At the age of 37, I had not anticipated being thrown into the menopause practically overnight. The ‘change’ was something that I had always associated with much older women, but I felt that when the time came, I would take this natural part of the ageing process in my stride. Perhaps I would not have been quite so smug if I’d known what was just around the corner.
The start of the journey
My menopausal journey really began when I was diagnosed with breast cancer in 1992. After undergoing radiotherapy and chemotherapy treatment, I was offered an oophorectomy (removal of the ovaries) and was put on the drug tamoxifen, an oestrogen receptor modulator. As some breast cancers feed on oestrogen, it was felt that my best chance for long-term survival was to remove as much oestrogen as possible from my body.
I accepted the treatment readily and with my eyes (reasonably) wide open as to the consequences. There would be no more babies. There would be hot flushes and night sweats. There was the likelihood that libido would diminish. And there was the increased risk of osteoporosis (brittle bone disease). All these symptoms and more were possible, yet to me it was a chance to prolong my life and I was more than prepared to accept the side effects.
What I wasn’t prepared for was the speed at which the symptoms hit me. What should have been a gradual process of adjustment became a crash course in coping with an emotional and physical roller coaster ride.
Sudden and unexpected
My experience of the menopause may have been sudden and unexpected but I believe it’s a fair reflection of what many women go through. Thankfully, nowadays, it’s not quite the taboo subject that it used to be, but it is something that women don’t always feel comfortable talking about. Neither do a lot of men.
On the physical side, the hot flushes began almost immediately. I can only describe the sensation as having an internal thermostat that has gone haywire. Outwardly you may look perfectly fine but inwardly you feel like you’re burning up. The night sweats can be both uncomfortable and terribly tiring, with profuse sweating posing additional challenges. This nocturnal wakening disturbs normal sleeping patterns, often making it difficult to drift back off again.
The biggest physical threat for women of menopausal age and beyond, is the risk of osteoporosis. This is due to a reduction in the levels of the hormone oestrogen which protects the bones by slowing the loss of calcium. Hence the need for menopausal women to be careful about their diet and to eat calcium enriched foods – calcium being perhaps the most closely linked nutrient to bone density. I regularly undergo straightforward bone density tests at my local hospital and am pleased that I’ve maintained an acceptable bone density level, attributed partly to a regular exercise program.
Then there is the emotional side of things. Let’s not underestimate how big an effect these symptoms have on this aspect of our lives. It is something that I have honestly had more difficulty coming to terms with than all the physical symptoms put together.
It is well documented that post-menopausal women can become depressed and irritable, with lack of concentration and mood swings thrown in for good measure. The knock-on effect can take a heavy toll on any relationship and it often requires a strong partnership to weather the storm and come out the other end. Certainly, there needs to be a willingness from both parties to understand the nuances in behaviour that the menopause can bring with it. And the problem with a premature menopause is that these events can happen perhaps 20 years ahead of time.
The treatment hailed as a proven effective solution for menopausal symptoms is, of course, Hormone Replacement Therapy (HRT). Many women find that it’s the only relief from a very difficult and often long-term problem, but for me, taking HRT was not an option. My oncologist’s advice was that, with my particular medical history, it would be unwise to consider any form of therapy that was oestrogen-related. So I shall never know whether or not it would have worked for me, but I do know that it has transformed the lives of others.
Patience and understanding
If you’re a woman reading this, perhaps you can identify with some, or all, of the symptoms I’ve described. And if you’re a man who didn’t automatically switch off at the outset, then hopefully you’ll have a better understanding of the challenges involved for your partner or spouse. Please try to be patient and understanding. The menopause can be very challenging for any relationship, but is made easier by both parties being honest and informed, and making compromises.
While I bemoan the fact that I had the menopause prematurely, I do try to concentrate on making the most of my life in the here and now. And that includes writing about subjects like the menopause that can often be uncomfortable for some, but it at least gets things out in the open.
This article is part of a series. Read the other posts here:
- Part 1 – getting into writing
- Part 2 – how I became a poet
- Part 3 – garden blessings
- Part 4 – cancer and me
- Part 5 – thank you for the music
- Part 6 – anyone for a carbonara?
- Part 7 – who cares?
- Part 8 – technology and me
- Part 9 – dementia and my family
- Part 10 – the visit to Auschwitz-Birkenau