12 minute read
LET'S TALK MENOPAUSE - Special Feature
With her Sex Myths and the Menopause documentary, Davina McCall has turned a taboo on its head.
Mariella Frostrup had started the debate back in 2018 – but Davina shouted it from the rooftops and urged us to do the same.
Dr Liz Stephens, sexual and reproductive health consultant, applauds Davina McCall and other menopause campaigners.
LET’S TALK MENOPAUSE by Jackie Rankin
Even in this enlightened age, vaginal dryness and lost libido are still far from making the list of after dinner conversations – or any other conversation, except maybe among (very) close circles of women of a certain age.
Community sexual and reproductive health consultant Dr Liz Stephens watched the documentary with her husband and teenage son (more about that later).
It brought her joy. She‘s campaigned for more awareness and better services since the 90s.
“To see Davina really covering the big issues was fantastic. She’s articulate and successful, so showing that level of honesty about subjects that are still taboo has opened people’s eyes and empowered women to be more open about what’s happening to them.”
Liz is frustrated, not just by the lack of discussion, but a reluctance among decision makers and employers to recognise how much menopause impacts on society.
Back in the 90s, as a doctor in one of the country’s few specialist menopause clinics in London, she saw how dedicated services could dramatically improve lives. Now a consultant in Mersey Care’s sexual health services she says not much has changed and services are still not joined up.
“There’s a real shortage of medical specialists and menopause services still aren’t regularly commissioned. Women are balancing work, family life, elderly parents and the symptoms of menopause. It’s not reasonable to expect someone experiencing significant symptoms such as sleep disturbance to fully function at home and in work without support. It’s about flexibility, being able to say, ‘I’ve had a bad night’s sleep and I need a couple of hours’. We could all do a lot more.”
At 52, she’s now able to draw on her own experiences - and she’s refreshingly honest. “I’ve always been able to sleep, function well, and speak confidently in public. Now I’m having sleep disturbances. When I’m in meetings I’m often struggling to find the word I want to say.
"I’m on hormone replacement therapy (HRT) which has helped. It’s enormously frustrating how women are suffering because they’re embarrassed to tell their GP, or they’ve been refused treatment. They go on struggling when we could help them.
“Lack of oestrogen can affect tissues and contribute to prolapse and bladder leakage, and many women feel uncomfortable talking about urinary incontinence. Contraception is still an issue – conception rates are rising in women over 40. Being pregnant at 48 can be disastrous for a woman. We need to take a more sensitive approach so they can share their concerns.”
GP Louise Newson has stimulated wider debate on openness about menopause and HRT.
Davina McCall
She’s infuriated that women are being unnecessarily denied HRT and supports GP Louise Newson and MP Carolyn Harris (see page 7) in their national campaigns to offer HRT as standard, and to stimulate a wider menopause debate.
“National best practice guidance is very clear – there’s no need for blood tests on women over 45 who have symptoms. If they have symptoms then they are menopausal. Talk to them about what they want to do – it’s that simple.”
“I’m not saying HRT is the answer for everybody – you should always start with your own lifestyle and what you can do to help yourself. But that’s sometimes not enough. If we take a detailed medical and family history, and there are no risk factors, then a trial of HRT could help.
“You have to take a balanced approach, but it’s not right that a woman who is symptomatic and desperate should not have access to a discussion.”
Liz wants to see more education in schools for both sexes. “It’s a cruel irony that as teenagers are going through adolescence, their mums are going through menopause.”
And she’s right behind Davina in calling boys and men to be supported to help the women in their lives.
“I asked the men in my family to watch Davina’s programme with me. They replied ‘what’s it got to do with us’? I said ‘everything’! So they did, and I was proud.”
MORE INFORMATION
For more information on the menopause, symptoms and treatments go to: Menopausematters.co.uk or visit: nhs.uk
WE SHOULD ALL WEAR THE BIKINI by Jo Henwood
Jo Henwood
“You’re really grumpy, you ought to get on HRT” said my mother. She didn’t say ‘really’ – she swore with gusto – but you get my drift.
