‘Scuse me while I go through organ failure.
After all, that’s exactly what menopause is.
There’s no cure. Though I’m not supposed to panic, because it’s not life threatening. And although this organ failure is wreaking havoc, I’ll never be considered for transplants.
That’s because this particular organ failure is considered a “natural process” so for the most part, I just have suck it up.
Bloody menopause
The term ‘menopause’ comes from the Greek word ‘pausis’ (pause) and ‘mēn’ (month) to mark the end of monthly cycles. Most of my life I’ve thought that this ‘pause’ sounded pretty innocuous. No more periods? Hurrah! That’s an extra $235ish a year I’ll save on period products, right?
I wish it were that easy.
What’s become more obvious recently is the massive impact menopause can have on women’s lives. A whopping 85% of women report unmanageable and life-altering symptoms, sometimes for up to a decade. Some, for most of their life.
Despite menopause being seen as a natural process of ageing, the reality is that menopause affects almost every single bodily function, and rarely in a good way. And in case you’re wondering if men go through something similar. Most don’t. Yes, andropause is a thing, but it only occurs rarely and with far less symptoms than menopause.
(Peri) Menopause and me
I had a moment the other day. I found myself envying the fit-looking 40-year-old women who were working out in my front driveway. How can it have been 2 years since I’ve managed to drag my ass out there for more than a couple of weeks before having it handed back to me and collapsing in a state of fatigue.
I’m told (often) that there’s no excuse — the gym is right there for goodness’ sake. My husband, one of the best (and most humble) CrossFit coaches I’ve ever come across ready and willing to take me on. The kids are old enough to survive without direct supervision for an hour. Why don’t I just turn up and work out?
7 years ago, I was getting up at 4.30am 3 or 4 times a week to workout. I felt vital and strong. Now, I’m tired. All the bloody time. It takes all I have just to get through my workday and have enough energy left over to walk the dog, be a Mum and have the odd catch up with friends.
In the past 12 months I’ve had a lung function test to try and figure out why I’m finding it so hard to breathe. I’ve had an echocardiogram to see if my occasional heart murmur and palpitations are a symptom of something more serious. I’ve had my bloods done to check iron and hormone levels. I’ve had an ophthalmologist appointment to make sure my blurry vision and ‘floaters’ aren’t caused by physical damage. And physio for shoulder pain. Thank goodness everything’s testing fine. But I’m still experiencing all these seemingly unrelated symptoms and more.
I’m eating well, taking supplements, doing gentle exercise, and generally trying to ‘be’ healthy. I’ve tried kinesiology, massage, and acupuncture and still, the thought that’s most often in my head these days is “why am I so bloody tired?”
Now I must acknowledge how lucky I am to have access to excellent healthcare and complimentary treatments. I’m in otherwise good health. So, I don’t want to make light of what some people must face with detrimental organ failure. And I know many people experience far worse symptoms than I have to date. But I still really wish there was more we could do to help people experiencing menopause, or peri-menopause symptoms. Or at least acknowledge how hard it can be.
Why menopause = organ failure
In a healthy adult female body, ovaries are produced and release eggs (ova, oocytes) into the female reproductive tract during each menstrual cycle. The ovaries produce female hormones: oestrogen and progesterone as well as male hormones: androgens.
These hormones affect almost every process in our body, directly or indirectly. For example, a reduction of oestrogen can result in an increase in cortisol (our stress hormone) which regulates blood sugar levels and blood pressure etc.
From about the age of 35 onwards, some women experience perimenopause, in other words a slow decline in ovarian function leading towards menopause. This is when things start to get a bit shitty for some people.
During menopause, the ovaries literally shrivel up, stop releasing eggs and quit making the hormones estrogen and progesterone. This is apparently when the shit really hits the fan.
Menopause symptoms
Disclaimer, this next bit makes for grim reading. I’m going to list some of the symptoms of menopause that have been recorded in research. I’m quite sure this list is not exhaustive as every woman will experience menopause differently. Some lucky few will sail through with only one or two symptoms and some other poor devils will suffer a gamut of tortuous bodily failings.
Overall, menopause affects the cardiovascular system, central nervous system/brain, breasts, digestive system, hair, lymphatic system, mucous membranes, musculoskeletal system, reproductive system, respiratory system, urinary tract, skin and more. I wish I was exaggerating.
- Acne — yep, as if puberty wasn’t painful enough, some of us gotta go through it again in our 40s/50s!
- Allergies — some people experience an increased immune system response probably due to increased overall inflammation.
- Anxiety — sometimes linked to depression, irritability, and sleep disturbances.
- Bloating — a hormonal imbalance throws the regulation of body fluids and sodium content off. More oestrogen often leads to water retention, while less progesterone can have a diuretic effect.
- Brain fog — problems concentrating and/or memory loss with potentially long-term brain degeneration.
- Breast pain — and loss of breast fullness.
- Burning tongue — can affect the tongue or the whole mouth.
- Cardiovascular conditions — increased risk of heart disease, high blood pressure or stroke. Heart palpitations.
-Cellulite — as collagen production declines/ deteriorates, the worsening connective tissue means cellulite becomes more obvious.
- Chronic pain — more likely to have chronic pain, e.g. fibromyalgia, migraine & back pain.
- Depression — Experienced by 70% of women during perimenopause vs 30% in premenopausal.
- Dry mouth — with increased thirst and potential for dental problems.
