The menopause, I am in my mid fifties and it is still a mystery to me. During my peri-menopause my periods got heavier and my migraines became much worse but, since then, I haven’t really had any symptoms. Or have I? I wake most nights feeling hotter than the surface of the sun and I sleep terribly, I’m usually awake between 3am and 4am. Then, in my research about preventing dementia I heard one Podcaster, Max Lugavere, whose mother died in her fifties from dementia, speak about how HRT can be an effective tool in warding off cognitive decline. I decided to undertake some rather belated research into HRT. Very few of my friends take it. Some of them have concerns about the increased risk of developing certain cancers and some are simply reluctant to take artificial hormones. Woman spend a third of their lives in menopause yet many of us really don’t know how to handle it or are even afraid of it. It seems to be viewed as the end of us being young(ish) and the first step on the path to decrepitude. Women past child bearing age are definitely less visible in society overall.

Some symptoms of menopause are well known, mood swings, insomnia, hot flushes and brain fog but I was blissfully unaware of some other potential issues such as the inner labia shrivelling once the body’s oestrogen supply is depleted. I have noticed that one or two of my friends have already begun to look slightly frail and post-menopause there is commonly a loss of muscle mass. I have definitely become a more anxious person during the past decade and this also seems to be the case for many women. The lack of sleep was my most concerning symptom, even more so than the migraines, because there is strong evidence that good quality sleep contributes to good brain health.

I listened to a few podcasts on the subject but all of the hosts seemed to have gone down the personalised private healthcare route, blood tests and hormones tailored just for them. My experience on the NHS has not been anything like that. Once I had decided to give HRT a try I had a five minute telephone consultation with a locum GP. To be fair, she seemed very knowledgeable on the subject and said she thought it was a good idea for me to take HRT as it can help prevent both osteoporosis and cognitive decline as long as the woman begins the treatment within six years of finishing her periods. She prescribed Estradiol patches, to be changed twice weekly and Utrogestan tablets to be taken before bedtime every night. She then called me a fortnight later to see how I was getting on. That was it, the extent of the medical advice. It seems to be a strictly “one size fits all” approach. I did ask how she knew which hormones I was deficient it if I didn’t have bloods but she insisted it wasn’t necessary.

As HRT requires a regular prescription you can purchase a pre-payment certificate which is currently £19.80 for twelve months. Beware though! The pharmacist at my local Boots put my migraine medication into the same bag without me realising and I received a £100 fine. In fact, on my last visit they did the same and tried to insist that I did not need to pay for my additional medications. This is incorrect.

I started HRT in January last year but my migraines seemed to become worse than ever and, after six months, I went back to the GP, for an in-person appointment. This time I insisted on a blood test. I saw a male GP who was at a standing desk. I completely understand why he chooses to work this way but it does mean that there is very little eye contact with the seated patient. This GP told me he didn’t really think that HRT offers any protection against dementia or osteoporosis . This completely contradicted what the previous doctor had told me and much of the research I had read. He said that my bone health was determined by the time I was fifty and there now wasn’t anything I could do to change it. He told me to take a break from HRT and see if my migraines improved. I stopped the treatment but it made no difference, my migraines continued to be unbearable until I sort further help , see my Migraine Misery posts. As I left the surgery I realised he hadn’t even glanced at my blood test results.

To be continued…

Thank you for reading

Samantha

Cover Photo by amjd rdwan on Unsplash