I’m one of the many women who are suffering from ‘menoconfusion’

To mark World Menopause Day on Friday, Kate Spicer reveals how the NHS made her experience worse

Back in August, when the Profam clinic in Birmingham said it could reverse the menopause using frozen ovarian tissue (for £7,000-£11,000), I couldn’t even get my hands on a supply of HRT. It wasn’t just that there was, and still is, a chronic shortage of the stuff, despite nearly half the population qualifying for it at some point in midlife.

The problem for me was that, despite several visits to the GP, no one would write me a prescription. HRT is considered largely safe now, and I have no history of oestrogen-related cancers in my family. I presented with symptoms of the perimenopause, none of the fabled hot flushes, but a definite woolly-headedness and memory loss – I’m doing the battiest things: leaving my phone in the fridge and forgetting my keys. Then there’s the bloated stomach, the laborious, painful periods and the stinging promise of tears at absurdly inappropriate things – not least the newspapers.

GPS at my practice have given me three blood tests so far and conclusions have ranged from, “Go away, stop overthinking it, you aren’t ready yet”; “I’m leaving the NHS to start work as a private menopause specialist on Harley Street, why don’t you come and see me there?”; “Let’s do an ultrasound”; and “How about a lowdose antidepressant?” One medical person suggested the woolly-headedness was probably just age-related cognitive degeneration. What? At this rate I’d have full-blown Alzheimer’s by Christmas.

All I wanted was some HRT. The multiplicity of conclusions left me utterly baffled and crestfallen. I wasn’t just 49, perimenopausal and a drain on NHS time, now I was also suffering from terrible “menoconfusion”, a little known phenomenon that seems to affect an awful lot of women. Forget my hormones falling off a cliff, I felt like jumping off one (menopause is a recognised cause of suicide). I felt rubbish about the future. In her book The Change, the normally ferociously confident Germaine Greer describes sitting with a friend at 50 and them both seeing “telescoping of the next 30 years into a single grim tomorrow”. And that pretty much sums up how I felt.

You don’t need to be suffering from oestrogen withdrawal to be confused by this. Turns out, I am not alone. Women are going into the menopause without any knowledge: one survey had nearly half feeling confused about their options for managing symptoms.

As so often happens in these situations when medicine abandons women, they turn to each other for support. One science writer acquaintance was horrified I’d been denied HRT and instead offered antidepressants: “That’s totally against Nice guidelines, yet horribly common.” Alison Cross is on antidepressants, and says they work for some of her symptoms, but that more worrying is quite how far she has to go to the nearest menopause clinic, two hours away. Kerstin Rodgers, the chef and food blogger, “took antidepressants for the hot flushes and it worked, but only for three months”.

For Dr Louise Newson, it is hormone replacement that is an essential protection from the serious health issues associated with oestrogen deficiency. “Even the contraindications of the worst type of HRT are offset by the improved [protections] against osteoporosis, heart disease, arthritis and diabetes.” She also makes a key point that I have certainly observed in older menopausal friend: “They’re drinking wine to cope.”

A rock star’s daughter told me she’s getting through it with microdosing magic mushrooms and doing a lot of yoga. Rodgers admits self-medication is essential: “I definitely drink more. The only way I can sleep is if I have a joint.”

Dr Newson is the author of the

‘My GP sent me for constant blood tests … no one said it might be the menopause’

extremely pragmatic and practical manual, Menopause (Haynes). When I ask her about “menoconfusion”, she agrees it is a patient and practitioner problem: “It drives me mad that professionals are doing unnecessary blood tests for hormone levels. They’re known to be useless – any woman over 45 presenting with symptoms should be considered for HRT.”

A few years ago, when Tania Smith started bleeding heavily in her late 40, “My GP sent me for constant blood tests and checks for cancer. No one, at any point, said, this probably or even might be the menopause and I had been taught nothing at school so I literally knew nothing.”

Dr Kate Panter is a consultant gynaecologist at Guys Hospital menopause clinic and a member of the council at the British Menopause Society. “NHS commissioning groups are cutting services in a lot of areas of women’s health,” meaning the expertise women need at menopause is very hard to access. “Most GPS will have a women’s health expert but your average GP is both deskilled and doesn’t think menopause is important. Fact is, about a quarter of women will have significant problems, half will have some trouble and only a quarter will sail through,” she said.

To an extent, sailing through the menopause is a luxury few can afford. Newson doesn’t want to have a private practice. Her Newson Health Menopause & Wellbeing Centre of 15 hormone specialists exists, she says, only because the NHS didn’t want her.

With a raft of access to top medical

advice and the attentions of expensive medical spas and grooming experts, women can stay in a glossy permaprime, if they have the time and the money. Another friend, a rich one, said I must go to the high-profile celebrity hormone doctor, Marion Gluck, for her exciting array of tailored bioidentical hormones.

With the first appointment at £300, and with a bank of tests and prescriptions stacking up annually into the thousands, Gluck is a luxury beyond most women’s means. Even less, an attendant industry of cosmetic medical, spa and beauty treatments for women keen to preserve the polish that comes so effortlessly in youth.

Esther Fieldgrass, the owner of EF Medi-spa, recommends a phalanx of treatments for menopause including a testosterone cream for flagging energy and sex drive, £200; a “Femilift” for stress incontinence and vaginal laxity, £5,000, that lasts just two years; and prophilo injections to hydrate the face, £500 a few times a year.

As with too many things to do with women’s sexual health, it’s not just a feminist issue, it’s a financial one. Gaining access to experts is hard unless you are paying.

Even those with private health insurance can suffer from this. “Profoundly unfair insurers,” says Panter, “have decided unilaterally not to cover menopause. Even mentioning the word can make a claim invalid.”

Could there be some benefit to being a bit of a menopause-denier, then?

I admit, talking about menopause can be enlightening, but it can also make you on paranoid high alert for symptoms. Was that a hot flush or is it just a bit hot in here?

Tania Smith’s own experience of “menoconfusion” saw her found regular retreats, Menoheaven: “A space for women to get information, tools [like lifestyle changes] and support to make the menopause a positive experience and important transition when women can come into their power. Most women arrive completely confused and leave feeling heard and transformed.”

For her, “HRT is a male invention to keep women in a juicy, libidinous stay. If you want to stay a dumb blonde, go for it. I actually prefer life now.”

I asked a group of groomed women at a smart London charity dinner and the universal response was: “No way.” One, a late fortysomething consultant, a patient of Gluck’s, motions to her perfect body and bouncy hair saying: “If we can live another 20 years like this, why wouldn’t we?”

What is the menopause? Thrilling rite of passage, life-threatening chronic condition or some kind of foe to be fought at all costs? As Panter says: “If women had good information, they would be better placed to decide.”