How are women supposed to survive this?

[VivienneBL]

I’m 42 and a single mother to two children aged 15 and 11 . I have a lovely extended family but very little day-to-day help .
I’m definitely having perimenopause symptoms which are really hard like fatigue, unwanted facial hair, my actual hair has gone berserk . I can’t lose wait no matter what I do and I’m going through major bouts of insomnia. All of this is affecting my work - I run a small creative agency in London. I feel totally mashed all the time . The worst bit though is I feel like I’m losing my mind. I get paranoid, anxious and emotional, and my resilience to stress is really low.
I had a fairly rough childhood ( alcoholic mum) and my ex husband is very nasty - incredibly wealthy but offers zero help either financially or practically, and puts so much pressure on me and constantly causes issues with the kids . But aside from those two things I’ve always been totally happy, a coper and good at handling issues . Thesedays I feel like a shell of my former self . It’s just crept up on me and I’m so scared at how I’m changing .
The doctor has been useless and I really don’t know where to turn. Women friends are amazing and some are on HRT but I’m a little worried about that.
Has anyone been through the same or had experiences of the same? Am I going crazy or is this to be expected? What is the best way to get through this?

For the weight gain, only thing that worked for me was change of diet. I gradually built up swimming, to 50 lengths 2 x a week (sets of 6 with a short rest and sips of water in between). Helped with MH and strength, but didn’t really help with weight.

Obvs discuss with GP. But in case useful, what worked for me is intermittent fasting and a keto-type diet. Never dieted in life, though never ate meat. Was inspired by Michael Moseley. Eat in 8 hour window: for me 1pm to 9pm, as suits my preferences/lifestyle. Weighed myself once a week on Sunday and wrote down, to hold myself to account and see progress.

Lots of water, plus black coffee (mornings) and green/herb tea (afternoons). Cut out all sugar (incl fruit like bananas) and most carbs. No bread at all. Same (homemade) dinners as kids (at least 3 veg), but without the potatoes or with tiny amount of pasta or cauliflower rice. Lots of salads with stuff that’s cheap and keeps well in fridge. Rocket or spinach, dill and parsley, then chop celery, cucumber, pepper, radish, beetroot, toms, avocado, olives, gerkins, plus salad topper (seeds) and chia seeds. Then add different stuff on top, like smoked mackerel (warmed in microwave), tinned sardines, smoked salmon, field mushrooms or prawns pan fried in garlic/chilli flakes, chopped vege bacon, sliced hard boiled egg, cheese etc. Snacked on natural yogurt, apple and nuts. No alcohol (v hard). Lots of herbs and spices.

Dropped from 11 to 9.5 stone in about 5 months. Had been referred to MSK for awful back pain due to prolapsed discs. But after weight loss (off belly) all back pain gone. Two years later, have kept weight off by largely sticking to above, but with odd carbs (e.g. sourdough toast for brunch, odd potato), limited red wine and chocolate rice cakes.

If sleep is a problem, cut out alcohol in evenings at least.

HRT all day long. It’s helps massively. Prioritise yourself it won’t get any better if you don’t. there is absolutely no need to cope to breaking point. Take care

Similar to you, but young DKs. Messy divorce (ex tried to kill me) emptying bank account,boss sacked me, because he didn't want the embarrassment of me working there, when it got in the papers. House re possession. Periods every 3 months at 42,all your symptoms and dreadful limb pains. I was doing full contact karate playing squash, went like a 90 year old in a couple of months. I felt menopause was natural,no hrt for me! GP did bloods, said I was 2 years off, and needed hrt for the osteoporosis protection as I was tiny, young and had had 2 fractures. I was on it 17 and in fact till I was 50 on the contraceptive pill as well. You have to use contraception till 50. I couldn't use any other method. I was absolutely fine, but we moved,new gp young female refused to prescribe it anymore. I looked into private,I couldn't afford it. Then it meant going to London, and about £350 a month excluding travel expenses. The symptoms came back with a vengeance. I saw a gynae consultant lady year, bladder prolapse which she said was caused by lack of estrogen, wrote notes for me, but failed to write on my GP letter,to prescribe it,so I got a curt phone call from the secretary, saying I had to get in touch with her. I tried every avenue. The hospitals had such huge waiting lists,I had waited a year, they draughted in locums and they couldn't trace her. Get bloods done,if necessary pay, take it from there.

Also treat vit d levels

I would be checking lots of things before you assume it's the menopause. At various times I have had similar symptoms and they have been caused by various things including low vitamin D, iron etc. HRT didn't help me sadly, in fact I felt worse on it and then was diagnosed with breast cancer so no more in any case. Diet, mindfulness, no/low alcohol, walking and some counselling helped. Midlife is complicated in all ways.

This! God, please get on it. What you have sounds like classic peri. Why suffer when you don't need to?!

