At the age of thirty-seven I had not anticipated being thrown into the menopause practically overnight. The ‘change’ was something that I had always associated with much older women but I felt that when the time came, I would take this natural part of the ageing process in my stride. Perhaps I would not have been quite so smug if I’d known what was just around the corner.
My menopausal journey really began when I was diagnosed with breast cancer. After undergoing radiotherapy and chemotherapy treatment I was offered an oophorectomy (removal of the ovaries) and was put on the drug tamoxifen. As some breast cancers feed on oestrogen, it was felt that my best chance for long-term survival was to remove as much oestrogen as possible from my body. I accepted the treatment readily and with my eyes (reasonably) wide open as to the consequences. There would be no more babies. There would be hot flushes and night sweats. There was the likelihood that libido would diminish. And there was the increased risk of osteoporosis. All of these symptoms and more, yet to me it was a chance to prolong my life and I was more than prepared to accept the side effects. What I wasn’t prepared for was the speed at which the symptoms hit me. What should have been a gradual process of adjustment became a crash course in coping with an emotional and physical roller coaster ride.
My experience of the menopause may have been sudden and unexpected but I believe it’s a fair reflection of what many women go through. It’s not exactly a taboo subject but it is something that women don’t always feel comfortable talking about, and certainly not a lot of men.
On the physical side, the hot flushes began almost immediately. I can only describe the sensation as having an internal thermostat that has gone haywire. Outwardly you may look perfectly fine but inwardly you feel like you’re burning up. The night sweats can be both uncomfortable and terribly tiring, with profuse sweating posing additional challenges. This nocturnal wakening disturbs normal sleeping patterns and it can often be difficult to drift back off again.
The biggest physical threat for women of menopausal age and beyond, is the risk of osteoporosis (brittle bone disease). This is due to a reduction in the levels of the hormone oestrogen which protects the bones by slowing the loss of calcium. Hence the need for menopausal women to be careful about their diet and to eat calcium-enriched foods – calcium is perhaps the most closely linked nutrient to bone density. I regularly undergo straightforward bone density tests at my local hospital and am pleased that I’ve maintained an acceptable bone density level, attributed partly to a regular exercise program, I expect.
Then there is the emotional side of things. Let’s not underestimate how big an effect these symptoms have on our lives. It is something that I have honestly had more difficulty coming to terms with than all the physical symptoms put together. It is well documented that post-menopausal women can become depressed and irritable, with lack of concentration and mood swings thrown in for good measure. The knock-on effect can take a heavy toll on any relationship and it often requires a strong partnership to weather the storm and come out the other end. Certainly, there needs to be a willingness from both parties to understand the nuances in behaviour that the menopause can bring with it. And the problem with a premature menopause is that these events can happen perhaps twenty years ahead of time.
The treatment hailed as a proven effective solution for menopausal symptoms is, of course, Hormone Replacement Therapy (HRT). Many women find that it’s the only relief from a very difficult and often long term problem but for me, taking HRT was not an option. My oncologist’s advice was that with my particular medical history, it would be unwise to consider any form of therapy that was oestrogen related. So I shall never know whether or not it would have worked for me, but I do know that it has transformed the lives of others.
If you’re a woman reading this, perhaps you can identify with some, or all, of the symptoms I’ve described. And if you’re a man (more likely on Slugger, I expect) who didn’t automatically switch off at the outset, then hopefully you’ll have a better understanding of the challenges involved for your partner or spouse. Please try to be patient and understanding. The menopause can be very challenging for any relationship but is made easier by both parties being both honest and informed, and making compromises.
While I bemoan the fact that I had the menopause prematurely, I do try to concentrate on making the most of my life in the here and now. And that includes writing about subjects like the menopause which can often be uncomfortable for some, particularly in the predominantly male domain of Slugger O’Toole. But it at least gets things out in the open.