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The British Journal of General Practice logoLink to The British Journal of General Practice
. 2017 Mar;67(656):125. doi: 10.3399/bjgp17X689689

My personal experience of the menopause

Louise R Newson 1
PMCID: PMC5325642  PMID: 28232350

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As a GP with a particular interest in the menopause, I spend a significant amount of time in my working week either helping and advising women with their menopause or writing articles about the health effects of the menopause. Often, I am surprised how little women know about their menopause and many aren’t aware of the wide variety of symptoms that can occur when their hormone levels start to change. They are also unaware of the increased risk of both osteoporosis and cardiovascular disease associated with the low levels of oestrogen occurring.

However, despite this I am ashamed to admit that I failed to diagnose my own menopausal symptoms; in fact, it was my 11-year-old daughter who actually made the diagnosis!

THE PENNY DROPPED

I had been experiencing horrendous night sweats most nights for a few months. Waking up in the early hours of the morning covered in a layer of sweat was disgusting. Some nights I would wake up worried that I had urinated in my sleep because the sheet around me was wringing wet. Changing my pyjamas and the bedsheets once or twice a night was doing nothing for my husband’s mood and energy levels or our relationship with each other.

I also found that I was much more tired than usual. The extreme fatigue was similar to the tiredness I experienced when I was pregnant. I had ‘brain fog’ and found it really hard to concentrate on even the simplest tasks. I became slower at work, needing to really concentrate on patients’ records and details, and being more meticulous at checking the prescriptions I was issuing. I had to go to bed much earlier than usual because I was so tired and I was worried that the combination of night sweats and fatigue meant that I had lymphoma or another serious condition; however, I ignored my symptoms and decided not to rush to my own GP to have blood tests or other investigations undertaken.

Then a month later I was cooking and out of the blue I experienced my first hot flush, which was dreadful. My daughter asked me what was wrong as I looked so hot and sweaty. She then asked me why I had been so short tempered with all the family over the preceding few months. She even asked if I was due a period as some of her friends were quite often stroppy before their periods! It was only then that the penny dropped — I realised that I hadn’t actually had a menstrual period for several months. I was 45 years old and, although perimenopausal symptoms can be common at this age, I wasn’t expecting them to happen to me. I felt quite embarrassed as I should have known better.

AVOID MISDIAGNOSING MENOPAUSE

I see so many women, both in general practice and in my specialist menopause clinic, who have been misdiagnosed as having depression and given antidepressants by their GPs. Other patients have presented with palpitations and been referred to cardiologists, while some patients with urinary symptoms have been referred to urologists, and others have been simply told that it is ‘just’ the menopause so there is nothing that can be done. More worryingly, I see many young women in their late 30s and early 40s who are being denied HRT by their GPs, despite guidance clearly stating the importance of these women receiving hormones to reduce their future risk of cardiovascular disease and osteoporosis.

The NICE guidelines on menopause were published in November 2015 and should certainly be encouraging for many healthcare professionals.1 These are the first clinical guidelines on menopause to be produced by NICE and provide clear recommendations on both the diagnosis and treatment of women with menopausal symptoms.

These guidelines should enable clinicians to feel more confident in offering HRT to eligible women. They should also be able to help women make a better informed choice regarding their treatment, which can now be based on a more balanced review of the evidence.

HRT is generally a safe and effective treatment of the menopause and as such should be considered for many more women than it has been in the recent past.

REFERENCE


Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

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