Becky Maynard has spent 10 years working in many international humanitarian crises, dealing with everything from earthquakes to refugees, and then did a Masters in Disaster Management. Consequently, you might expect her to be more resilient than most in dealing with the perils of the perimenopause, but like so many women, she was knocked sideways by mystery symptoms.
Her problems began when she was 44, driving home to Cornwall, and pulled her car over three times. I kept thinking I was having a stroke or a heart attack, says Maynard, now 48. I drew into a lay-by, realising there was no way I could drive any further because I was going to die.
She asked a lorry driver parked nearby to help, saying, I dont know whats happening. I cant be alone. He tried some breathing exercises with her and called a friend. Three hours later, she managed to drive herself home.
She wondered if she was suffering from PTSD from her work, was diagnosed with panic attacks and offered cognitive behavioural therapy, which didnt help much. Then she was given antidepressants: [They] made no difference. I continue to have constant anxiety, gain weight and feel utterly miserable. When she began to suspect her problems might be linked to hormones, she asked about hormone replacement therapy [HRT], but her GP told her to come back two years after your periods have stopped.
But Maynard had been on a pill that meant she was not having periods. So she started researching her symptoms and discovered they are common in the years leading up to menopause. Its been a revelation finding out about perimenopause, and Ive decided to see a different GP to discuss HRT, she said.
Perimenopause is menopauses dastardly little sister. On no account should it be underestimated, as it moves by stealth. Women in their forties find themselves flummoxed by a raft of mental and physical symptoms, and blame themselves instead of their changing hormones, because they usually still have their periods.
Until recently, there was silence and ignorance around perimenopause among women and even doctors, and only now is it beginning to get the attention it needs. If you looked on the NHS website three months ago, there was only one vague mention of the word perimenopause, but now (in a slight improvement) the site describes symptoms of perimenopause and menopause as one item.
But the emotional and physical rollercoaster of perimenopause needs far more explanation than that: it is a time of anxiety, sleeplessness and physical change for most. Suicide peaks among women, and divorce rises. In midlife, usually when women are in their mid-to-late forties, oestrogen and progesterone unpredictably drain and refill like rip tides, and then decline along with testosterone, which is also a female hormone. Every day can be different.
It is not merely the onlookers, families and friends that dont realise whats going on. Women themselves (along with some non-binary people and trans men who go through this process) often have no idea. Perimenopause can seriously affect mental health.
I am the producer of two recent Davina McCall menopause documentaries for Channel 4, and it was the perimenopause rather than the menopause that caused havoc in the TV presenters life. McCall was 44 when she started getting hot flushes, anxiety and brain fog that stopped her reading the autocue: I thought I had early onset dementia, she said.
For me, the perimenopause brought peculiar symptoms: terrifying heart palpitations in the early hours and overwhelming anxiety, as well as sudden gaps in my memory bank. The heart palpitations led to an electrocardiogram, which was just fine Im a regular runner. The doctor concluded the cause was too much coffee. Menopause was never mentioned, but the palpitations disappeared and my memory rebooted as soon as I sought out HRT.
I was so astonished at the lack of reliable information that I wrote a book, Everything You Need to Know About the Menopause (but were too afraid to ask) and discovered there were huge gaps in research, particularly around perimenopause. I only found out how common some of my own symptoms were after we commissioned a Channel 4/Fawcett Society poll of 4,000 women aged 45-55 for the second programme, Davina McCall: Sex, Mind and the Menopause. It turned out that 41 per cent had experienced difficulties with heart palpitations, and 73 per cent had brain fog and memory problems.
With menopause coming on average at 51 (though it can be younger, particularly for Black and Asian women) it was important to include women in their late forties in the poll, and what resonated was that 69 per cent suffered anxiety and depression, and 84 per cent sleeplessness. There was one other key finding 44 per cent said they had uncomfortably heavy periods in perimenopause. These flooding, tsunami-style periods stop some women leaving the house, and others need more access to the bathroom at work.
Theres no one-size-fits-all set of symptoms that define perimenopause, say nutritionist Emma Bardwell and menopause specialist Dr Shahzadi Harper in their book, The Perimenopause Solution. Hot flushes are not always the signifier. NHS guidelines say that women under 45 can be given a blood test to see if their hormones are low. But if your blood test comes back normal, you might think you cant possibly be in perimenopause. What you need to know is this: its not about the numbers, its about how you feel.
Bardwell and Harper say: Many GPs are still reluctant to prescribe hormone replacement therapy to women in perimenopause who still have their periods, even when symptoms are signalling hormonal change and a call for help.
As Becky Maynard found, perimenopause is often not identified as a possible cause of mental-health symptoms. That means women may miss out on effective treatment for their anxiety or depression.
Menopausal depression is different from clinical depression, and usually responds to hormones. Patients who have never previously been depressed describe low mood, a grey, flat kind of feeling, a loss of joy, said Dr Rebecca Lewis, a GP turned menopause specialist at the Newson Heath Menopause and Wellbeing Centre in Stratford-Upon-Avon. The reason women come to see me most in the clinic is not the hot flushes, not the muscle pains, but the psychological changes. As eggs begin to run out in perimenopause, that starts fluctuations in hormones which affect the brains limbic system, which governs anxiety, mood, libido and concentration.
So what can women do if they suspect they are perimenopausal? Obviously paying attention to lifestyle choices really matters and Bardwell points out that changing hormones can cause bloating and even alcohol intolerance. A diet overhaul is a good idea, looking after your gut microbiome and making sure you get enough vegetables, vitamin D, fish oils and even magnesium, which can help with sleep.
Exercise has also been shown to reduce hot flushes, but nothing can replace lost hormones except hormones themselves, and the new body-identical HRT available on the NHS is safer than the older preparations. A body-identical progesterone pill and transdermal oestrogen in a patch, gel or spray showed no increased risk of breast cancer in a 2022 study of almost half a million womens records in the UK databank.
One of the best resources, with more detailed information than the NHS website, is the balance-menopause.com website, and the free Balance app. Balances chief executive Gaele Lalahy explains: The app allows users to track their symptoms and print an individualised health report which they can take to their doctor. More than 250,000 health reports have been downloaded, and more than half of women who had been using the app for more than five months said it had helped them to access treatment faster.
We need to empower women with accurate information, and in turn improve their physical and mental health, as well as their quality of life.
Weve had period power. Now we need to talk about the perimenopause power and take control of our hormones.
Everything You Need to Know About the Menopause (but were too afraid to ask) by Kate Muir (Gallery Books, 16.99) is out now
Read more from the original source:
'I kept thinking I was having a heart attack but it was the perimenopause' - iNews
