I wanted to run and hide when Roisin Hillman asked me to speak to the BBC health correspondent, Marie-Louise Connelly, about having trouble filling my prescription for HRT. Who wants to talk about their menopause on the Evening News?
Roisin has started something amazing for women in the North of Ireland and beyond – a menopause support group with over 1000 women on Facebook, and I wanted to give something back, show solidarity and speak out about the HRT supply issue.
It was time to step up.
Women’s health has been on the back boiler for too long. If women suffer from something that men don’t, that tends to make it a taboo subject – menstruation, menopause, miscarriage, and it wasn’t that long ago that even pregnancy wasn’t spoken about in front of men – and certainly not labour and delivering the baby.
Admittedly, men have their health taboos, too – anything to do with ailments of the reproductive organs. And regardless of your gender, mental health issues are in that suite of unmentionable subjects also.
So, yes, my initial thoughts on being interviewed about menopause were – ‘No way!’
But what’s happening is atrocious, leaving women in a grim situation without their medication. Someone has to speak up. And if not me, who? I’ve spent so long jumping at the chance to promote my own agenda, books, and writing that it seems selfish not to use that experience to at least work for a wider and worthy cause.
That’s why I ended up speaking about how difficult it is to get and continue to get the right essential medicine during menopause.
Often women are not listened to when they present their menopause symptoms. Out of date information (e.g. fears that oestrogen could cause breast cancer, although new research disputes this) has led to GPs reluctance to prescribe HRT at all. Women suffer needlessly from hot flushes, interrupted sleep, migraines, tendon/muscle/joint pains, anxiety, and low moods (well, of course, with all that to contend with!), and those are just the symptoms I’ve personally had to deal with. There are a lot more symptoms. Every woman has a different experience with menopause. I’m not as severely affected as some women, which is another reason why speaking up about it made me a little uncomfortable. Have I earned my ‘complaining’ rights?
However, I share my journey through menopause to drag it from the shadows into the cold light of day. Enough of the whispers and euphemisms, no more code names and nudges – let’s call a ‘spade’ a ‘spade’ and a ‘drop in hormone levels’ an ‘issue that needs attention.’
For years, alongside conflicting information and fear of HRT, there’s a notion that menopause is merely a discomfort, and women can put up with the hot flushes, interrupted sleep and ‘battle on through to the other side of menopause,’ as a male GP once advised me in San Jose. It seems this dismissive attitude is a global issue.
There’s also the idea that menopause is a natural process and should not be interfered with. Well, so is childbirth, and for that matter, death! If I can get help making either more comfortable, I’ll take it, thank you. And if you think about it, many ailments are ‘natural’ but would you resign yourself to suffer without help if you didn’t have to?
I’ve had migraines since I was a young child. After puberty, I suffered migraines a couple of times a month or so. There are a host of triggers for my migraines, but the biggest factor is hormonal fluctuations. I was hoping that come menopause, my migraines would stop.
Instead, as my oestrogen levels plummeted, my migraine attacks rocketed. I’ve tried everything. I adjusted my diet, but that didn’t work. I avoided alcohol and, for the most part, still do. I exercise regularly, walking at least 3 miles a day first thing in the morning. I practice yoga. I’ve tried meditation, but my brain finds that challenging. I garden hail, rain or shine because that’s my happy place. I’ve tried acupuncture which became less and less effective. Eventually, I switched to reflexology with Karen Wasson at KW Mind, Body, Sole. The reflexology was amazing, but the conversation afterwards with Karen was life-changing. She suggested I speak with a menopause specialist.
The day after the reflexology, I didn’t have to take a migraine tablet (sumatriptan) for the first time in weeks – actually, I’d lost track of the last migraine-free day I’d had. I was tempted to leave it at that and not bother with the menopause specialist, but another symptom had crept up on me.
