When I was a teenager and starting my own journey into woman hood, if you had asked me what I knew about menopause I would have said it is something you get when you’re old, cross, have hot flushes and generally past your sell by date.  That was over 30 years ago. When I asked my 15-year niece what her perception of the menopause was, she replied in a similar manner as I had done all those years ago.  So clearly, we have not moved on that far when it comes to education about the menopause.

My own personal experience of the menopause until recently, was limited to working with clients and supporting them to make nutritional changes and manage their menopause symptoms (of which there are 34).  

I am in my early 50’s and haven’t had a period for almost a year. I suppose I have been a little smug when I listen to my girlfriends’ moan about hot flushes and brain fog.  I didn’t think I had any menopause symptoms. I put that down to eating a nutritionally balanced diet and exercising  most days. 

I think if you asked my husband he would not have agreed. He would say that in the last four years I have been more emotionally volatile, vulnerable and unpredictable. I had struggled with muscle pain in my calves, thighs, shoulders and my joints could feel stiff when I got out of bed in the mornings. I put it down to over exercising and ageing. My ability to go to London for the day without having to find a loo became something of the past. 

In the last few months have could have written the good loo guide as I must plot my day around where I can easily stop. I should have known better. Joint and muscle pain are a very common symptom of menopause, and as we have oestrogen receptors in our bladders it’s very common to experience bladder issues. The last four years have been challenging for me. My Mother was very ill and subsequently died, so I had put my emotional stress down to challenging circumstances.  I had failed to see that although I was sad, my hormone levels were decreasing and not helping with the way I dealt with the situation.

When working with a client, I always urge them to keep their doctors in the loop. Getting things right is a three-pronged approach and medication can be part of that.  I found myself at a crossroads. I have all the evidence that HRT is highly effective and have seen the severest symptoms relieved in 48 hours but is it for me? I have no issues with taking medication, (I took the contraceptive pill for years), so what’s the difference?  If I had a thyroid problem, I would be prescribed thyroxine and if I was diabetic, I would take insulin, both of which are hormones.

When you hear the phrase HRT uttered, it’s very easy to think ‘breast cancer’. We read inflammatory headlines in the papers that make us question whether we should be taking it. HRT is not just about breast cancer. Numerous quality research has shown that women taking HRT have a lower risk of heart disease, osteoporosis, osteoarthritis, type 2 diabetes, depression, dementia and bowel disease. All these diseases increase in women who have gone through the menopause and have low hormone levels in their bodies.  As far as risk, the evidence is clear; for the vast majority of women under 60, the benefits of HRT outweigh the risk.

The Menopause is still a taboo subject. I see women talking more readily about it, but many men are uncomfortable and would shy away from entering any menopause chat. Perhaps it’s because many years ago, women had the menopause at about 57 and then died a couple of years later. Now we live so much longer. 

We also need to consider that in living longer, we will always have the menopause. I have clients who say to me “I will struggle with the symptoms until I am through it”. The fact is, menopause is a female hormone deficiency we will never naturally replace the oestrogen, progesterone and testosterone are bodies have produced previously.

One thing I often come across is misdiagnosis, particularly with depression. I have clients who come to me who have been prescribed anti-depressants which have left them feeling no better because its oestrogen that they need.  I have always been very lucky with the doctors at my surgery, but many are not so fortunate.  Doctors are time short and menopause and perimenopause are often missed. I encourage patients to research menopause and present their doctor with their findings. Every woman should have access to evidence based, non-biased information that will empower them to make a choice as to whether HRT is for them.

Nutrition and exercise are so key in the management of menopause symptoms, however when you are feeling unwell, and lacking in energy exercise, preparing healthy food can just feel unachievable.  It’s often when HRT is introduced that I see clients  starting to feel stronger, turn to a better exercise routine and want to eat a healthier diet.  Low mood, lack of energy, depression can lead to wanting sugary and comfort food. It becomes a vicious circle, needing a sugary pick up, weight gain, depression and back to the biscuit tin!

 I urge my family, friends and clients in fact everyone to educate themselves, your partners, males and females alike, your children, so you can support each other.  Learn about your anatomy so that you can spot the changes and irregularities when they occur. Talk openly with those around you. Arm yourself with the knowledge that will help you recognise the signs and symptoms of menopause so when and if you need it your will feel armed and empowered to ask for the help and support you need.

Menopause is a completely normal and natural event that every women will go through, yet it can still feel shrouded in secrecy, however I do feel slowly we are starting talk about it more and get it out into the open.