You think you might be perimenopausal, but you don’t know what to do about it? Read on (you too menopausers!)
It’s fantastic that we are finally talking more and more about Perimenopause, but, how do you know if you are definitely perimenopausal and what should you do about it?
At 41, me and a few friends the same age, are noticing we are sharing some of the same ‘differences’; heavier periods, taking longer to properly come on our periods, more PMT symptoms, tiredness and the most common of all – brain fog. We chat openly about it, state that it “must be perimenopause” (i.e the very early stages of menopause) and then we move on. At no point do we ever conclude how we will treat the symptoms, we just accept them, as has always been done throughout the generations.
It is such an incredible step forward that the term perimenopause is so widely recognised and spoken about now, but the conversation shouldn’t stop there.
After a stressful year and the most annoying brain fog (plus, me doing that typical thing of not wanting to take up any of my GP’s time with a non-emergency) I went along to the beautiful Bronte Clinic in Sloane Square to discuss my symptoms with menopause specialist, Dr Samantha Brown. Dr Brown is also a GP but at The Bronte Clinic she can spend the time needed to unearth the roots to your symptoms. I tried to skip through a lot of the details of my stressful year but Dr Brown, listening so intently, knew which details needed more attention and encouraged me to explain more. Dr Brown didn’t make me feel like any symptom was trivial or something to put up with – I felt heard and understood.
The interesting thing is that there are SO many different effects of perimenopause and menopause but without having the luxury of a lengthy appointment time, all too often women are having the symptom rather than the cause treated. For example, for some women (note: some, not all), depression can be a symptom of menopause and rather than treating the depleting hormones –i.e, the cause, they are instead being treated for the depression – the symptom, which is not an effective long-term solution at all.
After our lengthy consultation, which felt more like a chat with a friend in a comfortable lounge (the Bronte Clinic have achieved the perfect balance between professional and cosy in its décor – making you feel totally at ease), Dr Brown thought I was showing some early signs of perimenopause but was also quite sure my symptoms were heavily connected to the stress I was under and my poor sleep pattern (i.e I go to bed at stupid-o-clock every night). To be certain, I was sent for some blood tests, all conveniently arranged by the clinic, and in the meantime was given clear advice on what I can do to improve my symptoms myself and how to manage my symptoms better; it was so good to take a small piece of control over what was happening to my body and mind.
My blood results came back quickly, and Dr Sam explained each part to me clearly – this is the first time I ever actually been helped to understand what exactly my blood results mean, and apparently, I should get my cholesterol results framed because they are so good! I’m now weirdly proud about my colesterol! In fact, everything on my bloods looked good, with the exception of my testosterone levels (yes women have and need testosterone too) being low which, you’ve guessed it, is in line with my perimenopausal symptoms. Dr Brown’s prediction, from her incredibly thorough consultation, were confirmed by the blood tests; my symptoms were mostly stress-related and exasperated by early signs of perimenopause.
So, the next part of my consultation was treatment. I, like many people, had heard scary things about HRT and I didn’t consider it to be something for women in their early 40s. I also didn’t think of HRT in a preventative capacity – I thought you had to wait for the hot flushes before you even thought about taking HRT! Dr Brown explained the different options (there are gels, patches and sprays to choose from) and more importantly, she explained the side effects. The side-effect I wanted facts on was the cancer risk. Now this will be a sensitive topic and ultimately, everyone has to make the decision that they feel comfortable with, but, newspapers and magazines had me believing that HRT gave you a hugely increased risk of getting cancer, the data however, shows a very different picture:
For example: Women aged 50-54 who are not taking HRT, on average 13-17 in 1000 will be diagnosed with breast cancer over a 5 year period. For women who start taking oestrogen-only HRT for 5 years, there will be 16-17 in 1000 cases (i.e an extra 0-3 cases) *data given Gedeon Richter.
This is just 1 example, the risks are also affected by the combination of HRT and the length of time you are on it, and any increased risk is still a large number when it comes to cancer, but I think it is worth knowing the facts, as propaganda had me believe HRT was incredibly unhealthy and dangerous (which it clearly is not!).
So, on Dr Brown’s expert recommendation, I opted for an oestrogen spray (1 pump on the inner forearm daily) and progesterone capsules at night to reduce health risks further (taking oestrogen alone causes the lining of the uterus to thicken which can increase your risk of endometrial cancer. Researchers have found that adding progesterone to hormone replacement therapy keeps the uterine lining thin, reducing the risk of cancer) as these 2 hormones can help to boost testosterone levels. I started my HRT journey immediately! I am looking at HRT in the same preventative way I look at skincare – I was using anti-ageing creams long before I actually ‘needed’ to, I had no wrinkles, but I wasn’t going to wait for a wrinkle to appear and then try to fix it. It’s the same with HRT, I am not prepared to wait for brittle bones, dry skin and low mood before treating it – I want to prevent or at least delay the signs of menopause for as long as possible – plus, the symptoms can creep up so slowly on you that you may just put everything down to growing older and end up delaying treatment. I know so many women whose relationships, jobs, self-worth was on the line due to late diagnosis and treatment – hormones can literally be a personality changer.
As for me, after 3 months use, I am starting to feel signs of improvement; I’m not forgetting every little thing (although I still repeat myself quite a lot) and I am feeling generally more ‘switched on’ but as the stress is still a major factor (selling and moving home straight after divorce and court is not fun, and I do not recommend!) I think my results will take a bit longer than most to present themselves. Some (a lot of) women say they feel like their younger self within weeks of starting HRT!
My recommendation is this; speak to a specialist – it can be a very emotional time in women’s lives – we have just figured out who we are and then we start changing! It is so important to receive the right advice for YOU, just like the contraceptive pill, it is not a one size fits all approach, and even if HRT isn’t the route for you, speaking to a specialist like Dr Brown will give you the support and information you need to understand exactly what is going on in your body.
However, it is worth knowing that, worryingly, there is currently a shortage of HRT in the UK, which Dr Sam talks in depth about on the Harley Street at Home Menopause Page https://www.facebook.com/harleystathome/ and also on her Instagram Page it has been a problem for some time blamed on by the increased demand for HRT (the possible silver lining of this could be
that more and more women are pursuing diagnosis, which is a very positive thing).
As for the Bronte Clinic, I could not fault it, they have got me back on track to feeling like my old younger self again! And btw, they also do tweakments, led by co-founder Dr Fiona McCarthy– a one-stop Doctor-led clinic to have you looking and feeling your best, inside and out? I’ll definitely be back!
Tel: 02034882582
Email: [email protected]
New Patient Consultation £300 (virtual consultations also available @ £275)