• Migraines are around three times more common in women than men
• Symptoms often include fatigue, nausea, sound and light sensitivity – and not everyone will experience headaches
• Strategies on how to manage migraines

Migraine is a common inherited neurological condition that affects around one in seven people – and is around three times more common in women than men, some of this difference is related to hormonal factors, including perimenopause and menopause [1].

And I’m among that number, having suffered with migraines since I was a teenager. I know all too well how migraines can negatively affect work and precious time with family and friends.

Migraines can be incredibly isolating, and it’s important to acknowledge they cannot be simply ‘willed’ away. Like many people with migraines, I know the importance of planning ahead and having a toolbox of measures to draw on when an attack occurs. For me, that includes eating regularly, avoiding processed foods and alcohol, and prioritising sleep.

You may be reading this because like me, you also experience migraines, or perhaps you have a loved one, friend or colleague who does and you want to find out more about how you can support them.

That’s why I’ve written this guide: to explore the different symptoms, triggers and management strategies for migraines when an attack occurs.

RELATED: Migraines and menopause: what’s the connection?

Migraines explained

Migraine is an inherited neurological condition that causes many different symptoms. Each migraine can follow a different pattern, and this can change over the course of a lifetime.

There are several phases of a migraine.

Before an attack starts people may feel tired or yawn more, some may have more energy or experience craving, or find they need to pass urine more. These symptoms can start several hours or even days before the migraine attack.

The next phase is the aura which is experienced in around a quarter of people. Aura is the name given to part of the migraine made up of a range of temporary neurological symptoms including visual changes (flashes of lights, loss of vision, zigzag patterns), tingling sensations, speech problems, dizziness, weakness on one side of the body and, very rarely, loss of consciousness.

The headache phase follows aura (although some people can experience aura without headaches). The pain of migraine headaches can be severe, throbbing and is often accompanied by excessive sensitivity to light (photophobia), loud sounds (phonophobia), or smells/odours, as well as nausea and/or vomiting. Migraines commonly last between 4-72 hours and can be made worse by movement. Many migraine sufferers experience significant vestibular symptoms (vertigo, balance disturbance).

The final phase is the postdrome/recovery phase. At this stage the headache has gone but person is usually left feeling tired and washed out which can last for 2-3 days.

Migraine attacks can be frequent, or there can be gaps of weeks or months without them. For some people, it is possible to identify triggers whereas for others the triggers are less obvious. It is often a combination of factors that act together to trigger an attack.

Migraines can be lifelong and disabling for some people. The onset often peaks between the ages of 35-45 years [2]. They can affect physical and mental health in different ways. The migraine process itself can cause low mood and anxiety before, during and after an attack. Living with migraine can lead to worry and fear about experiencing attacks and how they may impact on plans and commitments. Migraine can have a significant impact on a person’s ability to function in daily life, and on their wellbeing.

Chronic migraines – having headaches on at least 15 days per month, with eight of these having migraine symptoms, for at least three months [3] – are one of the most common causes of disability worldwide, yet many people are unable to access adequate support and treatment. 

RELATED: Migraines and hormones

Migraine attack triggers

Common conditions that make you more susceptible to an attack include: 

• Bright or LED lights 
• Loud and unpredictable sounds 
• Certain scents, such as perfumes, air fresheners, cleaning products 
• Going too long without food and/or drink, or certain types of food and drink, including processed or high sugar foods, and alcohol 
• Sleep disturbance (too little or too much)
• The build-up of, or extreme stress 
• Lack of routine  
• Too strenuous exercise 
• Being too cold or too hot 
• Change in weather pressure 
• Travel.

While some of these triggers can be managed, others are beyond your control – and sometimes, migraines can just happen without an obvious reason.

What are the signs a migraine may be coming?

Early warning signs, also known as ‘prodromal’ symptoms, that a migraine attack is coming include,

• Pallor 
• Slurring words / not making sense 
• Nausea
• Yawning
• Not feeling hungry or feeling far more hungry than usual and craving certain food types
• Feeling very cold or hot 
• Having heightened hearing – small noises can be a real trigger 
• Headache.

Recognising early warning signs can, but not always, help people with migraines take action to reduce the severity of an attack.

Treatment for migraine

Although there is no cure for migraine, there are many different treatments available which can often reduce the severity of a migraine attack. Often a combination of medication and lifestyle changes can improve both frequency and severity of migraines.

