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Mood swings to anxiety and insomnia: Mariella Frostrup on how the menopause caused her to suffer

The bedside clock was blinking an insulting 2am. Had I even been asleep at all? I remember putting the light out at the usual 11.30pm, so what was I doing here, wrenched into wide-eyed wakefulness, with my heart racing, at this ridiculous hour?

This wasn’t the first night it had happened. The year was 2011, my age was 49. A definite pattern was setting in.

As someone who’d always managed to sleep quite well, despite frequent interruptions from jet lag, young children and pressing work schedules, I now found sleep completely unfathomable and unyielding.

There’s not much you can do at 2am except worry or make lists, and I became accustomed to doing both. I could write shopping lists and arrange play dates for the children, while at the same time fretting about the situation in Syria. I could even fit in a lengthy fume about a witty put-down I should have delivered to some professional adversary 30 years ago.

If I was lucky, I’d fall asleep again — only to wake a couple of hours later in the same agitated state, and start the cycle again.

What on earth was wrong with me?

When Mariella Frostrup (pictured) investigated menopause and what is on offer for women she found the ‘lack of information and resources devoted to the subject is quite staggering’

With increasing fury, I tried all the tricks. I focused on my breathing, put lavender oil on my pillow, wore ear plugs, had relaxing baths before bed and even wore a beautiful silk eye mask from Liberty which my friend Penny Smith gave me.

Nothing made a jot of difference.

Fast-forward two years to 2013, and I was sitting exhausted and depressed in the London office of Sara Matthews, a gynaecologist who looked like a cross between Jessica Rabbit and a model from a Nineties Robert Palmer video.

She wore a black dress that looked like it had been poured over her curves and a pair of killer heels. With her mane of fabulous wavy hair, crimson lipstick and soft Northern Irish accent, I wanted her to sing me lullabies.

She sat down, put her hand on mine and asked how I was feeling. It was all I could do not to leap across her expansive desk and nestle, babylike, in her arms.

‘I’m so tired,’ I replied. ‘And stressed. I really don’t feel like myself.’

‘We can’t have you feeling like that,’ said Sara reassuringly. Those words sparked the beginning of the end of my nightmare.

This conversation took place five years ago and was the culmination of two years of anxiety and insomnia which I was pathetically unaware were signalling the beginning of the menopause.

As Sara scribbled a prescription for HRT, testosterone, melatonin and the hormone DHEA, all of which would make life more bearable, I felt conflicting emotions; shame at ignorance of my own biology that had led to two years of suffering, and euphoria that my misery might come to an end.

It appeared that I had reached the menopause with barely a hot flush to offer the slightest hint of what was happening.

BBC documentary explores the latest medical research on menopause in The Truth About Menopause

BBC documentary explores the latest medical research on menopause in The Truth About Menopause

FRANKLY, the lack of information and resources devoted to the subject is quite staggering. I honestly didn’t have a clue, and I cannot be alone.

That’s why I’m so thrilled that the BBC, on whose door I’ve been beating for three years, finally commissioned an hour-long, peak-time programme on the subject.

I spent eight weeks touring the UK speaking to menopause specialists and sufferers to explore all the myths and taboos while looking at the various treatments available.

Even then, it took a woman — Charlotte Moore, the BBC’s Director of Content — to do it, and she had to cut a decisive swathe through many levels of male concerns about losing viewers to get it made. Why is it that we know so little about this subject? And why are we — both men and women — still so queasy about discussing it?

There are two periods of significant hormonal activity during a woman’s life. And the second one, the menopause, with its end-of-life imagery, has more in common with a virulent disease than the mere resetting of our biological clock.

Mariella Frostrup with Her Husband Jason Mccue The Great Initiative Charity Dinner. Mrs Frostrup has created an hour-long programme on menopause for the BBC

Mariella Frostrup with Her Husband Jason Mccue The Great Initiative Charity Dinner. Mrs Frostrup has created an hour-long programme on menopause for the BBC

Image-wise, menopause has a serious problem. There may be little to generate excitement about the end of fertility, but it might at least be seen as a new beginning rather than a shameful secret.

Menopause is perceived as a shutting down. A menopausal woman is a pointless specimen of humankind. And lots of women walk into it with eyes wide shut. I know I did.

The average age of menopause is 51, but it can occur any time from your 40s to mid-50s and certain conditions can bring it on even earlier.

