I loved my 40s. I was living an expat life in Switzerland, work was good, lots of friends who wanted to explore and ski and have fun. Until it all came to a standstill in 2020 – my fiftieth year; when covid stopped the world. I was never looking forward to turning fifty. But I had hoped given the glory days of my 40s, that my energy would simply continue. Perhaps without covid it may have, but I’ll never know. It’s now 2 years on and I am 52 and have trouble associating myself with my age.
But regardless of my resistance to the number, I have changed, in mind, body and spirit.
Perimenopause hit me like a series of relentless sequential car crashes. First a dint in my previously perfect sleep cycle causing an inability to fall asleep and waking five times in the night, then the very unpleasant symptom of itchy skin – well more like a feeling of insects crawling all over me. I went to a Swiss gynaegologist who assured me this was all normal and ‘we’ all have to go through it. I begged and she prescribed progesterone which helped with the sleep. For my skin, I started lathering it in rich creams and taking antihistamines. I felt some ease in my body.
But the crash series was not over. The next set were rage-themed. I’ve always been a little impatient with a strong drive. The change was sudden, I became irrationally and constantly frustrated; huffing, puffing, ranting, stomping, yelling and swearing – all because someone was walking slowly in front of me. It felt a completely normal response. Actually it was my only available response to every single irritation that arose. I knew it was irrational but that awareness was simply not enough to curtail or redirect my negativity. God knows how many poor souls suffered that wrath – whomever you are I’m sorry!
I went back to my Swiss gynaecologist and begged for oestrogen. Reputable UK doctors were starting to use social media to extoll the benefits of HRT, so I was armed with data. Reluctantly prescribed Oestrogel – one pump per day. After not feeling any benefits and hearing from several UK friends taking 2-4 pumps, I returned to my Dr and she said in stern school mistress tone I could increase the dose to 2 pumps per day, but definitely not higher. I upped my dose and my mood rose as my patience window started to lengthen.
I was doing ok, I thought. So at the end of 2021 I decided to return to the UK, to leave the expat bubble life behind and make a home where I felt more at home, back in London. So I changed my job, country and house; all in a matter of months. This was not the first time I have done this, in fact it’s about the fourth.
But this time I simply did not cope.
Don’t use the M word (Part 2 of 3)
My return to the UK was met with the most severe round of car smashing. I was overwhelmed, paralysed, crying. And not just crying, but deep, long sobbing and howling. I couldn’t get things done. My heart ached from the loneliness. My old neighbourhood had changed – for the worse. My little crew of friends who had previously lived nearby had all moved, so even a simple walk or coffee date now needed an hour for each of us to arrive as well as 2 weeks’ notice. In Basel, life was more spontaneous and this sudden contrast thrust me into isolation.
My work and especially my work relationships suffered. My current role has its challenges and until then I had been able to live with them, but suddenly I had zero tolerance and no poker face. I became that aggressive reactive ‘Debbie downer’ that nobody likes. And I felt completely justified.
There was a heavy cloud sitting over me, and I became dissociated from my body and from everything and everyone around me. I simply could not connect. The only feelings I had were dark. And they scared me. Thoughts of suicide started creeping in and they seemed reasonable. I looked into options. Hanging seemed quite complicated. Overdose was unreliable. Stepping in front of a train was the most guaranteed and fastest option.
I had lost hope, inspiration and the ability to dream. There was one niggling thought; the mess I would leave my sister in sorting my affairs. I have bank accounts in 3 countries, property in London and no partner, so she is my next of kin and so would have to deal with it all. Frankly she did not deserve that.
My long standing therapist was becoming annoying and no longer helpful, so I cancelled her. But I knew I had to do something to stop the train platform becoming more than the increasingly loud whisper. I went to the GP and asked to be signed off for 3 weeks for ‘low mood’ and I booked an appointment with a Harley Street menopause specialist.
The time off saved me, literally. It was early November and there was a full Indian summer. Every day I reluctantly dragged myself out of bed, and went to a park or the coast. The open spaces, fresh air, unexpected sunshine and the sea started to inject me with micro doses of vitality. My mind had moved from dark to nearly neutral, still far from positive, but thoughts of train platforms were becoming less frequent.
My new gynaecologist said her treatment plan was to make me feel ‘fabulous’ again. I’ve never heard of that as a treatment aim, but I sure liked it! Confident that I needed additional forms of HRT to restore my energy and vibrancy, after some tests she prescribed testosterone and DHEA. These are both ‘off-label’ prescriptions, which means they do not have regulatory approval for this condition. The gynaecologist and I made the informed decision to take them. It’s been nearly 3 months, and on her fabulous scale I have shifted from 0 to a strong 6 out of 10.
Don’t use the M word (Part 3 of 3)
In addition to my new ‘full spectrum’ HRT, I also started working with a new therapist. My personal trainer became a bit of a confidant, and had praised the benefits of EMDR therapy, which enables the processing of old (trapped) trauma memories that cause repetitive negative patterns. With nothing to lose, I looked for a therapist who used this approach. I contacted 6 before I found one taking new patients. My childhood is another entire story, and not a happy one. Through the EMDR it became clear the dissociation I had been feeling as an adult was a coping mechanism I developed as a child which had protected me well at that time, but it also meant I had eighteen childhood years of unacknowledged fear, sadness and grief tightly confined and unprocessed in my body and mind. Peri-menopause had made this approach of dissociation no longer tenable. My wounds of the past had never really healed and were now leaking. That is what I had been feeling in the last few months, not simply the physical symptoms of low hormones but with the associated drop in energy and drive, my ability to put up a wall of indifference to my feelings was gone. That trapped turmoil of my past needed to be acknowledged and worked on, until then, I had no idea it was even there. EMDR therapy is unusual, but it’s doing something.
I am feeling better
I am feeling lighter
Hope is starting to be a more regular visitor
Do keep talking
My story was tough to write, but I know I am not alone. I found the way through my darkness with medical and psychological assistance and also by eventually asking my friends and family for help. From the latter, there was disbelief, and it took multiple conversations for some to eventually understand that ‘strong and capable’ Kate had lost her superwoman cape. Admitting I was not coping was also very difficult and brought feelings of shame and embarrassment. But sometimes the only way out of situations is through them.
We have only recently broken the taboo on discussions around infertility, childbirth and postnatal depression. It’s time to do the same with menopause, especially as it is inevitable for 50% of the world’s population.
Our population is ageing and there are 4.5 million women aged 50-64 in employment, so dealing with menopause in the workplace is an urgent topic. We need to talk about this and we need to create communities and structures of support.
If you know women in this age range, be aware of differences or changes in behaviour and be curious rather than dismissive. It’s too easy to turn your back and label a woman as ‘reactive or aggressive’. This will not help and it is not kind.
Please notice, please listen, please offer kindness.
Edward Tilt, author of the first full-length book on menopause in English – The Change of Life in Health and Disease, thought that menopause could cause alcoholism or mania, and could even make women murderously violent. My experience aligns with his observations.
By Kate Monro