Kirsty Wark: 'The menopause is a liberation'
Why is ‘menopausal’ such a loaded word? Going through 'the change' is a fact of life for all women, often in midlife when they are at the top of their game, but the connotations still conjure up images of madwomen in the attic. Mythology has got a lot to answer for, but it is certainly true that for many, the symptoms and effects are extreme and distressing.
I went through a ‘medical menopause,’ when the process is hastened by another operation, at the age of 47 following a hysterectomy. A difficult birth with my son nine years earlier meant I’d known it was on the cards, but the hard conversation with my consultant was whether it would include the removal of my ovaries, and with ovarian cancer in mind, I decided to go ahead with it. The operation essentially catapulted me straight into menopause; since that meant my body would literally stop producing oestrogen overnight, I started HRT the next day.
The most disconcerting side effects were disturbed sleep and night sweats
A hysterectomy is a major op and needs proper recovery time, so there was none of this back-to-work-in-two-weeks for me. I took eight weeks off work and spent six of these lying down, consuming Voltarol – the pain was possibly the biggest shock to me – and every episode of The West Wing. My family and friends were wonderful, popping in with books and food and flowers, and I relied on them a great deal in the weeks that followed. The HysterSisters website was also a crucial source of information and support during that time; following their advice about resting helped me to recover in good time.
http://www.telegraph.co.uk/women/health/the-menopause-myth-buster-every-woman-should-read/
Once it was all over I was bouncing with good health, in no small measure because of the HRT. But I was to come down with a bump: in 2002 the Women’s Health Initiative Study found links between HRT and increased risks of breast cancer, garnering headlines all over the world. That report has since been found to be less devastating than first feared, but back then, in common with thousands of other women, I instantly stopped taking the drug. And wham bam: there I went through a ‘hard menopause.’
Suddenly I had no oestrogen at all. The most disconcerting side effects were disturbed sleep and night sweats, waking up literally wrung out, with no discernible pattern to either. I learnt to be thankful for the nights when I had a good sleep, and kept - and still keep - a notebook beside my bed to write things down so I don’t fret about forgetting. The tumultuous nights have persisted, though to a lesser extent.
So when I was asked to work on a documentary called The Insiders’ Guide To The Menopause I jumped at the chance. When I told people - women and men – what we were doing, it was as if the floodgates had opened. Story after story, symptom after symptom - people were overcome with relief to finally to open up about their experiences. We knew we were onto something.
In conversation with senior female executives – some of them my own colleagues – I heard about their red mist moments when they could throw plates in an uncontrollable rage that came out of nowhere, terrifying them and their family, and often these clever women did not make the connection between their plate throwing and the menopause. In centuries past - and I mean right up to the twentieth century - that behaviour landed women in institutions, dismissed as mad, bad and dangerous.
In the programme we were aiming for humour, testimony and science. I feel proud of the women who told me about their myriad symptoms and how crushed beneath the weight of the stress they have often felt, while at the same time dealing with their career, children and ageing parents.
Often women do not realise that a loss of libido, weight gain, hair loss, joint pain and the horrifically named vaginal atrophy (thinning of the vaginal walls caused by a drop in oestrogen levels) are all symptoms of the menopause; one couple I interviewed have gone back to what they term ‘teenage sex’ because penetrative sex is so uncomfortable. Menopause can also result after chemotherapy treatment for cancer, as if the cancer itself isn’t enough to deal with.
This programme is not only for women, but for partners, family, friends and employers to foster a real understanding of what women go through during this time.
‘Low mood,’ too, is often part of the menopause, yet some women talked about being put on anti-depressants without a second thought. During the making of the programme I also got to know Dr Heather Currie, chair of the British Menopause Society and consultant obstetrician and gynaecologist at Dumfries and Galloway Royal Infirmary in Scotland, who runs the Menopause Matters website.
Discovering Heather was on HRT was an absolute eye opener for me: she says the revised guidance is clear, that HRT only increases the risk of breast cancer if you are already predisposed. As a result of meeting her and hearing her wise counsel I am now back on a small dose of HRT, and I’d encourage others who dropped the drug as a result of that study to seek medical advice as to whether they should be taking it again.
The lack of oestrogen present post-menopause also contributes to osteoporosis, and I was taken aback after a bone density scan revealed I have osteopenia - pre-osteoporosis - in my hip. I thought I was taking care to avoid it, playing a lot of tennis and working out with a personal trainer, but it turns out that isn’t enough. Restricting my alcohol intake and doing more weight bearing exercises will help manage, though not alleviate, the problem.
There are many ways women deal with the menopause, from breathing techniques to Cognitive Behavioural Therapy, but talking to each other and dealing in black humour can be a terrific tonic. I interviewed Jennifer Saunders, who had her own cancer induced menopause, and she’s actually pretty inspirational – she had to cope with alterations in her metabolism, changes to her skin and fluctuating energy levels. I asked her how she got through it, to which her reply was “with a large glass of champagne. Naturally!”
The subject has been covered with good humour by the likes of Absolutely Fabulous, Father Ted and Les Dawson, but what some women have to endure is far from funny, especially if menopause hits in their teens or twenties. We also feature some amazing work going on at Edinburgh University, based on Harvard scientist John Tilly’s research in 2004, which discovered stem cells within the ovaries that have the potential to create new eggs. In the future, the menopause may not signal the end of a woman’s childbearing years.
I wish the menopause was called something else. It’s sometimes called ‘the change,’ which is better, but perhaps it should be ‘the liberation’. The old fashioned ideas so long associated with it should be banished to the attic and all the wonderful creativity, resilience and fun of the next stage of our lives, celebrated.
As told to Joan McFadden
The Insiders’ Guide to the Menopause, Thursday, February 16 at 9pm on BBC Two Scotland.. It will also be available to view across the UK after transmission on BBC iPlayer
