I don’t often find myself agreeing with Gwyneth Paltrow but she was recently quoted as saying menopause needs a re-brand. And she’s right. The tired old trope of grey-haired women in elasticated slacks grumbling about ‘The Change’ simply isn’t representative of the modern experience. We need to be talking about menopause unapologetically and without shame. No euphemisms or behind-the-hand whispers. Half the population goes through this stage of life - one in a hundred are under the age of forty - so I’m delighted that it’s starting to get the attention it deserves and very open to sharing my experience. The more we talk about it, the less scary menopause becomes.
Like many women, my experience of this life phase has been far from straightforward. As a nutritionist I figured I knew what to expect, but in reality perimenopause was unforeseen and bewildering. My symptoms nudged their way in stealthily over the space of about a year, but they peaked somewhere around the time I hit 42. What I didn’t know then but am wise to now is that trauma can accelerate things and I’m convinced that’s what happened to me. I suffered a major upheaval in my personal life in 2014 which I believe plunged me into perimenopause good and proper. If you ask people what they associate with perimenopause, they’ll usually cite hot flushes and night sweats, but very often it’s the psychological symptoms that are most prevalent and debilitating. I suffered brain fog, low mood, insomnia, anxiety and a devastating loss of confidence. I couldn’t remember names or words (sometimes referred to as ‘loss of nouns’), I didn’t want to go out or socialise and, as a result, became very socially withdrawn. Throughout this period I carried a bone crushing sense of emptiness; it pains me to write this but nothing gave me joy.
It was when I started having palpitations, on top of all the other symptoms, that I approached my GP for a second time. Despite the fact that I ate well, exercised four times a week and didn’t smoke, he told me my symptoms would be alleviated by a change of lifestyle and ‘prescribed’ HIIT workouts, as well as counselling for my home situation. All questions about hormonal changes were brusquely brushed aside. I left the surgery feeling bereft, figuring stress and lack of sleep were to blame. It wasn’t until a good year later - having waded through a lot of research and slowly putting the pieces together - that I steeled myself to approach a different GP, a female doctor this time and a women’s health specialist. My periods were regular, albeit extremely heavy, and although I was told I was very young to be perimenopausal (not true, it can hit a decade before actual menopause), the GP sent me for blood tests. It turned out I was very low in iron (no doubt due to menorrhagia) and, low and behold, my oestrogen levels were sub optimal. I was prescribed Oestrogel and Utrogestan and told to come back in a couple of months for a review. Eight weeks later (and after a bit of a play around with dosages) I sat in the GP’s office a different person. I was sleeping better, my cognitive ability was on track and I’d got back some of my lust for life.
Perimenopause is undoubtedly a perplexing time. It certainly stumped me. The issue is that many of us simply aren’t prepared for this phase of our lives. We (wrongly) associate it with women in their 50s when in actual fact it’s something that can hit us in the prime of our 30s and 40s. 13 million British women are perimenopausal right now. I feel very strongly that they need to be informed in order to work out the best way forward. There’s a lot of unsubstantiated, highly unscientific information online and on social media. No wonder women get confused. That’s the main reason I started specialising in perimenopause and menopause nutrition. Whether you go down the HRT route or not, diet and lifestyle are critical factors, not just for managing symptoms but to future proof against health conditions such as osteoporosis, diabetes and heart disease.
Menopause seems to invite sensationalist clickbait headlines and mixed messages, which can feel very overwhelming. So how do you make sure you’re prepared? I’d encourage you to carry out a mini life audit: get your cholesterol and blood pressure checked, ask your GP to measure your ferritin (iron) levels, make a list of the aches, pains and niggles that are bugging you, then research specialists who can help. If you can afford it, I’d suggest going for a private DEXA scan (around £65 and almost impossible to get on the NHS) to assess your bone density. Start a food diary. Have a long hard look at the amount of exercise you do. What are the main causes of stress in your life - can you do anything short and long term to address them? Your thirties and forties are for carving out time for yourself and putting yourself first once in a while. Don’t under-estimate the importance of ‘me time’.
We’re all unique and we will all experience menopause differently. My clients are wonderfully diverse but united by the fact that hormone changes affect their confidence, their ability to live their lives and to be themselves. My job is to give them back their emotional and physical resilience so they can carry on being the dynamic, brilliant women they’ve always been. If you feel you might be going through some changes that don’t feel quite right, you’re not alone and nor should you be ashamed to get help. There are a wealth of options for you to choose from, make sure you’re as well informed as possible.