Things came to a head on our summer holiday. We had booked a nice place in Spain, the weather was lovely – but I felt anxious and irritable. Low-grade challenges like navigating an airport left me emotional and overwhelmed. I snapped at my partner and children, then felt guilty. Lying in a shady hammock in this beautiful place with the people I love most in the world I thought, I’ve lost my ability to enjoy life. Maybe it’s time for HRT.
I am not menopausal, but there had been signs of change for several years. Some were physical – my hair falling out, my periods getting more frequent and heavier. But mostly the issues were emotional. My five days of PMS now stretched to two weeks. I was often exhausted, lacklustre and irritable. But the anxiety was the worst – feelings that took me straight back to adolescence, when I suffered from panic attacks.
Somewhere along the way I’d heard about perimenopause; the period of hormonal upheaval leading up to menopause, when menstruation ceases. A friend started HRT at that time and raved about how much better she felt. I returned from Spain, reluctantly thinking the time had come.
But then I came across Dr Claire Jack, who offers coaching and counselling for mid-life women, and I decided to give that a go.
In our first session, Dr Jack reassures me there’s nothing unusual about the way I’m feeling. ‘Perimenopause can be worse than menopause itself,’ she tells me. ‘These are hormonal changes that happen for up to 10 years before menopause and they can have a huge effect. The classic symptoms like hot flushes continue after menopause, but often the mood swings and anxiety are much worse before and settle down after.’
It’s common for PMS to get longer and more severe in perimenopause. Oestrogen levels fluctuate wildly, which can exacerbate anxiety. ‘The effect is unpredictable,’ she says. ‘You may feel very anxious one day and fine the next.’ But while there are hormonal reasons for emotional turbulence, there’s often more underlying this. ‘It is a time of major transition,’ she explains, ‘often women are seeking change, whether they’re aware of it or not. This can cause friction in relationships and families because expectations are the same – but what was working isn’t working for the woman any more.’
Dr Jack continues: ‘In early motherhood we’re primed to care and bring the family together. At menopause, hormones spur us on to look at ourselves.’ This chimes with me. Since my children were young, I’ve worked part-time and done most of the childcare. This has been my choice and still is, but something is bristling. I realise I’ve started thinking more about my own future – what’s next?
Rebalance and support
In session two, we look at lifestyle and health changes that can ‘get your hormones working in your favour’. Dr Jack concludes that my symptoms point to adrenal fatigue and, as the adrenals control the anxiety hormone cortisol, this is bad news. She says: ‘Adrenals take up the slack of producing oestrogen in menopausal women.’ These glands produce only 10 per cent of oestrogen in a 20-year-old woman (the rest comes from the ovaries), but in mid-life they produce 90 per cent. ‘This is a huge shift and the adrenals are working very hard.’
To rebalance and support my adrenals, she advises me to cut right back on caffeine and alcohol, include protein in every meal, and get plenty of sleep. I’m worried my body may be deficient in certain nutrients, so she suggests omega 3 supplements, and vitamins B and C. She also recommends stress-busters such as yoga and exercise as well as a short daily meditation or self-hypnosis.
In session three, we look more closely at the existential shifts I’m experiencing, and all the emotions that bubble up as a result – especially anger. To Dr Jack, rage is a normal part of menopause.
‘There may be things that have suited women for a long time that no longer work – or things that they have put up with that they no longer want to – and because of the hormonal changes, these can crop up as anger,’ she says. ‘Women think, “but I’ve always done this, why am I suddenly angry about it?” They don’t understand why they feel the way they do. But change needs to happen, and it’s important to listen to your anger and address it, and use it.’
I use Dr Jack’s visualisation techniques and reflect on my life. It’s true – I am eager for a shift that feels pretty fundamental. My adult life has often felt like a struggle – to make my place in the world, to achieve some financial stability. Maybe it is mid-life talking, but I want to enjoy my life more, and focus my energies on things that are meaningful.
Dr Jack says repressed emotions that go back decades may also surface now, again due to hormonal shifts. ‘This is a good time to address things from 40 years ago,’ Dr Jack says. ‘Otherwise they’ll come out in emotional ways like anger and anxiety, or as physical symptoms such as high blood pressure.’
Again, her words strike a chord. Over the course of my adult life I have suffered several great losses, including my mother’s recent decline into dementia. For the last few years, I’ve experienced chest pain that has no obvious cause – could it be a bodily manifestation of emotional pain? Dr Jack and I work on this with a grief visualisation that is intimate and very emotional. I feel raw and tearful for several days afterwards, but then start to feel much lighter.
‘Menopause is a gift given to you as a time to increase awareness,’ says Dr Jack. ‘What do you want to do with the second part of your life?’ It’s an exciting and interesting question.
Over the next few days, I make lists of what my life is comprised of; and how I feel about it; what energises or drains me. I see how certain relationships grind me down, and realise I have to change the way I handle them. I need to be firmer about sharing out chores. In my working life, I can see which parts – like commuting – are a drain. I realise how important it is for my wellbeing to live life at my own pace, and that this is slower than it was a decade ago. I look at how things could change. As a freelancer, I have some flexibility so I look at small, affordable changes that I suspect will make a big difference to how I feel.
In our last session, Dr Jack asks me to visualise where I would like to be a year from now, and I realise that it’s pretty much where I am – with a few well-targeted changes. I feel extremely lucky that I’m so close to the life I want, and for the help Dr Jack has given me to enjoy it again.
The anxiety, PMS and grumpiness have not disappeared entirely but are vastly improved. Just being able to view mood swings and extreme emotions as a normal part of where I am in life – to know I’ll feel better in hours or days, and to have an armoury of techniques – all of this helps. I feel energetic and am looking forward to the future with real excitement for the first time in years. For now, at least, I feel a long way from needing HRT.
For more about Dr Claire Jack’s menopause coaching package, visit azuretransitions.co.uk