HRT these days is far better than it used to be. I know loads of people who use it. Honestly OP I think that's a great solution just waiting for you. The absolute worst thing that could happen is you don't get on with it and you stop so there's not even a downside (& there's a huge potential upside to go with that!!).

No, you have to weigh up the risks and benefits before you decide to take HRT. I was shown the best available evidence by my GP and had to make my own informed decision.
I decided to offset the minimal risks of HRT with a healthy lifestyle.
The statistics shown to me put obesity and drinking alcohol as much bigger risk factors than HRT.

I second swimming and definitely yoga - game changer for me in relation to sleep, stress, pelvic floor & body shape.

I was a complete beginner, not flexible at all, I just keep going to classes at local gym. It is addictive - because the improvement is incremental but definite. It is the one area of my life in which I can see myself growing younger - my spine, my posture, my balance - and then that starts spreading out to other areas. Highly, highly recommend.

Agree with this. I have an underactive thyroid too and a lot of the symptoms are similar. NHS guidelines are that women under 45 should have bloods to see what's going on and rule out thyroid and other conditions.

IMHO perimenopause prob causes lots of relationship breakdown in 40s. Especially where women have been used to carrying mental load and doing bulk of housework and if their partners aren’t informed about and understanding of menopause.

You can feel absolutely floored, v depressed and anxious and get v shouty. The slightest things can make you tearful and feeling vulnerable. If DPs see this as a personality flaw, rather than expected in face of huge bodily changes. And if they don’t get off their arse to share the load, reassure and support you through it, it’s often game over.

While I agree Davina and others have done a great job of informing women of the mysteries of the menopause, IMHO there needs to be education for men too.

Is that because they were being used instead of considering HRT? That would make sense.
It's horses for courses. My friend went straight on HRT, at the first late period. 2 years ago, 53.Swears by it. Intends never to stop. (Though she was motivated by the skin and hair benefits). She has monthly bleeds.
I'm too delighted to be nearly free of periods, to even consider that. I've gone down the swimming, pilates, walking,singing, dancing, improved diet, hobbies, self care route. But also 4 years of citalopram have been a game changer re anxiety symptoms, which had soared. B12 also. I'm 56 and nearly out the other side, and feeling the best I have in about 12 years.
Different routes for 2 friends, but both feeling good currently.

I’m the same age as you and feel the exact same. I can’t cope. I’m anxious and sad all the time. I’m exhausted I wake at 2-3am every day. I forget things. I can’t do my job anymore. The doctor won’t even entertain hrt until I’m 46 minimum. I don’t know how to get through the next 4 years like this

I'm not sure the confirmation blood tests are very good. They may have improved over the last 20 years though - can it really be that long ago!

At 43 my periods went all over the place. The GP did a blood test for peri and it came back negative. The gaps got more variable, up to six months and night sweats started. I didn't start HRT until about five years later. I was done at 49.

HRT was a game changer for me. I'd give it a go. It also might be worth seeing an endocrinologist who specialises in overall/women's health to make sure everything is tee'd up as it shoukd be for optimal wellness.

I hear you but this is the background to it.

Yes, absolutely, and part of the attitude of some drs towards women, who labelled everything as 'depression' and needed medicating.

They're specifically not supposed to be used for anxiety- CBT is now suggested along with HRT.

Anxiety is a main issue with menopause for many women and responds to HRT better than ADs ( Dr Louise Newson has masses on this on her website.) Consultants have been trying for years to get GPs to stop prescribing it for meno related anxiety .

https://www.balance-menopause.com/menopause-library/antidepressants-and-menopause/#:~:text=Menopause%20guidelines%20are%20clear%20that,symptoms%20of%20perimenopause%20or%20menopause.

With HRT, there's the bonus of heart and bone protection which ADs don't give.

Your friend doesn't need to have monthly bleeds- plenty of types of HRT that are bleed-free for women her age if she'd prefer that.

Oh yes, I should have clarified. I was very low and was unable to take HRT. The ADs helped, but only with the depression. My anxiety was still high. When I was allowed to use HRT I discussed the ADs. We agreed that the two working together might be useful and oh boy are they ever!

HRT game changer. Also Vitamin D, take it all year. Check iron levels. My hair was crazy and it turns out I was in range for iron but its a very broad spectrum so taking a supplement has sorted it all out.

And this might be hard with a busy job and 2 kids, but I walk every day. I either talk calls while I am doing it or go in the evening (even when dark). Even half an hour seems to help with the head exploding feeling, and inability to sleep. I tend to go at lunch as this is also a signal to my team that is ok to take a lunchbreak ...

Because IME a lot of GPs are woefully uninformed when it comes to women’s health in general, and menopause and its effects has been under researched and underfunded until very recently, as is the case with a lot of medicine that pertains only to the female half of the population.

