kicking back to the surface

a belated perimenopause update

[longer read]

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Whilst organising and editing content ahead of SSL 2.0 going live, I realised it had been a while since I’d posted an update on my perimenopause experience. This one was only six months into starting HRT and written in the spring of 2020 - no further explanation needed there. And this post from July 2021 felt akin to a post-apocalyptic confessional of how the toxic blend of perimenopause and pandemic went down… and almost took me down with it.

Lately it’s been creeping into my subconscious that things have been on the up for some time and nothing could encapsulate more accurately how I feel now than the title of this post. In some kind of inverted mirror reflection, just as I slid unwittingly into the perimenopause years, I can’t pinpoint when I began to feel I was drifting back to a new kind of normality. The irony isn’t lost on me that I had to go back through my own Instagram feed to ascertain when the tide began to turn, because despite my best efforts, it and this blog, have always been an outward reflection of my inner mood and sentiments. Never having been one to present a consistently detached front, I’ve worn my heart on my sleeve all my life – both the in-person and online versions. A quick reverse scroll into the past seemed to point to early 2022 being a turning point and how I knew this brought a wry smile – the intense, wordy navel gazing captions had begun to give way to more outfit posts.

Funny how something that others might deem a vanity exercise was actually an indicator of self-confidence, inner calm and a sense of peace – but then I’ve always maintained clothes are just more than garments upon the body. This signalling shouldn’t be confused with the [sometimes] false irony of the “Felt cute, might delete later” posting trend – this is more than that. This is the glorious practice of a woman posting a selfie or mirror outfit photo for the sole purpose of telling the world - I felt good today and I’d like to express and celebrate that. When I relate that sentiment to the monumental fug I’d resided in for the best part of seven years, I absolutely get it - when you feel good again you want to shout it from the rooftops. My emergence hadn’t gone unnoticed either – a couple of readers who’d become friends over the years observed the slow resurfacing and took the time to message to say they felt I was “Back”. It was only when it was reflected back at me in this way that I too began to recognise the changes - the upward trajectory was mirroring the downward slide in the form of small, almost imperceptible signals.

midlife woman reflections on the perimenopause journey — I absolutely get it - when you feel good again, you want to shout it from the rooftops…

Ingrained style blogger habits aside, the mechanics of my HRT dosage have remained the same for the last two and a half years. I’m still on three pumps of Oestrogel per day and take two Utrogestan tablets at night for the second two weeks of my cycle – if you could call it that as it barely exists now. It seems that with the dissipation of any kind of monthly bleed, the erratic peaks and troughs of hormone levels may have finally calmed the feck down. I don’t know this for sure – it’s guesswork - and even as I type, the voice in the far corner of my brain chortles the familiar “It ain’t over till it’s over!” refrain. The only difference between now and two years ago is that another voice comes back with “Actually, you’re nearly 54 and this shit started when you were 46 so maybe you have done your time already.” That positive counter-argument has been one of the things I’ve sorely missed these past few years.

I recently had a brief phone consult [is there any other kind now?] with a GP and asked, seeing as I hadn’t had a period to speak of since July 2022, should I swap to taking the Utrogestan to one a night, every night. The suggestion was to follow general advice which is its best to wait until one year clear with zero periods before switching. I’ve read more than once that you can switch after six months but with things working fine as they are, the old adage of “If it ain’t broke, don’t fix it” rings true for now.

The thing that almost did break me on this journey was the onset of anxiety like I’d never experienced before – it was by far my most debilitating perimenopause symptom. So I could almost weep with joy in reporting that for the most part, it seems to have become a much rarer beast these days. Occasionally, I can still go down a spiral, especially if its anything that poses a threat to the health and welfare of my loved ones – with good reason as there’s been plenty going on there of late – or, if someone mentions a bad news, media hot topic. But I feel a little more in control of that now and can recover a sense of equilibrium quicker than I could before.

Speaking of bad news, I’ve only recently realised that a significant improvement in the state of my mental health is down to the fact I haven’t watched or read the news, listened to the radio (I prefer Spotify, podcasts and audiobooks), or so much as looked at the BBC news website for the last six months at least. I deleted Twitter and Facebook over a year ago and have slowly begun to curate my Instagram feed into a place where I’m not continually faced with anguish, anger, aggressive opinions and performative activism – none of which come anywhere near to close to solving the issues they are a product of. At times, P, H and I might end up discussing prominent events or news stories amongst ourselves and I maintain a general awareness when I’m able but that’s about the extent of it.

A controversial stance maybe and likely to solicit the opinion that its naïve and irresponsible not to stay informed - that ignorance makes me part of the wider problem – nonetheless it’s been a game changer when it comes to the anxiety load factor. I know which causes I stand behind and support them how and when I can. I also know that when I continually consumed the pain, anger and opinions of the world, it put me in a place where I was of no use to anyone in my own family, let alone anyone else on the planet. When it comes to media – mass and social – we all have a choice and mine is to not continually absorb a myriad of information and potential outcomes that I have absolutely no control over. Other than the one certainty that all the clicking, scrolling and sharing of bad news (rarely is it the good), only helps media moguls become infinitely richer and more powerful than they already are. No thanks.

when it comes to media - mass & social - we all have a choice & mine is to not continually absorb a myriad of information…

Phew! And so then, to seamlessly drift from the scourge of the media to…dry vaginas. I guess, not a condition I can actually blame on the gutter press no matter how hard I try, but if you think of a plausible link, do let me know. I find this to be a conversation that only a few are prepared to have and yet it’s a condition that effects so many – I guess despite Gwyneth’s candles, we’re still not ready to speak about our vaginas much just yet. So… I’ll go first.

