“Ageing is a privilege, and the menopause is part of that transition”: My Menopause

Helen (she/her) is a holistic health champion, practitioner and consultant, specialising in project development around equity in health and wellbeing, hands-on complementary therapies and support at end of life. She developed her portfolio career as a result of the challenges and opportunities the menopause kindly brought.

Helen had previously worked full time in senior management roles. She has contributed to a number of research projects and documentaries around the menopause. She is currently leading on a sister Project to ‘Menopause & Me’ funded by the DHSC/NHS in Birmingham and Solihull called ‘Menopause in and out of the Workplace’.

Helen is 56 years old, post-menopausal, and identifies as queer.

When I first started to experience brain fog, forgetfulness, and cognitive issues, the last thing on my mind was menopause.

It was 2014 - it has been a long journey. I was scared. I thought I had early onset dementia. I had no hot flushes, no changes in menstruation, I was ‘only’ 47, I’d just got married (legally – having been but unable to marry for 24 years), my job demanded complex reasoning and mathematics. I ate well, slept well, took various supplements, did yoga twice a week. My wife is two years older than me and she was fine. It couldn’t be menopause. I put my head in the sand and weeks passed.

Gradually other symptoms piled in – 36 if I’m counting. I flooded, I itched, I ached, I cried, I raged, my teeth disintegrated, my skin erupted, my eyes dried up, I lost weight, I had pins and needles, acid reflux and carpal tunnel, my tolerance to sounds, smells, and people in general disappeared, I was totally exhausted, thoroughly anxious, I thought I was going mad, I just wanted to vanish. It was like puberty in reverse. I later realised I was also grieving on a very biological level: the loss of fertility, the loss youth, the loss of physical prowess.

However, I still had no hot flushes (25% of menopausal people don’t have them) and I even started to feel broody – and I’ve never wanted to have children of my own, ever. I went to the NHS for advice, and eventually the fifth GP prescribed Provera HRT – but to their bafflement, my symptoms persisted cyclically. I was referred to the menopause clinic - a long wait.

Social media did not exist for the menopausal – it was too much of a taboo. I was fed up with sharing with friends and colleagues who could not or would not empathise. I eventually found an open forum online. I hadn’t however, reckoned how cis, straight, white, and middleclass my new ‘tribe’ would be. It didn’t feel like a safe place to ‘come out’ so I stayed closeted, but I listened and I learned, absorbing the stories of all those people and how their lives were changed by hormone imbalance, and what solutions they found - both hormonal treatments as well as lifestyle changes. Now at least my knowledge was growing. Being part of the LGBTQIA+ community wasn’t something I’d really thought of as needing different menopause support.

I find that some people struggle to understand not feeling ‘safe’ – perhaps because they have never felt unsafe in a minority. It is important to remember many LGBTQI+ people who are experiencing menopause now in their early-fifties were born when male-gay relationships were a criminal offence. After de-criminalisation, we had to wait until the year 2000 for parity in the age of consent. We have lived as adults through 15 years of Section 28 legislation which prohibited the public promotion of homosexuality, and still leaves a shadow. It's widely accepted that the LGBTQIA+ community suffers from health inequalities and lower life expectancy than average. With underlying traumas and fear of discrimination, we are less likely to seek professional health advice.

We haven’t even had the language to self-identify until recently. Bi-sexual was as adventurous as it got in the mainstream. I didn’t feel comfortable in my assigned ‘Woman/Lesbian’ box but had no other choice. Androgenous felt possible but misunderstood. Life would have been different if we had access to language like ‘gender/sexual fluidity’, ‘queer’, ‘pan-sexual’ rather than ‘other’. Although the climate has changed in the UK, homosexuality is still illegal in more than 60 countries – this affects where we can comfortably travel. All this history underpins years of continually having to ‘come-out’, and frequent un-noticed micro-aggressions. When you are already not feeling yourself, tired and vulnerable, the last thing you want to do is have to manage discrimination, whether it's macro or micro-aggressions.

