We didn't know it was the menopause at first. We thought it was acute grief, depression, chronic anxiety and trauma. I'd just lost my dad, to the hell called cancer. So, it took a while to realise that something else was going on too.
The extreme weight gain was odd - I was eating less and exercising more, but getting bigger by the day. The exhaustion was crippling, no amount of sleep could solve it. The backache was relentless and no position could alleviate it. The anxiety and paranoia, was like having a alien living in your brain. I was simply unable to apply any kind of rationale to a situation, there was a primal rage and anger inside of me, with no where to go. But the the worst was still to come, after these initial symptoms, my brain simply shut down. The ability to give a sh*t about anything, the feeling of joy, of sadness, or any kind of feeling that required an ounce of energy, just went.
And with that came despair. A feeling of utter worthlessness, that I had never experienced before. A belief that the world was better of without me. I had absolutely no value to add to anyone, anywhere. In fact, quite the opposite, I believed that I was damaging my family and my friends - a f*cking noose around their neck and mine. No amount of objections to the contrary could alter my mind.
We tried therapy, anti-depressants - lots of them and HRT. Nothing made a difference. The symptoms just got progressively worse. I stopped exercising, socialising and stripped my life back to the bare minimum, to simply get through the day, which consisted of me getting the kids to school and then sleeping until I picked them up again. The weekends were bliss as my husband was home - then I could just stay in bed all day, everyday.
Eventually, we went to a private consultant. I sobbed as I told him, I simply didn't want to go living like this. It was a tsuami of desperation, that I simply could not come up from to get air. He listened, held my hand and smiled. And then he told me that it was ok. He knew why I felt like this - it was not in my head. I was not depressed, suffering from chronic fatigue syndrome, or any other kind of syndrome for that matter. I was having an early and severe menopause. The biological evidence was clear to see - it was all in my blood results. And that was the first time in over a year, that a glimmer of hope entered my life.
My consultant weaved together my blood results, to tell the story my body had been trying to. I was insulin resistant (insulin is one of our largest hormones, hence the massive role it plays in the menopause and the dreaded middle aged spread), my testosterone and oestrogen were virtually non-existent and my folic acid, vitamin B12 and vitamin D, far too low. We designed a phased approach. The first thing to tackle was the insulin resistance - a combination of medical interventions and diet and the vitamin deficiencies. After that we tackled the oestrogen and testosterone levels. And after that we looked at long term solutions, for controlling the insulin and fluctuating hormone levels.
It's been two years now. It has taken time to get all of the variables in balance and even now I have peaks and troughs. In fact, I'm writing this blog whilst I am in a trough. A trough consists of severe exhaustion, I cannot be arsed to do anything, I feel raw, anxious and inextricably sad. I know they usually last a few days and then pass. I say I know this, but in the trough I cannot relate to that fact, so my husband has to constantly remind me and that keeps the despair at bay.
I knew this trough was coming. For the past five days, I have felt more and more tired. Last Saturday I was my normal self, I swam 2 km in the lake, but on Monday, Tuesday and Wednesday, whilst I still managed to walk a few km each day, I was too tired to swim and had to nap each afternoon. By Thursday I no longer had the energy to exercise at all and today I doubt I'll even manage to get dressed. Tomorrow the trough may have passed, or not. If it's still here by Wednesday, I'll get some fresh blood taken, so my consultant can see where the imbalance is and then we can work out the solution. Until then, I have to accept that mother nature is bigger than me and go with the flow.
And that's the reality of the menopause. I'm 47 years old, my symptoms may well have to be managed until I'm 60 years old, or thereabouts, it's not an exact science. The problem is that we have have not evolved at the same rate as our environment. That means our brains require oestrogen to fire up our neurons, for longer than our bodies actually produce it. Eventually, my brain will get a software update and then it will be able to fire up the neurons, without the need for oestrogen. Until then, this is how it is.
Now, the really challenging thing about the menopause, is that it is different for everyone. Some women will sail though it, others will not. My diagnosis and treatment is unique to me. Each woman will have her own. A one size fits all solution - such as HRT is not enough on it's own. Each woman needs a much more sophisticated analysis of her symptoms and blood results, to truly understand the story her body is trying to tell.
I have no doubt that there are millions of women either suffering in silence, being mis-diagnosed as depressed or told to simply get on with it. I also believe that the rise in suicide related deaths, in the 40 plus age bracket for women, may well be linked to hormone imbalances. The menopause is about so much more than hot flushes and weight gain. It's not a matter of simply getting on with it. A severe menopause, left untreated, can have catastrophic effects for the individual and their families. I am not exaggerating, when I say that my menopause consultant, literally saved my life.
So, lets have an honest and uncensured conversation on this subject. The menopause can ruin your life - it's as simple as that. What I am learning as I battle my way through this phase is:
Do not be fobbed off with a one size fits all solution, get someone, somewhere to look at your blood results, with a degree of knowledge (for example, oestrogen levels should not be looked at in isolation of FSH and LH indicators, as these tell you whether you body is effectively having to shout for more oestrogen, if it is not getting enough. We must remember the oestrogen levels we are being compared against, are national averages, who really knows what our individual level needs to be in order for our neurons to fire).
Do not lecture people on whether they should take prescribed drugs to help them with their symptoms - that's between the medical professionals and them, no one else.
Do not underestimate the impact hormones have on a persons mental well being, it can result in severe depression which no amount of anti-depressants are going to solve, as it is a result of a hormonal imbalance.
Do not get frustrated or give up on someone going through a tough menopause, it can be a lengthy process with many peaks and troughs, you need to stay the distance. The person is still there, very often completely knackered by the effort required, to simply get out of bed each day.
Menopause is a significant transition in a woman's life. It may involve grieving for some and celebration for others. There is no right answer, so please don't try and apply one.
Don't shy away from talking about the menopause and how it really makes you feel. Own your story, use your voice and take your space. The menopause is not a weakness, a shameful secret or the beginning of the end. Remember when a female killer whale goes through the menopause, she becomes the leader of the Pod, she is revered for her wisdom, experience and strength. So, please keep thinking of yourself as that killer whale.
Sadly, I'm knackered now, so I'm off for a nap.
To anyone out there suffering in silence, or trying to support someone who is suffering, you are not alone.
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