There persists a sense that because it’s ‘natural’ - like childbirth - that we should just shut up and get on with it, no matter how devastating its effects might be, and part of the stigma around taking medication for menopause (see also c-sections, inability to breastfeed, dysmenorrhea, adequate pain management for gynaecological procedures, etc etc) is that you’ve somehow failed the test; you’re just a weak moaner and not quite woman enough to grin and bear it and handle all this shit with silent grace because, you know, it’s natural.

It’s rooted in plain old misogyny and can fuck right off.

Hi, just wondering what iron tablets did you use? I have low ferritin too and v anxious and tired.
OP- I'm on HRT too and do notice a difference, I had awful migraines every month and terrible mood swings which have cleared up since taking HRT. I'm still not 100 per cent but just discovered I have very low ferritin (17) which might be a contributing factor.

Various forms of HRT didn't work for me but, in a nutshell, here's the things I did to help me through menopause and not go mental:

• swapped HRT for a low-dose SSRI anti-depressant - absolute game changer, personally
• started strength training with a personal trainer twice a week - the sheer thrill of getting stronger, both physically and mentally cannot be overstated! I can now lift 100kgs, I sleep better, have lost weight and feel focused and determined in a way I have NEVER done before.
• stopped drinking alcohol - I think this was the single biggest 'quick' positive step. At one point, I didn't think I'd get through menopause without alcohol, but now I realise it was really messing with me.
• upped my protein intake and reduced my (massive!) carb intake - my PT is also a qualified nutritionist so making these sorts of changes was super-easy
• said 'no' to things whilst I was sorting my life out
• I spend less time in front of my phone or a screen and get out walking more, or reading, or even just starting into space listening to the birds. No screen time for two hours before bed - another game changer, my brain winds down much more naturally and prepares for sleep
• developed an evening self-care routine (mainly looking after my skin and face) with a small selection of really good bio oils (including 'Feminine Happy Oil' from Il Apothecary - can't praise this amazing stuff enough), some magnesium body cream (from Neom, if anyone's interested)
• started taking Biotin to help with thinning and shedding hair

I, too, thought I was going crazy and had a couple of really scary episodes that seemed very much like some sort of psychosis. Like you, OP, my GP was absolutely useless, so I resolved to find my own way through. I booked an appointment with a women's health specialist GP (not cheap but worth every penny). She took the time to go through my medical and family history and, together, we came to the conclusion that HRT wasn't right for me at this time - which may not be the case a year, two years or whatever from now but, for now, I feel is the right decision for me.

I took each day as it came, small steps towards a more positive future - anything more seemed just too big a concept at the start! Hope you start feeling better soon.

Thank you all so much for the lovely replies - I’m obviously crying reading them all 😂😂
I do have Mirena coil and an underactive thyroid, so have regular bloods done but it sounds like I need to push for more tests .
I find all the different supplements advice so overwhelming but I think someone said treat it like a project and that makes a lot of sense to me! The most important thing is that it will pass and I’m so grateful to hear that - obviously all our mums and grans have been through it. It’s just unbelievable how much it’s impacting me, it makes me look at older women differently. We are so strong and have to go through so much.
I am going to call a menopause specialist and the GP again today I won’t rule out HRT. I can’t live like this and I’m worried for my business and my kids! They must think I’m cracking up . Thanks again everyone its cheered me up and given me a little bit of hope! x

Gosh sorry to hear this. You’ve been through hell by the sounds of it . X

Thank you, I do acuallly have an underactive thyroid which was diagnosed just after I had my eldest . I have regular blood tests for it and my medicine and dosages haven’t changed. But yes I think some of the symptoms are very similar .

I remember hitting menopause (without knowing it was that), and honestly thinking I was going mad or had early onset dementia, and would have to give up work (which I cant afford to do). HRT and Sertraline have made a huge difference op. Takes a bit of time to find what works for you best, but defo consider HRT (and maybe A-Ds if anxiety is your issue as it is with me). It really is life changing. See a specialist menopause doctor if you can - I got referred from my GP and it took 2 full years to see her but she’s great. I also take magnesium and wellwoman max supplements (which include vitamin D). I don’t drink alcohol either now - personal choice, and I don’t know if it helps but I like to think so. I also remember we all go through this in some form, and some of us suffer more, some less, and some lucky women not at all! My mum didn’t work, or have a mortgage which probably helped her too - I have a very different life, and different stressors. Good luck with everything.

You point out your medication dose hasn't changed but has your TSH changed?

If you use the online NHS app, it might be worth checking your TSH and looking back and seeing if the levels are the same ir have increased even with the same dose of medication

So you’re not touting it as a miracle cure, are you? The risks still stand and each individual responds to them based on their life experiences. I wouldn’t take up smoking occasionally and I won’t take HRT. People who don’t know better are happy to risk the cancers involved and may even be choosing based on the reductions of other cancers the research shows. Your comment seems like a knee jerk reaction to perceived critisism as it’s agreeing with what I said.