The Perimenopause Diaries

Make a snack, it's a long one.

“Perimenopause has made me stupid” ← I thought those words the other day. I was reading a particularly evocative Substack post from someone who writes beautifully and my brain began its narration: “You used to write like this. You used to write so well, so easily! Everyone loved your words. But now you can barely get a post out. Maybe you shouldn’t bother.”

Perimenopause has made me so tired at any point during the day I could keel over and die QUITE HAPPILY. The word “fatigue” does not convey the bone crunching, soul withering enormity of how very tired I am. It’s been a long six years.

In the interests of posterity, and because this might help someone struggling, here’s how it’s gone down for me.

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Somewhere in 2017, aged 44, the chronic tiredness began. I was convinced it was a sleep disorder. At no point during my search for answers did a medical professional ask about my periods. I also, seemingly out of nowhere, developed a bunch of allergies.

From a newsletter sent in February 2018:

The day after my 45^th birthday I attended a beautiful menopause workshop led by Jane Hardwicke Collings in Glastonbury. With two good friends sat beside me I got to join a circle of women and share our feelings (you know I love that stuff). Every time someone's mentioned perimenopause or menopause to me in the last few years I have cringed and run away from them in my head and heart. It’s something I’ve been incredibly resistant to because my greatest fear about menopause is that I’ll become a dried up old hag that no one wants to shag (can’t make that any more palatable - it’s the truth!) which is interesting considering how much I’ve been enjoying getting older. 

I was wildly unconscious in my twenties before my life changed in my thirties after my bereavement. Since then I’ve been unravelling the layers of my self to get to the juicy core of who I really am and that has only been amplified in my forties. I think part of my fear of menopause is sadness that I’ll have to change yet again after I’ve “only just found myself”. Because let’s face it, the menopause story our western world tells is an unflatteringly negative one. In a world where we’ve only just starting to talk about our menstrual cycles without embarrassment or shame it’s no wonder we’ve yet to catch up on the bookend to that experience. It’s very clear to me that we’re the generation that’s changing the story for the generations that follow.  

And so I went to the workshop to start unravelling what this next part of my journey will ask of me. On the train home I still felt a bit sad about what’s to come because I’ve only begun working through my feelings about it, but I also came away with a very clear sense that it’s less of a change and more of an EVOLUTION. It’s a natural part of living in a female body, and as much as I don’t want to only identify with my human form — I’m so much more than this! — I’m also aware that everything I experience in life happens through my body so of course its biological functions have an impact on me. Plus our bodies don’t just age, they also change. 

One nugget of information Jane shared was how the luteinising and follicular-stimulating hormones change function after menopause and become neurotransmitters for the right side of the brain “increasing intuition and visionary capacity.” As I’ve just spent the last few weeks preparing my newest course on that very subject I jotted this one down in my journal with lots of underlinings. Jane and another woman in the circle both reported that their orgasms have been much deeper and richer since menopause, so there’s also THAT to look forward to!

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From a newsletter sent in April 2019:

My period was 10 days late this month. Ten days of convincing myself “I’m day old bread” as Samantha famously quipped in Sex and the City. It’s been ten very sad and peculiar days, I have to admit. For ten days I felt an enormous void I didn’t know how to handle. Ten days might not sound a lot but I’m so used to my clockwork-regular cycle — honestly, you could set your watch by it. Over the last year I’ve had a few extra days tacked on to the end here and there, and each time I noted this and tucked it into my “this might be happening” folder, but this month was the first time my cycle has done something dramatic enough to really throw me.

I’ve read books, attended workshops, am taking all the right supplements and am now committed to my Pilates classes and I really thought I preparing myself quite well — and I am — but I now realise I was preparing for a future event. Surprise surprise, the future is actually already here. I’m in it and this is just the beginning.