To be fair to me, that conversation happened as she lay in a hospital bed in my house, rigged up to an oxygen machine in what I now know was the last few months of her life. My daughter was about to sit an A level, I was managing a stressful job, my husband was working away. And I was menopausal.
‘Grumpy’ did not quite hit it.
The trouble with the menopause is you never know when it’s coming, and it happens alongside other stuff – parents’ declining health, teenage hormones.
Mix all that with a cocktail of dry eyes, dry mouth, dry vagina, brain fog, lack of sleep or any of the other 34 symptoms and it’s a wonder one makes it through the day, never mind book an appointment with a doctor.
In the midst of terrible grief of losing my honest, loving, feisty, hilarious, sweary mum, I found myself in the surgery, discussing my options for HRT.
My periods hadn’t stopped – in fact some of them were so heavy I couldn’t leave the house. Yet I was only in ‘perimenopause’, a vague term meaning around the menopause, a phase that could last for months or even years, along with the heavy periods.
My doctor advised patches – I have coeliac disease so it would avoid stomach absorption issues. I opted for the Mirena coil to help with the bleeding. I’m lucky, my doctor recognised and understood the condition, and was prepared to prescribe drugs. Five years on I’m still experimenting with doses.
But I have a new dilemma – do I wear my favoured bikini on the beach with my patches on full view? The sisterhood Twitter has been alive with ‘wear the patch – wear the bikini,’ ‘think of it as body art’ and the pragmatically put ‘the HRT generation are invisible to the general population so wear what you want’.
What would my mother say? ‘Wear the b****y bikini!’
SYMPTOMS OF THE MENOPAUSE
As well as irregular, painful periods symptoms of the menopause may include...
Stress
Acne
Thinning or loss of hair
Constipation and diarrhoea
Breast tenderness
Weight gain
Difficulty sleeping
Excess facial and body hair
Decreased sex drive
Depression
Headaches
Changes in blood pressure
Vaginal Dryness
WHY THE SECRECY? by Sophie Brown
The menopause is a hot topic for women over 40 – but only among themselves.
Why aren’t partners and family members prepared for the knock on effects of living with someone going through it? Why aren’t young women prepared for what’s to come? And why are we still turning to Google for advice?
Sophie Brown, Digital Communications Officer at Mersey Care NHS Foundation Trust
As naïve as it sounds, I knew nothing on the subject until my mum began her ‘change’. No school subject covered this. My friends didn’t discuss it.
What I was least prepared for was the deep emotional turmoil, the confusion whether there’s something really wrong. I wonder if other young women (and men) feel the same. We’re suddenly thrown into watching our strong, independent, resilient mothers knocked down by something they say is ‘normal’ and are unable to help them.
I think back to the countless appointments, medications and side effects, which were not only overwhelming for my mum, but for all of us around her. Some symptoms – hair thinning is an example – are so drastic, yet families and friends still don’t make the connections, and how can they with no prior knowledge?
With a male manager and no workplace support, is it any wonder my mum’s daily struggles left her emotionally and physically drained by the time she got home from work?
Kathie Cooke, a menopause specialist at Liverpool Women’s Hospital has met many women who simply stop coping. “Through fatigue from sleeplessness and anxiety about severe flushes they lose a sense of self and become withdrawn... isolated... depressed.” Her role is to give women
the sense that they’re not alone and their feelings are not only justified, they are completely normal.
There seems to be a great gap here, one which Kathie alone cannot fill. The situation could be so much different if we were prepared and had basic knowledge of side effects and how to deal with them.
Right now we’re still searching for the answers. And our wives, mums and colleagues are suffering alone when they don’t need to.
THE HIDDEN SYMPTOMS
Writer Tamara Lawrence reveals some menopause scenarios only close friends would share.
• ‘I’ll DM you my thoughts – if I remember, my fingers aren’t too fat to type and I’ve finished plucking my chin.’ Kate, financial services administrator
• ‘Road rage – if someone blocks me in the red mist descends’. Ellie, mum of three
• ‘Severe joint stiffness as well as the general aches and pains. I thought I was working out too hard, but my GP said it was a symptom’. Sally, a personal trainer’
• Heartburn. ‘Everything I ate seemed to sit on my chest, or make an attempt to reappear later.’ Liz
• Anxiety. Successful women who have raised families, held down jobs and ‘kept it all together’ for years describe feelings of unease, inadequacy or loss of confidence.