Being queer, for me, is about being different, demonstrating that there should be less narrow-mindedness – because I strongly feel I’m not part of the status quo, that I don’t fit in with society’s prescribed ‘norms’. This sometimes makes me feel ignored and erased and this layering of not being heard makes for a different and more challenging menopause experience. It is all too easy to be invisible as part of the LGBTQIA community. People make discriminatory comments easily because you are invisible to them. We are continually put in the position of having to decide to out ourselves or not – risking judgement from outside or from within depending on how confident in the moment. Despite the change of climate in the UK, homophobic hate crime remains a real threat.

In addition to supporting the LGBTQIA+ community experiencing menopause now, we need to plan and cater for the future. We are witnessing a revolution in awareness and presence of gender and sexual fluidity, especially in Gen-Z and Gen-Alpha. By the time these generations reach menopause, the complexities of gender presentation will be enormous and we need to start discussions now to be able to support everyone equally. It is a crisis waiting to happen, both culturally and medically, for both cis and trans people.

Back to my menopause story... By now, having continued with the lifestyle changes in terms of nutrition, exercise and reduced stress, and having found an HRT regime which worked, my symptoms were settling. Supported by the menopause clinic, it had taken me 12 months and 5 different HRT options to find balance. I had also changed career, and got a dog. Round 1 – victory to Helen.

A few years passed and more symptoms took me by surprise as I thought my battle with menopause symptoms was over. Round 2 started with urinary infections. I sat on ice blocks for days at a time, and made excuses for not attending social events. Then, looking through my menopause notes I came upon the idea of topical oestrogen not only for vaginal dryness/atrophy but for genito-urinary syndrome of the menopause (GSM). I got some ‘vaginal’ oestrogen from the GP – I haven’t looked back. I will probably take this until I die.

If anyone tells you a year after you stop bleeding you will be post-menopausal and everything with calm down – they don’t know what they are talking about! So many people continue to suffer as a consequence of reduced hormones because they are written off as post-menopausal. In my experience, many of the women who say ‘I just got on with it’ have a line of family, friends or colleagues standing behind them rolling their eyes and shaking their heads. They may not have understand why but they knew for sure something was wrong. So, when your mother says she didn’t have any symptoms delve a little deeper and wider.

The time came to switch to taking HRT continuously. I was looking forward to ditching all sanitary products for good. But no, the menopause gods were gearing up for Round 3: continuous massive bleeding and cramps for weeks, amongst other new symptoms. Back at the menopause clinic I tried tweaking my HRT regime, underwent ultrasound scans and hysteroscopy twice, which detected fibroids and a bulky uterus, and finally an MRI which detected historic endometriosis – but no underlying cause for bleeding other than the HRT. After 18 months I came off HRT for 9 months and developed hot flushes and debilitating joint pain and sporadic asthma– joy! Now I’m back on HRT - patches this time Round 3 continues... post-menopause me.

Everyone can help shine a light on menopause symptoms. Many of us are experts by experience and if we all bring menopause into our social and work conversations – just as you would many other health issues – then this is the best way to break the taboo. I have a competition with my friends to see the most random conversations we can turn to the topic.

Within the menopause world there is too much gender and biological emphasis on ‘reproduction’ and ‘vagina’, and ‘loss of fertility’ – the menopause is so much more around sexual health and ageing well. The stigma of childless by choice underpins this. Until we address the anti-ageing culture, menopause will remain a taboo because it is an irrefutable sign of ageing. We should celebrate the wisdom it brings. Ageing is a privilege, and the menopause is part of that transition.

Some people have said to me that being menopausal is like being given a sword of truth. Perhaps this feeling of empowerment is a contributory factor to why people leave their careers and jobs, or even their relationships. Perhaps this is why they leave situations - to find themselves. Menopause lifts the scales from our eyes, reduces our inhibitions, and once our confidence is rebuilt we are a force to be reckoned with – no wonder people don’t want to talk about it.

“One day, an army of grey-haired women may quietly take over the earth.” – Gloria Steinem

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