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Trees stood tall above me casting long shadows, the sound of the twigs snapping underfoot echoed, my skin felt cold and clammy and my breath fast, urgent and shallow. I was running away from something, unsure of what and fear raged through me. Then I woke, sweating, panicking, gasping for breath with palpitations and flailing with the bedsheets.
Another anxiety-dream. Another night broken. I thought the sleepless nights were long behind me now the small-folk were not longer so small. But no, mother nature has another plan.
I settle in for another few hours of racing thoughts, worries about worries, mental checklists and wide-awakeness. When I get up before my alarm my joints are stiff, some even swollen. I stretch, put the kettle on and mentally prepare for the day ahead. I try to take a few deep breaths and moments to myself before the chaos of the preschool breakfast drama begins. And then all systems go until its time for lights out again, and oh dear God I just cannot wait to get back to bed.
Everything that goes on in-between starts to feel like a chore. I have stopped laughing and goofing around with the kids. My temper is constantly frayed, and I can’t bear for my husband to even breath near me let alone comfort me.
Focussing and decision making at work is impossible: I double check things for fear of making a mistake. I cancel plans to see or speak to friends as I am simply too bone tired and engulfed by social-angst. No amount of caffeine helps as that just makes the palpitations and the crushing chest tightness worse.
Must keep my brave face on. But oh god, did I forget to lock the car? Did I remember to send the right kid with the right PE kit? Am I going mad?
I knew all too well what was starting. I recognised the signs. As a GP and menopause doctor I spend hours of my working day helping and advising other women experiencing similar symptoms of hormonal imbalance. Now it was happening to me. And yet, I found it incredibly hard to accept what was happening and ironically, found it even harder to get support. Doctors make terrible patients.
So here I am, a mum and a doctor struggling with my perimenopause and reaching out to any of you who may be going through similar.
Menopause is defined as the point at which a woman has not had a natural period for 12 months. The time after this is described as “post menopause” and the time preceding this is termed “perimenopause”.
During perimenopause we experience shifts in our normal reproductive hormones: oestrogen; progesterone and testosterone. This imbalance manifests as a broad range of symptoms. Post-menopausally, hormone levels are chronically deficient, so symptoms are more persistent.
Perimenopause is an ill-defined period that can last months, or years and can start without us noticing. Symptoms creep up. One or two vague things at first maybe, that we brush off or rationalise. Because we are busy, right. And that’s why we are tired, anxious and can’t think straight.
And we aren’t sleeping, so that’s why we don’t have the energy or motivation for things and have lost interest in sex. That is, if we managed to get that back again after the kids.
There are over 30 well recognised symptoms of perimenopause, several lesser-known and I am certain that we will come to recognise more in time. I have attached a symptom checklist at the end of this article that you can download and use to assess and track symptoms if this resonates.
“Average” age of Menopause is 51. However, 1 in 100 women will experience menopause before the age of 40 and 1 in 1000 women will do so before the age of 30. These are big numbers.
So, it is super important to be alert to it as a possibility and raise it as a question with your healthcare team. Women experiencing symptoms early require proactive treatment to reduce the risk of developing long-term health problems such as osteoporosis. The mainstay of treatment is “Hormone Replacement Therapy (HRT) with a combination of oestrogen, progesterone and testosterone.
We are all on our own personal journey with our own unique back story and have different thoughts around risks and benefits and as such, a 1-size-fits-all approach to perimenopause is not feasible or safe. We can start though, by opening conversations and sharing our stories.
Please join us on the Nourish App Instagram Live on World Menopause Day, Monday 18th October at 8pm GMT for a Menopause 101 and Q&A session where I invite you to ask me anything you like. I look forward to meeting you and hope I can help you outrun those nocturnal anxieties if you get them too….
About the author
Dr Fionnuala Barton is a GP, Women's Health Doctor and registered member of the British Menopause Society.
She is passionate about optimising physical and emotional wellness for women at all stages of life and has particular interest in early recognition and management of perimenopausal and menopausal symptoms, POI, PMS and PMDD.
She draws on a wealth of clinical and personal experience to provide an empathetic, holistic, personalised and proactive, evidence-based hormone therapy approach. Private 1:1 appointments can be booked directly at www.themenopausemedic.com or complete a contact form for group or corporate services."