PERIMENOPAUSE AND A PANDEMIC - THE PERFECT STORM
There’s been prolonged silence here for a number of reasons - a couple of which you’ll now know about if you arrived via the Slow Coastal Living letter. This post has also played a significant part in pausing my fingers over the keyboard - to share or not? In the end, serendipity lent a hand. Having edited the draft for the umpteenth time and closed it with the intention of sleeping on it (again), last night I finished inhaling Elizabeth Day’s handbook of wisdom - Failosophy.
Within the pages of this small but perfectly formed pale pink book, Day talks through the seven principles of failure - every single one of them containing meaningful takeaways that I just want to print out or tattoo on my person or sky write for the world to read. Or all three. It’s a refreshingly realistic take on our perception of failure and the useless pursuit of perfection… and I think it landed in my world at just the right time. Her seventh principle of failure speaks to how being open about our vulnerabilities can be the true source of our strength. So in the spirit of openness I decided to hit publish and share how perimenopause had me at my most vulnerable.
When it comes to the anxiety I’ve lived with on and off since entering perimenopause around the age of 47, I feel I could write chapter and verse on, what for me is the most debilitating of symptoms listed. Anyone who’s known me for a number of years will attest that anxiety was not something I suffered with prior to this time - existing without it for most of my life and then finding myself plunged headfirst into its turbulent and unfamiliar waters has provided some of the toughest, recurring challenges.
I’ve written here and here about my journey so far with menopause and HRT but even so, wasn't quite prepared for my reaction to the recent Davina McCall documentary - Sex, Myths & The Menopause. I found myself on the sofa with Patrick and H, hot fat tears rolling slowly down my face, practically holding my breath as I listened to the stories contained within. Early on in the programme there was an interview with fashion designer Karen Arthur who bravely recounted the life-changing effects of her menopause, her destructive downward spiral and how she’d ended up feeling it would have just been easier if she wasn’t around anymore.
Perimenopause and the pandemic summer of 2020, took me to a place I hope never to find myself in again. After identifying so closely with Karen’s story and many elements of the others in that documentary, I’ve come to the conclusion that the more honest we are about our menopause experiences, the better it will be for those who have yet to get through it.
In early spring, on the telephone advice of my GP, I’d adjusted how I take the progesterone part of my HRT but by the time we hit summer I was feeling a lot worse. I couldn’t work out if the steep anxiety increase was down to my out of control pandemic fears, erratically shifting hormones or both. As I mulled over the causes under the glare of the bright summer sun, I felt like I was in the darkest of places.
I felt inept, useless and an emotional burden to my immediate family and too ashamed to tell my closest friends how I was really feeling. The fact that we couldn’t see each other in person and have those valuable woman to woman, brutal truth conversations only exacerbated the feeling of isolation. My perception of those around me both in real life and on social media was one of coping and of making the best of the situation - everyone else had it sussed so where was I going wrong? I now recognise that this mindset came from the false idea of perfection that we insist on feeding ourselves on a constant drip - in retrospective calm and clarity, I of course know that was not the case. But back in the thick of it, most of my waking moments were spent berating myself for not relaxing into it and focusing on feeling grateful for our health and the circumstances in which we lived out the first lockdown.
Instead, I lived out the days as a hollowed out husk - nauseous, edgy, unsettled and shaky, feeling bouts of exhaustion for large portions of the time. The magnitude of how low I was only hit me when one day, after seeing Patrick outside watering the garden whilst on the phone to his best friend, I became paranoid, convincing myself that he was confiding that he could no longer cope with me anymore. As I later found out he was saying no such thing; but as continually on edge as I was, snapping at him and at H and biting their heads off over the smallest of things, I wouldn’t have blamed him if he was.
As I stood in the bright afternoon sunshine washing lunch dishes, I remember entertaining the thought that they would just both be better off without me - I was failing. Here were my resilient husband and daughter, managing to live life amid a pandemic to the best of their ability and yet I couldn’t get anywhere close. I was rendered useless and ineffective by anxiety and fear and felt like nothing but an emotional drain on their resources. Consumed by self-loathing at my own perception of how weak I had become in this particular crisis, I felt I was just holding them back. I used to be pretty good at living through life’s more shitty moments, calling on my reserves of optimism, and yet now I no longer had anything left of that strong core.
A couple of days later in a slightly calmer moment, I went back over my thoughts and was brought up short by the realisation of where they could end up heading if left unchecked. I was shocked and frightened at the depth of how bad things were but, feeling like I shouldn’t take up my GP’s time (because - global pandemic), and unable to see my therapist who worked out of a surgery that was all but locked down, I didn’t know where to turn.
It was after enduring another round of the raging, ready-to-snap at anything version of me that Patrick suggested maybe my HRT dosage still wasn’t right and I should see if there was someone else I could talk to about it. I remembered from the early days of looking into being prescribed HRT that there were menopause clinic sessions run by a gynaecologist fairly local to me. As restrictions were slowly beginning to ease, I thought that it was worth trying to get a private appointment and pay for it myself.
I remember sitting there masked up on a boiling hot summer’s day, attempting to find the right way to explain how I felt, whilst simultaneously trying to avoid the very words that scared the crap out of me. Because admitting to the depth of it all was frightening and left me wondering if I was putting myself up for judgement from this complete stranger.
