Friday 31 January 2020

Perimenopausal? You’re far too young for that...

It crept up on me and I hid the struggle that I went through.
 
Looking back, that’s what stands out... so far.

In the whirlwind of bringing up two children amidst a full time responsibility laden teaching job, whilst caring for a dementia ridden mother in law and supporting a husband on whom this was severely taking its toll, I started to realise that I didn’t feel quite right and it went way beyond being part of the ‘squeezed middle’, between parents and children. 

I had vague notions that my sister and mother had gone through an early menopause.  Idealistically I was abjectly opposed to being ‘perimenopausal’, but irrefutably physically changing and struggling to manage the changes.  In a recent documentary for the BBC, Mariella Frostrup explored people’s perceptions of the menopause – ‘mad’ and ‘old’ were adjectives that featured heavily.  I didn’t disagree and I didn’t want to identify, I didn’t want this to be me – I wanted to be anywhere other than here...

But the evidence was mounting up and to be honest, I was starting to feel old and mad. These are the symptoms I had at that time: 

  • ‘Brain Fog’ – I’ve never been good with names but my inability to recall names when I needed them was embarrassing.
  • ‘Changes to your periods’ – I have always had heavy periods, but at points now was struggling to get through an hour long lesson with the heaviest protection available.  I was taking spare sets of clothes into school.  Worse, having been able to predict with absolute calendar detail when they would arrive, I suddenly had no idea. Hugely stressful.
  • ‘Worsening pre-menstrual symptoms’ – At the time of the month, fury could consume me.  Anger is an emotion I was used to dealing with, but now I became weepy; I was so uncomfortable, give me rage over tears all the years.  I cried in public repeatedly and felt vulnerable permanently - repeatedly in staff briefing, in front of all my colleagues.  Repeatedly. People tell me I shouldn’t find it humiliating, but I did. I do.
  • ‘Hot Flushes’ – I don’t think this term does them justice: imagine that all of your bone marrow has been replaced by red hot fire ashes, whilst you are standing in a huge fire and you’ll have it.  Remember, that it comes on instantaneously and uncontrollably – one minute you are fine, the next sweating profusely and trying to resist removing all your clothes.
  • ‘Night Sweats’ – see above, but imagine lying in red, hot ashes, which your covers are made of... as is the air around you.
  • ‘Difficulty sleeping’ – feeling like your body is on fire and sleep seem to be diametrically opposed. Weird, huh?
  • ‘Joint stiffness, aches and pains’ – plantar fasciitis is highly associated with the menopause and yet despite seeing countless health professionals, no one had mentioned it.  I suffered for two years and had electric shock therapy before considering that I might be perimenopausal.
  • ‘Palpitations’ – heartbeats that suddenly become noticeable, that beat out of my chest... my husband had a stroke in 2015, followed by the discovery of a hole in his heart so big that it required open heart surgery.  I hid it for fear of what it might be and felt really anxious...
  • ‘Mood changes, such as low moods and anxiety’ – I am an anxious person, but this was crippling; I doubted everything and everyone.  My mind rarely at ease. Tears at the ready.
  • ‘Weight gain’ – I gained over two stone, partly due to erratic life style choices and yet the weight gain was way out of proportion to the choices I was making. My clothes didn’t fit.
To recap and set the scene for the rest of the blog, by the summer of 2018 I was unable to remember most nouns, bleeding heavily, not sleeping and severe plantar fasciitis made every other step I took kill.  Every now and then I felt like my heart was beating out of my chest and my body burnt to dust, whilst my anxiety made me doubt everyone and everything, especially myself. My PMT was out of control, I suddenly spent a lot of time crying... oh, and none of my clothes were fitting so my self esteem was pretty non existent.  Life had become a permanent struggle.

 By January 2019 I'd had enough, I went to see my GP, who administered a blood test, which showed high levels of the Female Sex Hormone*.  Everything about the language used for the perimenopause feels humiliating – ‘Sex Hormones’?  I wanted to deny it, but the results refuted it; normal could be up to 21 and mine was over 90, proof positive. At 45, I was early to be perimenopausal. Every medical practitioner I meet comments on it; ‘too young’ is the silver lining of this experience. I can’t remember the last time I was ‘too young’ for anything else... it was the only way I could talk about being perimenopausal** at the start, "I've gone into the perimenopause early...', I'd say as if this was less shameful. 