I’m talking about this because it feels like no one ever talks about it. Every time I see an actress of a certain age on my screen I think: why aren’t you talking about it? Or an online peer a few years ahead of me: why aren’t you taking about it? Gwyneth Paltrow’s brand Goop recently launched Madame Ovary, a supplement designed to support women through perimenopause and I was DELIGHTED to hear her talk about the fact that she’s 46 (my age) and experiencing perimenopausal symptoms. But that one video hasn’t exactly changed the landscape.

When I talked about perimenopause on Instagram last year I received a flood of supportive and grateful comments, but also one message telling me not to “make a fuss” and that it “wasn’t a big deal”. This was from a woman who had reached menopause and hadn’t experienced any dramatic or debilitating symptoms. From my research it seems her experience is quite rare, but that isn’t the point. This attitude of not making a fuss and hiding it away seems to be attached to much of a woman’s experience as she goes through life. 

Periods, pregnancy, miscarriage, infertility. Fibroids, PCOS, endometriosis. Mood swings, breast tenderness, and all the bloody rest. There’s a lot that half the planet puts up with so the human race can continue. And don’t get me wrong — I love being a woman, and despite the intense PMS and fibroids I’ve lived with for so many years, I feel pretty attached to my monthly cycle too. I know how it works and I know what to expect, so it’s no wonder this month threw me. My body is changing and I’m not ready for the change. I struggle with how out of control I feel. I can choose to colour my hair and tattoo my skin and exercise to stay in shape. I choose the foods I eat and the places my feet walk. I’ve gotten used to having control over the physical manifestation of my self, but my body is suddenly walking its own predestined path.

My body is changing. I am changing. I can’t stop it so I’m going to have to sit with my fears and learn my body’s new language. The morning my period arrived I felt such relief (I may have shed a tear or two — premenstrual much?) 

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From a newsletter sent in September 2019:

This month I skipped a period. My first skipped period, aged 46. It feels as significant as my first period when I was 11 years old. I spent two weeks waiting for it to arrive — I certainly had enough PMS going on to be ready for the release. I also had a fair amount of pain — usually an indicator my bleed was about to begin. But… nothing. Right now I can feel my hormones levelling out again and feel a lot calmer, like I would if I was around day six or seven of my cycle. I’m sharing this because no one tells you the ins and outs of this stuff! “Irregular periods” they call them in the books but that isn’t enough information. I need someone to say “you’re going to feel like you’re in the highs and lows of your cycle but there won’t be any blood”. I’ve been quipping to friends that it feels like I have PMS all the time, but this month I see how I’ve gone through the mental and emotional swings that I’d expect in the days before and after my period but there just hasn’t been any blood.

I realise next month might be different. I’m in the very early stages of all this and each woman is going to experience it in her own unique way. There will be similarities, of course, but perimenopause has so many associated symptoms we can’t predict how our bodies will react to the enormous changes that are happening inside us. So far I’ve experienced sleep issues (this is the most debilitating), restless legs at night and now irregular periods have officially begun. Oh the joy! ;-)

I know that the perimenopause stage can last for YEARS and I can sense this is a gateway I’m passing through. A long drawn-out frustrating gateway that will lead me to a new version of myself. I have friends already on the other side telling me the sun still shines. Sharing our experiences is so supportive.

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From a newsletter sent in October 2019:

Since I’ve been home I’ve been taking a serious look at my health. [Edited to add: while I was abroad I had horrific PMS preceding the heaviest period I think I’ve ever had] As the let lag has subsided I’ve shifted back to my usual sleep pattern: wakefulness through much of the night including the really fun 4am adrenaline wake up. I’ve been dealing with this for a couple of years and have investigated every possible avenue to fix my sleep issues because if I can’t sleep I can’t function as a normal human being. I can’t focus, I can’t create, I can’t run my business. I can’t connect with loved ones. I can’t be ME. Honestly, the fatigue has become debilitating.

After yet another night of broken sleep, and nearly passing out in the supermarket, I had the brainwave to go see a menopause specialist (Dr Louise Newson’s clinic in Stratford Upon Avon for those of you in the UK). I’ve been doing more research into perimenopause and it (finally) struck me that I have far more symptoms than I realised. So many of the things I thought were unrelated might not be. 