At first, the onset of joint pain was so insidious that I didn’t connect it with menopause. In the mornings, my Achilles’ tendons were like a pair of rusty steel cables, so tight and stiff that I had to hobble like an old lady when getting out of bed. I also suffered pains in my neck, shoulders, elbows, wrists, hands, hips, knees, and toes. I’d been on prescription non-inflammatory anti-steroidal medication that hadn’t worked. Because of the pandemic, I didn’t want to bother my doctor, so I just lived with it, chipping the edge off with over-the-counter pain medication. I was popping paracetamol and ibuprofen along with the sumatriptan daily. It wasn’t doing my liver any favours, but what else could I do?
A touch of arthritis, or rheumatism, perhaps? My brain fog hadn’t registered which my chiropractor had suggested. Old age was creeping in on me, and I was only 52! What would I be like at 70 or 80?
So, I was amazed when I happened upon an article by a woman who described having similar pains and that HRT had eased it. Could HRT really be the answer? My GP led me to believe that replacing oestrogen now simply postponed menopause, and I’d have to suffer through it later to ‘get to the other side.’
Was there another side, and if so, what kind of hell was awaiting me?
There was nothing else for it. I had to speak with a menopause specialist. You can get a referral to the NHS Menopause Clinic from your GP, but the waiting list is long. If you want to be seen quicker, you can go privately to Kingsbridge Menopause Clinic.
The menopause specialist listened to me and answered my questions. My concern with going cold turkey coming off HRT was unfounded. I could stay on HRT for as long as my body needed it. She said she knew eighty-year-olds still safely on HRT. She gave me a prescription for bio-identical hormones in a gel that I rub onto my thigh or upper arm. The hormones are absorbed through my skin into my bloodstream. Bio-identical means the hormones are in the same molecular form as those my body made, and therefore safer to take.
Within a day, the joint pain had subsided. The frequency of migraines decreased. Over the next six weeks, I needed to tweak the prescribed amount to get better results. With each trial (and error) session, I suffered migraines as the hormone levels fluctuated, but eventually, I worked out the optimum dosage and stabilized migraine free.
Why hadn’t I done this sooner, like at least five years sooner? Why had I suffered for so long when the treatment was so simple, effective, and less expensive (in both economic and biological terms) than treating daily migraines with sumatriptan and paracetamol?
I had to share this information with my friends – with any woman willing to listen, especially those around my age. I expected to be met with resistance (at best) for bringing up the taboo subject of menopause, or with ridicule for telling them something they already knew about but which I had somehow missed the memo on, or (at worst) with scepticism. But the women leaned in. ‘Tell us,’ they said, ‘For we suffer too…’
And we shared. And we listened to each other. And we joined Roisin’s Facebook group. And we had access to reliable information. And we made our GPs listen and brush up on their training. And we felt healthier and happier. And we began to think that together we had this thing sussed… until we couldn’t get our prescriptions filled because of shortages in the supply of HRT across Northern Ireland.
That’s when Maire-Louise Connelly stepped in and picked up the baton, and ran with it. She put together a comprehensive and accurate story, asking people to tell their experiences. Here’s the link to the article.
My story was simple. I’d tried to fill my prescription at my local pharmacy. They are brilliant in there. They’re doing their best in very trying circumstances. They have gone out of their way to source supplies of my HRT, often calling around other pharmacies for me. However, after owing me my medication, this time for several weeks, they still couldn’t fill the prescription. They can’t magic it from thin air, and I appreciate all they do. But I was down to the last of my meds and didn’t relish returning to the migraines and joint pains – indefinitely! Since they didn’t know when they would be able to fill the prescription, they suggested I try a different HRT, but I knew that adjusting to that would prove painful.
It’s unacceptable to constantly worry about getting a supply of essential medication, but my story ends happily this time. A shipment arrived to the pharmacy in the nick of time, and my prescription was filled – for now.
My generation of women is lucky to see this awakening to the tribulations of menopause. Happily, the groundwork is being laid for the women who come after us. Half of the population will go through menopause. It’s important to recognize that, for some women (and their family members), this is a difficult transition that can be efficiently and effectively managed with the right hormonal support.
If you would like more information on the menopause, it’s out there. There are Menopause clinics. Ask your GP for the referrals you need. Join the Menopause Support Group on Facebook. Start a local support group. Tune into Dr Louise Newson podcasts.
Be a sister – share and listen.