Treatments for migraine are either ‘acute’ treatments, ‘preventative’ treatments or sometimes both. A headache diary can be very helpful to both help with guiding treatment as well as monitoring response to different treatments. It can be common to try several treatments before finding one that suits you and your treatment or treatments may change with time.

Acute treatments

Acute treatments are used to try and stop a headache once it has already started. Aspirin (dispersible, 900mg for adults) can be very effective. Some people find non-steroidal anti-inflammatory medication such as ibuprofen beneficial as an alternative to aspirin [4].

Anti-sickness medications can also be taken to improve the nausea and vomiting. These medications can also help you absorb your painkillers and any other medication faster. There are a group of medications which can be prescribed specifically for migraines called triptans. There are different types, formulations and doses of these medications – for example they are available as tablets, nasal sprays, orodispersible tablets and injections. Many people find that they have delayed emptying of their stomachs when they have a migraine attack which means that regular tablets are less likely to be absorbed effectively, which is why the nasal sprays, orodispersible tablets or injections work as alternative ways of getting the medication into your body. The different triptans can have different effects too, so if you have a side effect with one, or it doesn’t work like you hoped, then it is worth asking to be prescribed another to try.

Many people (including me) find that a combination of treatments, including a triptan, anti-sickness plus either aspirin or an anti-inflammatory taken all together at the start of an attack can be effective to either abort an attack or reduce the severity of one.

Preventative treatment

Preventative treatments are used to try and prevent migraines occurring [4]. If you are having frequent migraine attacks – more than three to four times per month, then you may benefit from taking a preventative medication.

These are not the same as the acute treatments.

Many of medications prescribed are actually licensed for different indications – for example for epilepsy, high blood pressure or depression – but clinical studies have shown that they can be effective for some people with migraines.

If these medications are not effective or lead to unwanted side effects, then injections of Botulinum toxin A (Botox) may be given. There are also a class of drugs called CGRP monoclonal antibodies which have been shown in many studies to be effective for frequent migraine where other treatments have not been successful [4].

There is a device called Cefaly which uses a mild electric current (eTNS) to stimulate and desensitise the trigeminal nerve, the primary pathway for migraine pain. It can be beneficial for some women to relieve acute symptoms and also to prevention migraines occurring [5].

For some people. Single Pulse Transcranial Magnetic Stimulation (STMS) is prescribed and can be beneficial to treat acute migraines and prevent future migraines. This patented dual migraine therapy directly targets and signals the brain to quiet the hyperactive nerves thought to be the source of migraines [6].

Migraines and hormones

Changing hormone levels can trigger migraines in some women – all three hormones oestradiol, progesterone and testosterone are made in your ovaries, adrenal glands but also your brain. They have important effects in your brain, so when levels of these hormones reduce and/or fluctuate then this can trigger a migraine [7].

It can be common for migraines to start during puberty and then worsen during perimenopause – these are both times when hormone levels greatly fluctuate.

Taking oral contraceptives is often not advisable for women with migraines as these are associated with a small risk of stroke and can lead to worsening of migraines. However, having natural (body identical) hormones at the right dose and type can really improve migraines – both their frequency and severity [8]. Using hormones can reduce the fluctuations as well as replace the missing hormones. In addition, there is some evidence that women who take testosterone have lower frequency and severity of migraines [9].

Lifestyle changes

Migraines can often be triggered by changes to routines so many people find it useful to try and eat their meals at the same times each day as well as go to bed and get up the same time each day. This includes the weekends – I set my alarm clock the same time each day so I can’t remember the last time I had a lie in!

Reducing or cutting out alcohol can be useful for some people. If you find certain foods – such as cheese or chocolate – trigger migraines, then it is worth reducing or even cutting out these food groups. Processed foods and sugary foods can lead to sugar spikes to often changing to fresh fruit and vegetables with plenty of fibre can improve migraines. Some people have benefit with various supplements – for example magnesium and fish oil.

Things that can help if done promptly: 

Food and drink: This can include drinking water to help with hydration, or eating a snack such as nuts or dates to avoid the peaks and troughs in blood sugar which can trigger migraines or make them worse in some people

Quiet and rest: moving away from an over-stimulating environment and getting some rest where possible may also help

Rescue medication: taking rescue medication – which could include an over-the-counter painkiller such as dispersible aspirin, and an anti-sickness medication such as prochlorperazine, can help with symptoms

Triptans are a group of medications which are prescribed to ease symptoms of a migraine. They work by changing the way your brain processes pain signals. Sumatriptan can be bought over the counter in some countries, but it is the triptan associated with most side effects

Neuromodulation: devices that use technology to alter nerve activity.

