Since my 30's I've been an avid listener of Radio 4 (Woman’s Hour in particular!). I used to listen to it on my 3 hour commute to Heathrow and for the hours and hours I spent renovating my home.
Every so often Jenny Murray would discuss this thing called the Menopause I don’t really remember what was said but it felt like it was discussed in hushed, almost reverential, tones.
In later life I listened harder thinking this may be me in a few years’ time – but came away from each programme none the wiser. They discussed hot flushes, night sweats and the embarrassment of sweating in public. I don’t remember any solutions other than, again in hushed tones, conversations about this thing called HRT but I had no real insights.
Then in 2002 as a new mum (awake all hours) I heard a discussion on radio 4 about that day's Daily Mails headline regarding the American research programme, known as the Women's Health Initiative (WHI) study this was the headline:
“HRT linked to breast cancer by JENNY HOPE, Daily Mail
Scientists have warned women against long-term use of HRT after discovering a 26 per cent higher risk of breast cancer. They have abandoned a major research programme after deciding the health risks far outweighed the benefits. The study also found a 29 per cent increase in heart attacks, a 41 per cent increase in stroke and a 22 per cent rise in cardiovascular disease.”
Moving on to my 47th year and I’m in a terrible state. Stressful job, mother slowly dying after a massive stroke and sister going through a horrendous divorce - anxiety is through the roof! After 2 years of struggling and thinking this isn’t right, I eventually go to my lovely female GP (a little younger than me) and we discuss my situation. We decide anti-anxiety medication is the best course of action. HRT wasn’t mentioned.
2 years on. I’ve put on 2 stone feeling a little spaced out. But hey! I have anxiety, so this is what I need to take. Right? As I’ve put on weight, I’m presuming that’s why my joints ache, I’m feeling dire, I just can’t remember ANYTHING I struggle just keeping things together. But I’m too busy to do anything – oh well, I’ll have a glass of wine that’ll make me feel better. Won’t it?
So, at 49, I’m seeing the same lovely GP to come off the meds because I feel even worse on them spaced out not really ‘on it’ at work, not really feeling anything. We discuss coming off the medication and the pill too as I’m nearly 50. HRT not discussed.
Around this time, I heard a discussion about breast cancer and the menopause again. Mum and sister by this time both had had breast cancer so obviously HRT was not for me. Anyway, HRT only delays the inevitable. Doesn’t it?
Feeling blah, not feeling myself but it’s been so long since I have that I can’t really remember what myself feels like anymore. Strange heat at night but not hot flushes or night sweats so that’s not the menopause. Right? (NB: Woman's Hour was the only time I heard mention of the menopause) Also this isn’t menopause because that happens at 51, or a year after my periods stop. Doesn’t it?
Moving on. COVID. I swing between wanting to laugh and cry – but so does everyone, the world is in crisis isn’t it?
Haven’t slept through the night now for over 7 years.
May 2021. Davina McCall: Sex, Myths and the Menopause. Let’s watch.
WAIT…WHAT…...! What’s Perimenopause?
Why didn’t my lovely female GP tell me any of this?
An explosion of information hits me along with many many ‘Ah-ha’ moments.
After jumping through hoops at my GP’s surgery to discuss HRT. I finally get hold of a GP. Who rings.
Dr. 1. Male. July 2021.
Me - Hello, thank you for calling. I’d like to discuss starting HRT.
Dr. - I don't ‘do’ HRT, ring reception and speak to a nurse.
Me (Being exceptionally bold!) But. But…. this will happen to 51% of your patients, shouldn’t you be more informed?
Dr. - Speak to the nurses.
I rang the surgery and spoke to a lovely older receptionist who was clearly embarrassed by Dr's attitude. She said she’d get another call back. I said I'd only speak to a female GP because they must know about the menopause - surely!
Dr. 2 .Very young, female, possibly a Locum. August 2021
Me - Hello, thank you for calling. I’d like to speak about the menopause and HRT.