The onset for me was first noticeable back in the early days of perimenopause when it came to sex… which by the way, when you couple this with a distinct lack of interest in that particular subject for reasons you can’t put a finger [or anything else] on, it causes all kinds of self-doubt and soul searching. Fast forward to a year ago and I began to realise that there would be a few days a month [sex or no sex but mostly no], where I would feel dry and uncomfortable to the point of it being pretty painful. Light finally dawned on marble head when I read that this was yet another glorious symptom of perimenopause and in less severe cases, can be helped by use of a long-lasting moisturiser applied as needed. Another phone chat with a thankfully understanding female GP, a recommended Amazon order of Replens [Yep – that’s an affiliate link because I know you won’t mind me earning a small amount of commission at the expense of my vagina], and all was right with the world once more. Well, the region below the equator at least. As directed by the GP, I now use it when needed but it’s pretty costly so I’m thinking of asking if I can have it (or something similar) on prescription when I go for my next HRT check. At least that way, when P asks what’s in the Amazon box as he did that fateful day, I won’t have to say “Oh you know… just some compostable bin liners, a birthday gift, some Turmeric tablets for the dog and some vaginal moisturiser.”

In regard to hot flushes and night sweats, I’m grateful that they haven’t been on the radar that much yet. Occasionally I have something akin to an excessive overheated moment in the day and often, if more than one glass of red wine has been a factor in the evening, I’ll wake up in the night with the urge to fling the duvet off and whisper loudly “What the actual fuck?? Is the heating on??” to my sleeping husband’s back. A mostly dry January has helped considerably with this, so I think the effort to stick withe weekend-only wine should continue.

The potential clash between hay fever meds and HRT in the summer of 2020 that I mentioned here was I think, an anxiety shaped red herring as there hasn’t been any ill-effects in the last two years. Although my reaction to household dust when cleaning seem to have gotten more severe – but I’m thinking that’s an aversion to the domestic chores themselves as opposed to an increase in menopause-related histamine levels. After the Christmas Tree Dust From The Attic incident that resulted in my feeling as if an elephant had decided to sit on my chest for a couple of days, I’ve taken to wearing a dust mask when cleaning. Which, when sported with noise cancelling headphones for podcast consumption whilst hoovering, gives an overall vibe of a Dr Who Cyberman but, hey… I never said I was in it for the glamour.

I realise that every woman experiences the onset of perimenopause and menopause differently and that HRT isn’t and, in some cases, can’t be, an option for many women. One of the best books I’ve read (and there’s been a few) is this one – it explores both alternative and complimentary strategies to HRT too. Below is a brief list of some things that have helped me – things I want to delve into a little deeper in the Flourish section of SSL over time:

Taking time out to commit to a Friday morning yoga class - I’ve been doing this since last April and I swear by it.
Meditation - I turn to the Calm App when things feel overwhelming.
Learning to deploy the opposing arguments of reason when battling with anxiety catastrophising - this book helped me with that immensely.
Practicing a degree of acceptance – but it is a practice and doesn’t always come easy. The School Of Life App mentions it a lot.
Making time to do absolutely nothing and not feeling guilty about it.
Good sleep routines - no screens, a book, pre-bedtime ritual with this & excellent black out blinds.
Getting out for a walk at the beach or anywhere in nature – it always brings me back on the level.
Cold water exposure – swims, cold shower rinses and even a pod for back garden dipping.
Getting lost in a book or a movie just for the reason of taking my mind elsewhere.

The one thing I take from all of this is that, whilst I feel like I might be coming out the other side, I’m not naïve enough to think that it’s plain sailing from here on in. I fully expect further changes but I wouldn’t hesitate to push for help if needed. We have some sizeable family challenges on the horizon, including H’s departure to University come September, and I know these changes will have some impact when it comes to emotions and anxiety levels. But now, with understanding and knowledge of what happens in perimenopause, I at least feel better equipped to deal with these things – which is a world away from 2016 me who thought she was just plain losing her shit for no good reason.

I remain grateful that, on the whole, the world seems to have woken up to the impact of menopause on women’s lives and the need for wider support and greater awareness. Progress is still slow and sometimes feels like a case of one step forward and two back – Yay for the HRT annual one-off charge finally coming into force this April – BooHockey to the UK government for blocking the law to make menopause a protected characteristic under the Equality Act. Yep - despite my earlier declaration, that is a link to a newspaper - The Guardian is the only one I’ll occasionally dip into.

Unfortunately, when my content was migrated from the old site to this one, I lost reader comments and there were some amazing contributions on all three previous menopause posts. One this very first one where I explained why I’d decided to try HRT, I had more comments than I’ve ever had on any post. It was both glorious and yet saddening to see so many Me Too’s about a subject we should have always been given more help and support with.

So feel free to keep the conversation going in the comments here or drop me an email if you think there’s anything that might be useful to include in future Flourish posts.