, indeed, in full blown menopause. My specialist (I see him for my thyroid and bone density check ups) suggested that in order to protect my bone health and ensure I continued to experience the cardio protective effect of female hormones, I should take option 2. So I did!
I am already taking a fistful of tablets on a daily basis – so this really wasn’t an option for me (just my preference). I discovered there were two great alternatives. One was a gel pump. Like a moisturiser, you rub it into your skin daily – one pump or two, depending on the dose required. The down side of this product is that it isn’t licensed in Ireland and so doesn’t fall under the drug payment scheme.
The other option was a transdermal patch as pictured above. The HRT can be absorbed through the skin so this option really appealed to me. It is changed twice a week and there are a few different dosage options. The aim is to start on a dose as low as possible and increase it as needed. I chose this option.
Ongoing doses of oestrogen without the balance provided by progesterone can lead to a higher risk of uterine cancers. As I already had the coil in place for birth control, I was covered and didn’t require supplemental hormone therapy. Advice regarding correct prescribing should obviously come from your general practitioner or specialist who will suggest another medication if required.
Where Am I Now
Every day is an adventure. Hormone levels change frequently so one set dose of HRT does not work all the time. I will be great on a normal dose for 2 months, then BANG! – my boobs have gone from a barely there A cup to a D cup and my skin breaks out like a teenager. When this surge occurs, I reduce my dose for a few weeks until everything normalises. As long as I am symptom free, I keep my dose as low as I can. The second a hot flush creeps in, it goes up again incrementally. Mostly everything else is carrying on normally because for all intents and purposes, with the HRT I am not ‘menopausal’ – I am going to need to do a follow on post for when I decide to quit the patch!
Support is so important. As with anything, it is important to keep communication channels open with the individuals around you. Speak to your friends, explain what is happening and how you are feeling. At the very least, this will make them more aware of potential symptoms that they might encounter.
What To Do
First of all, do a girl a favour – have a chat with your girlfriends, mums, sisters, aunties. Be under no illusion birds, it happens to us all of us so let’s break down the barriers and talk about menopause! Its ok if you feel you are going off the deep end, but don’t go there alone. Talk to your GP – there may be something they could do to help.
Stay active! Exercise is so very important during this entire phase. Let’s face it, we should all be exercising a little anyway, but particularly during these changes, just moving and getting some fresh air can be an absolute life saver. Taking 20 minutes to an hour for yourself without anyone around you is a great opportunity to just let your mind wander and allow you to breathe.
Your Life – Your Way
Finally, look at the positives first. No – More – Periods!!!!!! Do we really need to even discuss any of the others? Just like growing pains or moving house, this is simply just another phase. It is an opportunity for you to make changes. Get out walking to help protect your bone density and your heart health. Use this change as your pivot point to step up and look after you! Join a yoga class, clean up your eating, decide on something you love and start doing it! But most of all, embrace it! Embrace this period of growth and ride the wave knowing that you will come out stronger for it.
*Shandon Bells is a very tall church in the city of Cork. When I was a child, we used to climb to the top to pull the ropes and ring the bells. It is claustraphobic and the sound is brain bursting to a small child!