What can be done?
‘Talk about it,’ says Kate. ‘Knowing other people are experiencing these things gave me the confidence to go to the GP and get help.’
READY FOR REVOLUTION?
Timpson’s Director of Happiness Janet Leighton (right) and colleague support worker Laura Garside are leading the company's wellbeingstrategy around menopause.
Joel Goodman
If a Welsh MP gets her way, hormone replacement therapy (HRT) will be free to every woman in England who needs it.
IS POLICY CHANGE THE KEY?
Swansea East MP Carolyn Harris is spearheading a campaign to improve policy around menopause, and make HRT exempt from NHS prescription charges in England. Prescriptions are free in Wales and Scotland but women in England are still paying for pills, patches, pessaries or gels.
Launching the #MenopauseRevolution, backed by Davina McCall, Carolyn Harris said: “I know from my own experience that for too long, menopause has been overlooked in so many policy areas, from the workplace to healthcare.”
At Timpson, no one is overlooking menopause and it is high on the agenda. Originally cobblers and shoe menders, the Timpson team was traditionally male but following the acquisition of Max Spielmann, Tesco photos and Johnsons Dry Cleaners with predominantly female workforces, the balance of the sexes evened out.
According to the Faculty of Occupational Medicine almost eight out of 10 menopausal women are in work and, according to the CEO of Timpson, James Timpson, it is important to keep them there. Writing in The Sunday Times he said: “It is important women are assured that if their work is affected [by menopause], they won’t receive a warning letter or a P45.”
With symptoms like poor concentration, feeling low and tiredness, the menopause can cause problems for any woman worker. Excessively heavy periods and hot flushes can also be excruciatingly embarrassing.
Swansea East MP Carolyn Harris
Timpson’s aptly named Director of Happiness Janet Leighton says that their key is an open culture where people aren’t afraid to talk to their team manager about anything that is bothering them. There is a regular wellness email, a wellness page in the newsletter and every week James distributes a three-minute video to all colleagues via WhatsApp. The week Janet spoke to MC Magazine, he had chosen to talk about the menopause.
“He doesn’t profess to be an expert on the matter but it just prompts everyone to think about it.
“The menopause obviously affects women but the young men on our team have got mothers and the older men have wives or sisters who might be going through it so they all need to understand more about it.”
Colleague support worker Laura Garside is leading the company’s wellbeing strategy around menopause.
She said: “There is a lot of information for teenagers about puberty when they are at school and then again when a woman gets pregnant. The next major change for women is the menopause and there is very little support or discussion about what is, after all, a natural process.”
“Our area managers and development managers know their teams and we encourage everyone to be open about anything that is bothering them. The more they know about the menopause and the more they understand, the easier it is for them to open up that conversation.”
• The Menopause (Support and Services) Bill will get its second reading in Parliament on October 29 this year.
THE MEN IN MENOPAUSE
Working in a female dominated workplace can be tough for any man, just as it is for women if the tables are turned.
Dwayne Johnson, Chief Executive at Sefton Council
But the chief executive of Sefton Council on Merseyside is taking steps to understand more about what makes women tick, or not tick, when they reach menopausal age.
Dwayne Johnson took up the gauntlet laid down by Active Workforce to join a men only session to find out more about how the menopause affects women.
Dwayne said: “Local government is nationally a female dominated workforce with an average age of around 40.
“This means a significant proportion of our workforce will be affected by menopausal symptoms during their working day.
“There are so many employees suffering without any support or understanding, resulting in absences from additional anxiety and unnecessary stress and that is why Sefton Council has introduced a policy so people understand the issues and how we can support people.
Husband and father Dwayne added: “As a male employee, it is important to understand the menopause, recognise the symptoms and be aware of the treatments to be able to support female colleagues.
“Men can make a difference in the workplace and at home!”