 (*The FSH is also called the 'Follicle Stimulating Hormone', ask your practitioner to refer to it as such if, like me, it makes you uncomfortable - its the hormone that stimulates your ovaries to secrete an egg and causes PMT)

(**Check out the title of this blog!)

We discussed HRT and I was sent away with information to read and digest, but which I ignored whilst I buried my head in the sand, striving to survive.  By Easter, I knew I needed HRT and started the process: I would be fitted with a progesterone HRT coil and use a gel everyday to administer the oestrogen - an alcohol gel you rub into your skin.  I booked time off school for the appointments/recovery, but a month before became severely ill with acute tonsillitis, which did not respond to penicillin.  I was a wreck.

I remember, at one point, asking how quickly the hormones would work and being told it would be immediate.  FAT CHANCE, I thought. Vividly feeling trapped, knowing it would not change, cynically deciding that this was ‘it’ now; my new reality. Mad. Old.  I suddenly had grey hairs to prove it.

I was admitting the truth a little more by this stage.  It’s really hard to admit to being perimenopausal; when do you do it? What do you say?  My Headteacher said that I was ‘stoical’ in response. I looked up the definition; ‘enduring pain and hardship without showing one's feelings or complaining’ and was surprised. It felt like I was crumbling to dust visibly every day, clearly I wasn't and at the time, I took heart from this. I remember thinking that it was good that no one had noticed I was struggling - how wrong is that? In my eyes, it was ok to be perimenopausal as long as no one noticed, as long as I hid it, as long as I carried the burden alone... When you think of how women manage menstruation it's not a surprise, from the age of 12 I had been silently hiding the monthly struggle; it has been difficult to remove this mindset from the perimenopause, but I now believe we really have to try. It's too much to carry alone.

When they fitted the coil, it took a while after to get the gel as my BP was raised.  So as I started using it, I was being rigorous with myself about diet and exercise.  This certainly has had an impact beyond the drugs – I am taking better care of myself - yet I could not do it before the drugs, I’d tried and failed.

It turned out that they were right about HRT, you do feel better instantly and it grows and grows...  Now, don’t get me wrong, nothing about this is easy: having a coil fitted is painful; it leads to near constant bleeding in the early months as your periods adjust and lighten.  Just remembering to take the gel is difficult and it really has an impact if you do forget, but from day one, I started to feel more me and this has just grown and grown.

A colleague remarked to me recently that I had ‘more of my old sparkle’ back.  Another told me I was looking ‘different’.  This week, I returned to the menopause clinic as my coil was hurting me, I thought.  The consultant confirmed that it had caused an infection and set me on 14 days of two kinds of antibiotic, so it’s not been plane sailing and this week I have truly felt dreadful again. Yet, Dr Ghosh noticed what my colleagues also had, I am better.  She remembered meeting me in June, how I had cried, and cried, and cried, and said, ‘You’re not like that now, Mrs Tulloch.  You are much better in yourself.  You are not crying now.’

And she’s right.

For anyone feeling the same, I have found these sources helpful:

All the love to you, keep going, reach out by DM if you want to.  Moving forward, I think I will need to develop a school policy for supporting staff, who will meet the same; in one way or another this will hit all female staff, most commonly between the ages of 40-58.  The NEU has developed a model Menopause Support policy, here. 

 I sincerely hope this blog helps teachers and leaders, it's helped me to write it. 

 If you have finished reading this blog and are thinking I am brave to publish this, I'd urge you to question yourself - this will happen to one half of the population - why aren't we talking about it more?  Women should not feel ashamed, because they have hit the menopause. It shouldn't be a secret, a burden carried alone, a struggle that goes unnoticed.

 We are enough as we are. There is no need to deny, who we are or where we are.


After all, the teaching profession needs us, so must learn to support us through this.

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