Like Gwyneth, I was lost when my menopause began in my 40s
When the hot flushes and mood swings arrived early, Sarah Ivens sought comfort from friends who knew what to expect
Astrange thing has been happening to me and my friends over the past year. On the infrequent nights we spend together, away from our offices, children and husbands, small talk is out of the window. Instead, we delve straight into what is making us happy. And, more importantly, as we each hover around our late thirties and early forties, what isn’t.
Never was this more obvious than a few months ago, just after my 42nd birthday, when I met four friends I hadn’t seen for 12 months for a celebratory meal in a Hertfordshire trattoria. We didn’t gossip, moan about partners or over-analyse Meghan Markle’s self-confidence. I asked for advice on dealing with a newly sprouted blonde moustache.
Then Nicola shared that she could only muster the enthusiasm to have sex with her husband every other month and felt increasing asing alarm that she didn’t miss the he physical connection that once e kept her marriage interesting. . Lara unloaded her disappointment ointment that after surviving two wo pregnancies – one with ith twins – her tummy had ad started to slide towards rds her kneecaps, despite e the extra effort she was putting in to crunch and plank daily. We all swapped tales of sweaty, sleepless nights spent racked with a heartpumping panic.
“I guess that’s just the life stage we’re at now,” said Melissa. “We have young children and we’re juggling motherhood with work, trying to maintain a relationship and a social life, and look somewhat decent. No wonder we’re all paranoid about our appearance and feeling stressed and exhausted.”
Lara countered that this catalogue of unsettling symptoms wasn’t purely circumstantial, but medical, too. She’d been to see her doctor the week before. “We’re perimenopausal, ladies. Our bodies are going through big changes, only exasperated by our current situations.”
“What? I’m only 42 years old,” I replied. “I’ve got a decade before all that starts.”
“You’re thinking menopause,” she replied. “I’m talking perimenopause, which starts up to 10 years before you actually stop having periods and have officially gone through the menopause.”
Last we week, the actressturned turned-entrepreneur Gwyne Gwyneth Paltrow revealed that sh she, too, had entered the ea early stages of meno menopause, at the age 46. In a video posted on her w wellness company Goo Goop’s homepage – to laun launch her latest dietary sup supplement, Madame Ov Ovary – Paltrow spoke of the symptoms she is experiencing. “I th think when you get i into perimenopause, y you notice a lot of changes,” she said. “I can feel the hormonal shifts happening: the sweating, the moods. You’re just like all of a sudden furious for no reason.”
According to Dr Ali Abbara, academic clinical lecturer in endocrinology at Imperial College London, Paltrow may have got off lightly with hot flushes and the odd temper tantrum. “Perimenopause means ‘around the time of menopause’ or, in medical terms, climacteric, when the ovaries’ function begins to be reduced. Women may start to have symptoms such as hot flushes, sweats, mood disturbance – but also vaginal dryness, decreased libido and difficulty sleeping.” More disturbing side-effects include short-term memory disruption, a difficulty concentrating (often at inconvenient times, such as during a speech, job interview or a moment of passion) and uterine bleeding.
So my friends and I aren’t just feeling rubbish due to being at a difficult life stage? “It can sometimes be difficult to differentiate between symptoms which are specifically due to the hormonal changes of menopause and those which are coincidental to the time of menopause,” says Dr Abbara. “But it is widely accepted in the medical community that symptoms in the lead up to menopause are both genuine and troublesome, and are due to the changes in hormones as the ovaries cease to function.”
I found this information helpful in two ways. First, I wasn’t going mad. The changes I felt could be scientifically explained. I wasn’t lacklustre in a self-imposed vacuum, and my symptoms wouldn’t continue to get worse and worse; my medical manifestations had a timeframe and an end date. Secondly, I now knew I wasn’t alone. Not only were my friends experiencing similar maladies and worries, but my entire peer group would be, too, if not now, then soon.
‘Once I knew why I felt like this at the age of just 42, I knew I could get through it’
Once I understood why I was feeling these things, from jet lag-like tiredness to irrational worry, I knew I could get through it. Knowledge is power, and as my friends and I shared information, we felt more in control over our minds and bodies. We talked openly about this pre-change part of our life and gladly swapped advice on what to expect and what could help: weekend walks in nature and morning meditation to deal with anxiety, Bach’s Rescue Sleep Remedy and no caffeine after midday for insomnia, a fan and a cotton nightie for the hot sweats.
The decreased libido was the hardest thing to self-medicate and the most embarrassing to discuss. “Libido goes up and down, and it’s hard to feel sexy when you’re a parent,” advised a wise friend who, at 51, had been there, done it (or, rather, not done it). “Intimacy is much more than sex – focus on that. And also remember, most people don’t have sex as much as they used to, unless they feel they have to, and if they say they are, they’re probably lying. When I acknowledged that, at your age and stage of life, I felt like a huge weight had lifted from my shoulders.”
At the moment, I’m at a healthy, workable level of acceptance and evaluation of the symptoms Dr Abbara had warned me to expect. When I’m unusually irritable with my pre-schooler, I can catch myself, take a breath and appreciate that it’s my hormones leading me to feel that way.
“There is no question that perimenopausal symptoms are not a real condition,” Saffron Whitehead, emeritus professor of endocrine physiology at St George’s, University of London reminds me. But can a doctor help when self-awareness and self-care aren’t enough?
“The obvious treatment for perimenopausal symptoms is to replace oestrogen,” Whitehead says. “This is known as hormone replacement therapy [HRT], which can be oestrogen only if women have had a hysterectomy, or oestrogen plus progesterone in women with an intact womb to prevent endometrial cancer.”
But doesn’t HRT have terrible side-effects? “In the Sixties and Seventies, HRT became a panacea for the menopause to treat symptoms, prevent osteoporosis and to stay young and sexy. In the Nineties, several very large studies showed links between long-term HRT, breast cancer and blood clots, although some of this data was subsequently disputed. The current advice is that HRT should be prescribed to women who have more severe menopausal symptoms that reduce their quality of life. This should only be for about two years. Osteoporosis, which results from oestrogen deficiency, should be treated with other drugs.”
Knowing I have HRT as a back-up if my symptoms become too severe – and that the medical community understand this time in a woman’s life better than they did when my mother was going through it a couple of decades ago – has reduced my anxiety about it. For now, I feel perinormal again, much to the relief of everyone who lives with me.