A few years ago I hadn’t given menopause a second thought. These days it’s pretty much all I think, talk and write about, but that was never the plan. In the summer of 2012, I had to undergo a total abdominal hysterectomy, including the removal of both of my ovaries, due to suspected ovarian cancer.
Two days after surgery I was back at home, my feet up as instructed, which was perfect timing for the London Olympics. There was no discussion before or after my surgery about all the possible implications of surgical menopause, the state I now found myself in. When leaving the hospital I was simply told to see my GP at some point to discuss hormone replacement, but concerns about it meant that I initially chose not to take it. That was a big mistake. But I had no idea at the time, because nobody had explained it to me.
Initially I thought I was doing well, but about three months after my surgery, I was struggling to sleep, was constantly anxious and irrational, and felt that I had become useless, hopeless and worthless. As the weeks went by, I retreated from the world. Work was out of the question. I had become a non-functioning husk of a woman who one day came very close to taking her own life. I am blessed with a husband who took control when I couldn’t and secured the help that I so desperately needed.
All those sleepless nights were not wasted. I uncovered a world I knew nothing about: thousands of women online at all hours who, like me, were desperately searching for others who felt like they were going mad. They all had age range and symptoms in common – this was menopause. But why were so many struggling? I made a promise to myself that if I ever felt like me again, I would find out what was going wrong and make sure I did something to change it.
Before you change something, you need to understand the problems. It became obvious that there were three big hurdles to better menopause care and support, and education was the key. Historically, menopause has not been talked about openly and is not formally taught to women or men, so how the hell are any of us supposed to know what’s going on when the early stages, termed perimenopause, arrive, often in our early 40s?
GPs, the gatekeepers to accessing the right care, still don’t receive mandatory training in menopause, which makes no sense. Every woman – half of all patients – will go through menopause, and four out of five will experience symptoms, so surely it is just common sense to equip GPs to recognise and, where appropriate, treat the symptoms?
I have counselled so many women who have seen their doctors countless times, taking up hours of scarce consultation time, desperately trying to find answers to the debilitating symptoms interfering with their personal and work lives, only to be told that they are too young for menopause. Or they are told that they are anxious and depressed and so are incorrectly prescribed antidepressants, causing distress to patients at who knows what cost to our struggling NHS. Many of the women I counsel have considered giving up work; some already have. Surveys tell us approximately one in four women going through menopause consider resigning. Those who do leave due to menopause often don’t realise that’s what they were experiencing. Women who do know report feeling unable to discuss their situation with managers, or unsupported when they do.
Menopause support in the workplace is not rocket science. It is about taking the time to understand and normalise the conversation about a phase of life that every woman will experience at some point. Raising awareness and offering support is a win-win situation for both women and employers, and I am encouraged that slowly but surely things are starting to change.
To speed up the pace of change, I launched the #MakeMenopauseMatter campaign with three specific aims: to ensure mandatory menopause training for all GPs, to provide menopause guidance in every workplace, and for menopause to be included in the new relationships and sex education (RSE) curriculum in secondary education. I am delighted to say that as a result of the campaign, menopause will be taught in RSE from September.
Menopause is not just a women’s issue. It can affect us all: women suffer in silence, relationships break down, and careers are lost. Far too many are paying the needless price for a woeful lack of menopause education, care and support.
The highest rate of suicide among women in the UK is between the ages of 45 and 49, when most women will be experiencing perimenopause. This could be the ultimate hidden cost, and it matters.
• Diane Danzebrink is the founder of Menopause Support UK and the #MakeMenopauseMatter campaign