I’ve heard good things about the Newson Clinic and when I rang they’d just had a cancellation — I took this as a sign I’m on the right path. I’ve compiled a list of my symptoms and concerns, and have an even bigger list of questions. After doing more research I’ve decided I’m open to the possibly of taking HRT if that's something that will help me get my life back. I’ve dug into the “natural” way of dealing with perimenopause — nutrition and supplements, exercise, acupuncture, essential oils — and the spiritual way of viewing this transition, and now it’s time to explore the medical way.  

SPOILER: the medical way was the one I needed.

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May 19^th 2023. Today.

I am now, shockingly, 50 years-old. The pandemic stole three years from me, but that’s another story. I’ve been on hormone replacement therapy since October 2019 and it improved life immeasurably. It helped me sleep through the night, helped with the brain fog and eased the restless legs. It didn’t have much effect on the allergies, but I took the wins where I could. It was sanity saving during that first year of lockdown.

Nearly four years on I sense my body is nearing the end of perimenopause. Last year I had 3 periods; this year, so far, just one. I’m actually shocked at how easily I’ve let go of my menstrual cycle, though it’s taken a lot of work to get past those unhelpful societal assumptions about being on the shelf. The premenstrual rollercoaster has been replaced by a continuous single note that I deeply appreciate most days. Trouble is, within that note is the primordial desire to burn everything to the ground. No longer tossed around by my fertility drives, I’m furious about pretty much everything. I’ve stepped into the training for my crone years — they’re not that far off, I can see the smoke coils rising above the forest.

So in this final season of perimenopause my symptoms are overwhelmingly mental — much of my ADHD research spoke about hormonal changes making it worse and I can authoritatively confirm that is true. Oof! I’m so grateful I got the intuitive — and frankly desperate — nudge to try HRT back in 2019, because let me put it this way: if this is how I feel with HRT? Holy crap, how would I feel without it?

Grateful I had the option and the means to go to the clinic. HRT does not stop the process, it just alleviates some of the more debilitating symptoms, but it’s not for everyone — and not everyone needs it. I have friends who sailed through their perimenopause; I have others who are in the trenches with me now.

Glad I’m nearly on the other side, whatever that will bring.

Glad we’re all talking about it. Glad the silence is ending. My perimenopause coincided with the rise in menopausal awareness, but we’ve got a long way to go.

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RESOURCES

WEBSITES

Balance (site & app) by Dr Louise Newson
The Menopause Charity
Menopause Support
Menopause Matters
Women's Health Concern
International Menopause Society
Hey Perry
Menopause & ADHD

UK CLINICS

(* = the clinic I attended)

* Newson Health Menopause & Wellbeing Centre (Stratford Upon Avon)
Hormone Health Clinic (London & Nottingham)
Dr Hannah Short (Ely, Cambridgeshire)
Dr Imogen Shaw (Cambridge)
Dr Sarah Gray (Cornwall)
Dr Suzanne Saideman (Elstree)
Dr Tina Peers (Surrey)
Dr Alice Scott (Essex)
Dr Mandy Leonhardt (Hampshire)

BOOKS

The Definitive Guide to the Perimenopause and Menopause by Dr Louise Newson
Menopausing by Davina McCall
The Menopause Manifesto by Dr Jen Gunter
Second Spring: The Self-Care Guide to Menopause by Kate Coddrington
Menopause: The Answers by Dr Rosemary Leonard
Natural Solutions to Menopause by Dr Marilyn Glenville
Perimenopause Power by Maisie Hill
Oestrogen Matters by Dr Avrum Bluming & Carol Tavris

Wise Power by Alexandra Pope and Sjanie Hugo Wurlitzer
Flash Count Diary: A New Story About Menopause by Darcey Steinke
Tantric Sex and Menopause by Diana Richardson and Janet McGeever
The Slow Moon Climbs: The Science, History and Meaning of Menopause by Susan Mattern