Little girls nowadays are so in tune with their bodies, they are, quite rightly, fully versed in menstruation and what it means long before their first period. Words like ‘the curse’ have been banished, as has that cruel, antiquated practice of ‘not talking about it’ and leaving terrified young girls totally ignorant and unprepared.

So why are we abandoning older women to this fate, at the other end of the journey?

Is it really shame? Embarrassment? Prudishness? That a menopausal woman is in some way unmentionable?

Given that life expectancy for women is now almost 83 years, it’s astonishing that perception of successful females should still be tied up with our ability to procreate. People don’t walk around saying, ‘You can’t have babies, you’re finished’, but it’s implicit.

What I didn’t know, but do now, is that there is no uniform response to the drop in oestrogen that happens when ovaries stop releasing eggs each month. (The growing eggs release the oestrogen, so the fall is a result of less egg growth).

For many, there are irregular periods and hot flushes. Others suffer low libido, anxiety, sleeping problems and night sweats. Some have no symptoms at all. I had the Mirena contraceptive coil, which stops periods altogether, until the age of 49, after which my periods were irregular.

Mariella Frostrup: 'Image-wise, menopause has a serious problem. There may be little to generate excitement about the end of fertility, but it might at least be seen as a new beginning rather than a shameful secret'

Mariella Frostrup: ‘Image-wise, menopause has a serious problem. There may be little to generate excitement about the end of fertility, but it might at least be seen as a new beginning rather than a shameful secret’

During my research, I was shocked by the levels of ignorance and the amount of women who were so embarrassed they didn’t go to their GP, even when their work and personal lives were significantly affected.

I now know that it can be entirely physiological as well as psychological; shifting hormone ratios — in particular oestrogen and progesterone, the other hormone that falls off a cliff in menopause and which promotes sleep.

The problem with not sleeping is that your ability to function on full power just isn’t there. Everything is harder and takes longer. Suddenly the week just didn’t seem to have enough days in it to get everything done.

I found my memory was affected. I always used to wonder why my mother had lists everywhere — now I had lists on WhatsApp and Post-Its scattered throughout the house. I still can’t live without the white board on my fridge keeping me operational.

Hand in hand with insomnia came crushing and inexplicable anxiety — an irrational feeling which I’d normally associate with being stressed, even though during lucid moments I knew I didn’t have that much to be so agitated about.

Yet there was no respite, and it didn’t have a filter; I’d be as overwrought about internet shopping as I was about getting home from the USA in time to relieve the babysitter. Was I snappy with my husband? I was snappy with every single person I encountered.

I now realise I’m one of millions suffering similar bewilderment, and that many of my contemporaries are enduring this — and worse — in shamed silence, unlike me.

My husband said that I needed to relax and try to get more sleep. Most helpful! But the hardest thing was not knowing why I wasn’t sleeping in the first place. We were just moving from London to Somerset, and there was obviously associated stress, but I was excited rather than harassed.

The most recognisable symptom of menopause, apart from dwindling periods, is the hot flush, but I’ve only ever had two. That was enough to understand how incredibly debilitating they must be for the many millions of women out there for whom they are a regular occurrence.

My symptoms were nothing compared to those I interviewed for The Truth About The Menopause — Anita Carter, a 60-year-old JobCentre manager from Warrington, suffered 30 hot flushes a day, for example. Her work and sleep were dramatically affected. But my meagre two hot flushes were a glimpse into their hell.

On both occasions I was lying in bed. The best way of describing a hot flush is someone blasting boiling hot air all the way from the soles of your feet through your body, with volcanic strength. It’s quite unbelievable, and the extreme heat like a physical force.

As for libido. Well, of course I noticed, but anyone desperate for sex when they’re in a long-term relationship in their 50s has some other condition! I know plenty of men of the same age who aren’t as rampantly sexual as a decade earlier.

There are many aspects of the menopause which are, I suspect, common to both sexes, or simply side-effects of increasing age. For men, these are regarded as part of growing older; for women, they’re terrifying totems of obsoletion.

Eventually, after a year and a half, I went to see a private doctor who did three blood tests over the course of six months to check my hormone levels: the first test said that I was post-menopausal, the second said I was perimenopausal and third said that I wasn’t menopausal at all.

Baffled, he recommended that I go and see the gynaecologist Sara Matthews.

There was just one obstacle — my private health insurance. I phoned up AXA PPP and said quite cheerfully that I was going to see Sara, and might I have an authorisation number for the upcoming claim.

The lady on the other end of the line sounded sympathetic and finally suggested that my symptoms might be menopausal. When I agreed it might, her tone changed and she said: ‘If it’s anything to do with menopause we don’t cover it.’