He listened, wrote notes and explained that in perimenopause, some women can experience extreme hormone fluctuations that will temporarily exacerbate their symptoms for a few months at a time, including anxiety. After talking through how I felt - my pandemic fears, the grief over losing my mum and my inability to cope with general family pressures - he also said that sometimes it can be more than hormones and if things didn’t improve, he strongly urged me to contact my GP about medication to treat depression.
His immediate instruction was that I increase the Oestrogen gel from two to three pumps per day and also restart the two out of four weekly progesterone dose so that it was back in line with my menstrual cycle. He felt that this would be easier to track things moving forward and also help to rule out anything that could be causing the mid-cycle breakthrough bleeds I’d been having for three months. I left feeling like I had new knowledge of these prolonged hormone dips and their effects. I was willing to try the increased dosage to see if it helped - at least it was something to work with.
I continued my early morning swims in the sea as often as I could and spent as much time outside as possible. When I was able to, I got a couple of appointments with my therapist in the Covid-safe conditions of her back garden. I journaled my thoughts from time to time and used the Calm App to gain small slices of quiet mind time - all the while wondering if it was perimenopause or if I would end up resorting to antidepressants at some point. To this day I still don’t know for sure but can only presume it was hormonal as, ever so slowly I began to experience some levels of calm. The edginess began to recede and I could take in and appreciate small moments of joy again. It’s odd but I’ve since realised that whilst wading through a stormy patch such as this, it's best not to keep taking its temperature - I had to just be. Only later was I able to look back and recognise the subtle signs that I was beginning to feel more positive overall.
Down the line, I confided in Patrick about the thoughts that came at my lowest point and how much they’d scared me. He was both my rock and my safe place. There was no judgement or the dreaded response of “I don’t get it” - he listened and assured me he was there for support in whatever form I needed. Looking back, I know it wasn’t an easy time for him or for H but we pulled through it by doing what we’ve always done - talking as honestly as possible.
Instead of trying to fight the feelings and irrational fears back down into submission by myself, I learnt to let them out into the open, running the more out of control thoughts past Patrick when a sense check was needed. Whilst H was facing her own steep challenges brought about by lockdown, I was candid with her about why I felt so bad and what I thought the causes were. I see no reason to brush under the carpet the very thing that she and every woman will experience at some point in their lives, albeit in a myriad of different ways.
In hindsight, I feel that the difference it made in airing the out of control emotions and feelings was crucial. Anxiety has a way of taking every bad thought you have and amplifying it to another level - reason flies out the window. To bring it out into the open is to remove its power and deflate it somewhat - a process I kept repeating, that in turn, gradually began to leave a bit more space for calm to seep back in. A couple of meditations I’d picked up on the Calm App also focused on learning to see anxious thoughts merely as a thing to observe and then let go of so that they can drift on by. And to remember that you are not your thoughts, they don’t define you they and they won’t become your permanent state from here on in. Returning to listen to those particular sessions often really helped.
Later in the year I confided in my closest friends and was again only met with love and understanding. For Patrick, H and for them, I feel so incredibly grateful and know that I’m lucky to have them. On the flip side, there are others in my life who wouldn’t have a clue how bad things got… you inherently know when things will fall on misunderstanding ears and so tend to stick with silence. This was highlighted to me on two occasions when, having briefly touched on the depth of my anxiety by way of explanation for my behaviour, I was left feeling let down by the subsequent responses. There is never any point in attempting to clarify to those whose response is “I just don’t get it” - you only end up feeling worse than before you set out to explain and it’s not your place to attempt to enlighten them or make excuses for what you’re going through.
In all of this, I’m not discounting the pandemic and its effect on my own anxiety levels and those of millions around the world too. I know it played a significant part and continues to still do so now. However, Society’s perception of what it's actually like to go through menopause is so off kilter and far removed from the reality of it all, it's little wonder that I didn’t know what was happening to me, either when it began at age 47 or throughout the events of 2020. In the last couple of years, as a menopausal woman actively seeking advice and information, it’s been uplifting to see an increased awareness and lots more resources becoming available, a few of which I’ve listed below.
But we still have such a long way to go. On the whole, we continue to gloss over it, poke fun at it or just belittle the very real effect it can have on women and on their families too. I only wonder at how many women experience the lesser known symptoms such as anxiety and live through it without ever really knowing what the hell is happening to them - and worse still, that they could safely alleviate their symptoms with HRT, should they so choose. We could still be a whole lot better when it comes to widespread knowledge and education around dealing with something that is as big a part of women’s reproductive health as periods and pregnancy are.
I too have a way to go - at 52, my periods haven’t yet stopped and I keep wondering if anytime soon I’ll be dealing with the more commonly recognised symptoms such as hot flushes and night sweats. Perhaps I won’t - some women don’t ever get these. But whatever comes next, I’ll try and remember to turn to the things that help ease me through it, learning from past experiences and remembering that all phases are temporary.
Storms pass. And eventually, so does a pandemic and so will menopause. There are next chapters still to come.
A few Resources That might help:
Sex, Myths And The Menopause - Documentary on Channel 4
The Menopause Charity
Karen Arthur’s Podcast - Menopause Whilst Black
Balance - The Website, app & online community founded by Dr louise Newson
The brilliant book - Failosophy by Elizabeth Day [Affiliate Link]
I’ve also included a number of books about menopause here on my Bookshop page [Affiliate Links]