Supporting a loved one or friend? Here’s how you can help them through a migraine

Migraines usually affect thought processes, so it can be common for people with migraines to forget the tried and tested strategies they need when they need them the most, so you may have to prompt them – they may not appreciate it at the time, but they will when they feel better.

My husband has used these tips for decades for me, and my eldest daughter’s friends also use them with her.

Things you can do to support someone experiencing migraines: 

• Be reassuring: remind the person that the attack will not last for ever
• Ask them if stroking their head is helpful

• Helping the person into bed (if possible), make the room as dark as possible by closing the blinds and turning out the lights, and keep the environment as quiet as possible
• Making sure they have used the toilet before going to bed, and check if they have recently had a drink of water as well as putting a drink close to them
• Be present: offer to check on them regularly, for example every 15 mins 
• Avoid asking the obvious: you may find asking ‘how are you feeling?’ will only remind the person how bad they feel. Instead, be proactive: ‘is there anything you need?’ ‘can I get you some water?’
• Keep perspective: conversations with someone during a migraine are likely to not make sense: they may be emotional and negative – after all, they are in pain and also their thought processes are likely to be impaired. Listen, be empathetic and non-judgemental, and try not to dwell on their comments at this time
• You will often feel powerless to help but know for that person it will be a comfort just to know someone cares.

References

1. National Institute for Health and Care Excellence (NICE) (2024) Migraine: how common is it?

2. Bigal M.E., Liberman J.N., Lipton R.B. (2026), Age-dependent prevalence and clinical features of migraine, Neurology, 67(2):246-251. doi:10.1212/01.wnl.0000225186.76323.69

3. International Headache Society ‘Chronic migraine’

4. NICE (2024) ‘Scenario: migraine in adults’

5. Trimboli M., Marsico O., Troisi L., Fasano F. (2023), External trigeminal neurostimulation in patients with chronic migraine, Pain Manag, 13(3):185-192. doi: 10.2217/pmt-2022-0082

6. Bhola R., Kinsella E., Giffin N., Lipscombe S., Ahmed F., Weatherall M., Goadsby P.J. (2015), Single-pulse transcranial magnetic stimulation (sTMS) for the acute treatment of migraine: evaluation of outcome data for the UK post market pilot program, J Headache Pain, 16:535. doi: 10.1186/s10194-015-0535-3

7. Godley F. 3rd, Meitzen J., Nahman-Averbuch H., O’Neal M.A., Yeomans D., Santoro N., Riggins N., Edvinsson L. (2024), How Sex Hormones Affect Migraine: An Interdisciplinary Preclinical Research Panel Review, J Pers Med, 7;14(2):184. doi: 10.3390/jpm14020184

8. Sacco S., Ricci S., Degan D., Carolei A. (2012), Migraine in women: the role of hormones and their impact on vascular diseases, J Headache Pain, 13(3):177-89. doi: 10.1007/s10194-012-0424-y

9. Dourson A.J., Darken R.S., Baranski T.J., Gereau R.W., Ross W.T., Nahman-Averbuch H. (2024), The role of androgens in migraine pathophysiology, Neurobiol Pain, 6;16:100171. doi: 10.1016/j.ynpai.2024.100171

The post Migraines: what you need to know appeared first on Balance Menopause & Hormones.

Advisory: this article contains themes of mental health and suicide.

Newson Health’s new research on absorption, highlighting that some women need higher doses than others for adequate absorption through their skin, can be found here.

It’s taken me 17 years to learn how to manage my menopause symptoms. At 33, I began to feel exhausted, my body ached, I couldn’t think clearly, and I began to experience premenstrual syndrome (PMS). I went from being a hardworking, active woman, regularly travelling around the world as part of my job as a geologist to being completely debilitated.

I was diagnosed with chronic fatigue syndrome (CFS) but over the following year, I developed acne, blinding headaches, tinnitus, skin that was so itchy I would scratch it until it bled, palpitations, UTIs, allergies and my PMS escalated. My periods changed to a 21-day cycle and were so heavy I thought they resembled what the collapse of the Hoover Dam might look like.