- Ears — tinnitus and reduced hearing
- Electric shock syndrome — literally electric shock sensations in the head and skin
- Fatigue — often described as persistent and severe enough to significantly affect quality of life.
- Fluid retention — heavy legs, bloating, “fat fingers”.
- Foot pain/ peripheral neuropathy
- Hair loss — thinning, brittle hair.
- Unwanted hair growth — almost everywhere else, especially facial hair.
- Headaches — Migraine-like headaches
- Hot flushes/flashes — can last beyond the age of 80 years FFS.
- IBS symptoms — bloating, constipation, diarrhoea, heartburn, vomiting and lactose intolerance.
- Immunity decreased — more susceptible to common cold/flu or autoimmune conditions.
- Insomnia — restless nights, broken sleep. Waking at 3am.
- Irregular periods — sometimes that means extra periods, sometimes it means missed periods, or long gaps between. Sometimes with unpredictable/ heavy bleeding
- Joint pain — e.g. Japanese women report more midlife shoulder pain.
- Liver disease — increased risk of non-alcoholic fatty liver disease, fibrosis & cancer.
- Low libido — decreased sex drive, reduced frequency and less orgasms.
- Lung function — Reduced lung function and breathlessness, similar to smoking 20 cigarettes a day for a decade.
- Mood changes — irritability/ anger. Reduced serotonin.
- Muscle pain/ tightness
- Night sweats/ chills
-Odour — increased B.O.
-Osteoporosis — increased risk of fractures or breakage.
- Restless legs — Nearly 70% of women experienced worsened RSL symptoms.
- Taste changes — a bitter or metallic taste in the mouth.
- Urinary tract — e.g. frequency and urgency of urination and greater risk for urinary tract infection and prolapse.
- Vaginal changes — thinning tissues and dryness increases risk of tears, bleeding, injury and pain during intercourse.Change of pH can lead to yeast infections and/or smelly, watery vaginal discharge.
- Vision disturbances — blurry vision, dry eye, glaucoma, and/or cataracts.
-Weight gain — extra total body fat and an increase in tummy fat, damn it.
It’s A LOT, isn’t it? And I’m quite sure I’m missing something? That’s brain fog for you.
Is Menopause slowly starting to gain recognition?
Of course, women have been going through menopause forever, but I still feel like I, and many of my friends, were unprepared for this onslaught of symptoms. I know of people who’ve spent thousands of dollars on ‘natural therapies’ to manage their symptoms with little to no evidence of benefit. Many have even resorted to self-medicating with diabetes meds to control their weight gain. Clearly, many of us feel very unsupported.
So why do I — an ex-nurse, with an older sister, plenty of female friends and working with women every day feel like everything I’m learning about menopause has been a voyage of desperate discovery? Beyond hot flashes and weight gain, I really was almost completely ignorant of 90% of these symptoms. Why the hell aren’t we warned? Why isn’t there more support? Why isn’t EVERYONE talking about how shit it is?
I have some theories! Maybe we just have it a little harder than in previous generations? With more of us in full time work and still juggling family commitments etc. Perhaps the exhaustion is an extension of our busy lives and so our symptoms are understandably worse. Or at least, they’re harder to hide in our more public lives?
Perhaps it’s a fallout from the fact that pre & peri-menopausal women have only relatively recently been included in clinical trials with any consistency and so we have a lot of catching up to do?
Or maybe it’s just that women’s health, especially the icky parts of it, are still taboo? My hubby who glanced over this, wondered that I was so happy to “overshare”. I firmly pointed out that this is the whole idea. We must share our collective experiences. Isn’t it only by speaking up, that we can properly address the problem?
ABC recently reported that “Menopause is estimated to cost Australian women $17 billion a year in lost earnings, super”. The Australian Institute of Superannuation Trustees (AIST) is calling on the federal government to look at how menopause affects women’s employment, retirement decisions and superannuation. It’s early days, but so encouraging that the conversation has started!
Menopause treatments
The good news is that there are treatments to manage most of these symptoms, and research in the area is improving (eventually). I’ll list some treatment options here, but please, please book yourself in for a long consult with your GP to discuss what options are best for you.
Menopausal hormone therapy (MHT) or hormone replacement therapy (HRT) is designed to replace the hormones your ovaries have stopped producing: oestrogen and progesterone, and sometimes testosterone. Many women find it very effective for treating many of the symptoms of menopause. Your Dr will discuss dosage options and any contra-indications.
HRT can be administered as oral tablets/capsules, skin patches or creams/gel or spray for skin and/or vaginal creams or pessaries.
Anti-depressants
If/when your GP suggests anti-depressants, that’s not them telling you that “it’s all in your head”. With menopause our serotonin production can be affected, and there’s great evidence that anti-depressants can help with mood disorders during menopause.
Complementary treatments
- Lifestyle modifications, e.g. quitting smoking cessation and exercise
- Mindfulness/Cognitive behaviour treatment/ meditation
- Traditional Chinese medicine/acupuncture
- Massage/ Endermologie
- Consider taking herbal remedies, e.g. black cohosh, dong quai, evening primrose, hops, Korean ginseng, linseed (flaxseed), red clover, St John’s wort and wild yam. Remember that even “natural” supplements are really chemically derived treatments and can cause health issues and/or interact with other medicines, so don’t just take stuff willy-nilly. Consult a qualified naturopath and/or GP first.
Menopause resources:
https://www.menopausecentre.com.au/latest-studies-research/
https://www.healthdirect.gov.au/menopause