So, a huge range of symptoms are all lumped together, called the menopause, and completely dismissed.

I’m so incensed, I’m seriously thinking of mounting a legal case.

If a man in his 50s suffers sleeplessness, anxiety, mood swings or depression, they’re regarded as individual symptoms and dealt with accordingly. But a raft of things a woman may experience as she journeys through middle age and beyond are all dismissed as side-effects of a condition that doesn’t exist except as a name for the end of your monthly cycle!

The National Institute for Health and Care Excellence (NICE) announced new guidelines for diagnosing and dealing with menopause only three years ago, even though women have been coping since time immemorial.

There are clearly solutions, and now that attention and investment is beginning to be focused on it, medical breakthroughs are occurring.

During my research, I met doctors who can reverse the menopause and came across an amazing new drug being trialled that seems to halt hot flushes.

As for our amazing NHS, when it comes to menopause you may find yourself in a bit of a lottery, depending on how up-to-date and interested your GP is.

There simply is not enough resources and research being put into menopause - Mariella Frostrup found

There simply is not enough resources and research being put into menopause – Mariella Frostrup found

Many of the preparations are decades old, and haven’t changed much since HRT was first introduced in the UK in 1965. A few new ones have come onto the market since: as well as tablets, there is the HRT patch, which I clearly remember my own mother wearing when she was going the menopause 30 years ago.

There are also gels, which are applied topically, meaning the hormones are absorbed through the skin.

These may be available across the country, but for many women HRT treatment can be a very blunt instrument.

When I went to see my gynaecologist Sara in 2013, she said immediately that everything I’d described pointed to the menopause. She wrote out a prescription for HRT, testosterone, melatonin and the hormone DHEA, a mixture of tablets, creams and patches, all of which would make life more bearable.

The first patch I tried from Sara had to be replaced every three days. I felt like a branded cow, walking around with a plastic square stuck on me, which induced flashbacks of my mother doing the same all those years ago.

The second one was supposedly better but thicker. It used to fall off and didn’t deliver the correct amount of hormone, so my oestrogen levels plummeted, sending me back to square one.

After a bit of trial and error, I settled on an oestrogen gel, which I apply to my inner arm in the morning, and I take a progesterone pill at night. Within a week I felt like myself again. Sleep patterns reset, vigour renewed and mood swings levelled out.

The biggest difference was that I got stressed in a normal way; about normal triggers like my children dropping wet towels on the floor, rather than 24 hours a day about nothing in particular.

I also learned coping mechanisms. Talking helped, as did learning to breathe

— if I can’t sleep I do counted breathing, which works most of the time.

Once I knew what was happening, I was quite happy to talk about the subject, but found I was in the minority. What really shocked me was that in my own circle of friends, whom I consider to be forward-thinking and educated, there was an avoidance of the topic.

I’d mention it to girlfriends and they’d shudder and say, ‘Thank God I don’t have it yet’, as though it was a disease. If I joked about the menopause in front of men, there was just total silence.

I first mentioned it in a column back in 2015. In the days afterwards, total strangers, female naturally, came up to me in restaurant loos, on public transport and on street corners telling me how brave I was. It felt like I’d started a secret society.

On one memorable occasion, at a swanky party in London where Michael Fassbender was the most exotic guest, a woman in her 30s elbowed past him to tell me that I was her heroine for not being embarrassed to use the M-word.

Now aged 56, I am firmly post-menopause. The bell finally tolled two years ago, though I suspect I’ll be taking HRT till the day I die (although another area we cover in the programme is the risk of breast cancer).

For me, I feel it’s minimal enough that the benefits outweigh the risks. However, I spoke to Woman’s Hour matriarch Dame Jenni Murray, who took it and subsequently had a breast cancer diagnosis. She understandably stands firm on the other side of the debate.

Emerging from the menopause has given me an amazing sense of rebirth. I feel stronger, with renewed confidence. I am fitter than I was in my 40s and have a far healthier lifestyle — these days you pay heavily for any form of debauchery. Post-50, there’s no such thing as ‘just a hangover’!

I desperately want to ensure that other women don’t see the menopause as being a full stop, that we stop sweeping any discussion of it under the carpet.

And most importantly, that my daughter’s generation are better informed and utterly unashamed to talk about the menopause, which is not a time bomb, but just a necessary readjustment to our biological clocks.

n The Truth About The Menopause is on BBC1 on Monday, November 26, at 9pm.



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