Dr. - Silence. A giggle. Oh, sorry I don’t know about that it’s not my area of expertise.
Me - Sighs…. can you please ask my own GP to call me back.
3 weeks later. I speak to my lovely GP armed now with so much information (dog - bone) she agrees to me taking exactly what I ask for and so it begins.
I collect my body identical HRT, Oestrogen gel and Progesterone tables, and 3 days later I sleep through the night for the first time in 7 years. A few months later I gradually found myself again. Happy days.
Why? Why has it taken so long? Why wasn’t this discussed with me, ever, even with my lovely GP? Well, I’ve since discovered there are various reasons for this.
1. Lack of training. A 2021 survey of 33 UK medical schools found 41% did not have a mandatory menopause medical training on the curriculum. Medical training for GP’s is seriously lacking.
2. Then there is the lack of time – only minutes to make assessments.
3. Add the (now completely debunked, even by the institute that ran it! ) WHI study is still causing confusion regarding the link between HRT and breast cancer. An ill-informed GP (who is not up to date with their training) will still not prescribe HRT as they genuinely believe it could still harm their patient.
So, what to do?
Get informed!
These are the resources I have found useful. Though there are many more out there.
Watch Davina’s evidence-based documentaries:
And read/listen to her brilliant book ‘Menopausing’
Look up Dr. Louise Newson. She is a well-regarded GP and menopause specialist (she also sits on the new Governments Menopause Taskforce) She uses evidence-based information in her private practice and has provided access to FREE training to over 30,000 healthcare professionals to be experts in the menopause space. She also has an app called Balance which is full of free information.
If you really like details…try the House of Commons Women and Equalities Committee report too:
If you choose to go down the HRT route, don’t forget you can get the new HRT PPC certificate which came into force in April 2023. This will reduce prescription costs to just £19.30 per year for ALL HRT prescriptions.
Then visit your GP armed with as much information as you can gather. Be firm. Decide your own path. Remember we are all individuals so it may take time to tweak your HRT - if that is the path you wish to go down - If you choose not to go on HRT there are other routes nutrition, exercise etc..
So, in conclusion. We must talk about how we feel during the perimenopause (which can start in your 30’s, though most typically in your 40’s) and find the support we need. More importantly, please don’t think you are going mad!
I find it astounding (though tragically not unbelievable) that the highest suicide rate for women is between 45 and 55. For every 100,000 women in this age group 7 take their lives. These are frightening stats.
So, this is my story. It has a happy ending I am now on HRT (including testosterone, which is another story!) and I plan to stay on it for life. There are some healthcare professionals who say it should be called hormone ‘top up’ therapy as we are just replacing the hormones we are losing as we get older. Think about it. It was only a hundred years ago we’d all be dead by the time we reach 60 so no wonder we need more hormones!
I’m aware that there’s a lot more I can say but for now if I have just persuaded you to get informed my job is done!
Do NOT ‘Suffer in silence’ or ‘Just get over it because your mother did’. Why would you? You wouldn’t tell your GP you don’t want to take insulin or thyroxin if you needed it would you? Both of those are hormones!
I also haven’t even mentioned the BENEFITS of taking HRT - reduced future risk of heart disease, osteoporosis, type 2 diabetes, clinical depression, UTI prevention and dementia. In fact, women even in their 70’s and 80’s have been put on HRT as a preventative measure against some of the above.
I have spoken to numerous women in my coaching business and noticed the conversation often turns towards perimenopause or menopause, especially around anxiety and confidence. So, I have got myself informed. I am not a GP or a health care professional, but I have personally been through it - and nearly out the other end! I am also on the Newson ‘Confidence in the Menopause’ course initially designed for GP’s but now open to everyone. Including you if you wish!
If you’d like to delve deeper, I have devised a 4-week coaching program for women going through challenges such as menopause, caring responsibilities, divorce or just finding out who they are after children. I have been through it all and am passionate about helping others so do contact me to find out more.