My GP diagnosed perimenopause, and I was told if I wanted children, I’d need to get a move on. Fertility tests revealed I had premature ovarian insufficiency (POI) and through IVF, my husband and I successfully conceived our beautiful baby girl.

When I was 41, my headaches became worse and were accompanied by visual disturbances and vomiting. One time I abruptly became unwell with a migraine whilst on holiday in Wales – I threw up in a shop doorway and had to return to the campsite to be looked after by my four year old. By my mid-40s, I had a migraine for 16 days out of every month.

My mental health began to suffer. I’d been struggling with postnatal depression and PTSD after a traumatic birth and the depth of despair during PMS episodes was so uncontrollable it greatly impacted my ability to function.

RELATED: Postnatal depression, PMDD and menopause: Wendy’s hormone journey

RELATED: All about progesterone: PMS, PMDD, postnatal depression and menopause

During this time, I had retrained as a teacher, so life was stressful. I had also relocated so had attended a different doctor’s surgery – my GP never talked about perimenopause, instead I was given antidepressants. Eventually I was referred to a gynaecologist who suggested a drug to quieten down my ovaries – it left me so exhausted I wasn’t able to function, and the migraines became worse.

My blood pressure was high and I experienced my first major palpitation, whilst I was teaching. My colleague took me to the hospital where I had an ECG. Again, this was put down to stress.

After charting my migraines and discovering a cyclical pattern, I learned about the link with menopause and joined the dots. However, my GP didn’t agree as I wasn’t experiencing hot flushes.

RELATED: Migraines and menopause: what’s the connection?

In January 2020 I saw a locum GP who got it straight away. She prescribed HRT: 40mcg of Elleste Solo HRT patches and a progesterone tablet. It dramatically reduced my symptoms. However, this only lasted a couple of months, so my dose was increased to 80mcg of Elleste Solo patches.

During the summer of 2020 I was advised to stop HRT because I wasn’t experiencing hot flushes. After I stopped, I did experience hot flushes, so HRT was re-implemented.

I plodded on and between 2021 and 2022, my symptoms began to ramp up and I became extremely anxious. My career as a teacher, in a high pressure, high workload environment exacerbated the situation, but I felt like I was going insane. I thought I was having a breakdown and was signed off work for two weeks.

However, a week into the crisis, the acute anxiety and depression flicked off like a switch. I was suddenly normal again. It lasted for about three days, before the next cycle began. I had no doubt what I was experiencing was hormonal in nature. I asked my GP if I could be referred to a menopause specialist and asked about more HRT but was told that 80mcg was the highest possible dose and that I could not have vaginal HRT and transdermal HRT patches together. When they asked what I hoped to achieve by seeing a menopause specialist, I realised that I wasn’t going to get the support I needed so I turned to a private menopause clinic.

RELATED: HRT doses explained

The day I had my appointment at Newson Health in Easter 2021 was a moment of recognition and hope. I was clinging onto my life, career and sanity. After talking about my symptoms, I was prescribed 100mcg Estradot, testosterone and vaginal oestrogen (I already had the Mirena coil for my progesterone).

Within two weeks, I felt so much better, almost superhuman. I bounced back like Zebedee and was myself again for the first time in a decade. But it didn’t last. After a couple of weeks, the migraines and low mood began to re-emerge. I contacted the specialist who went through my symptoms and recommended increasing the HRT dose. I gradually reached a dose of 150mcg and remained well for several months. I went on holiday without struggling with symptoms and I climbed a mountain for the first time in ten years.

I began the new school year with vigour but in October 2021, I had a mental health crisis that resulted in more time off work. This time, however, I had immediate access to my Newson Health specialist who was brilliant. She recommended lowering my HRT dose over several months to ensure the mental health symptoms I was experiencing were not due to having too much oestrogen.

My GP recommended I take an antidepressant. It was horrific – I was anxious, jittery, and couldn’t sleep. I decided to stop when I started hallucinating.

RELATED: Am I depressed or menopausal?

My symptoms appeared to be uncontrolled, and I felt like I couldn’t do my job. I was concerned that if I didn’t take action to reduce the distress I was experiencing, I may have taken my life, so I resigned from my teaching role.

After investigating my HRT dose and testing absorption, it was decided that I needed more oestrogen, and my dosage was slowly increased. I began to get closer to myself again.

For the remainder of 2022, my medication was periodically optimised by Newson Health and I got better and returned to teaching part-time and an active lifestyle.

In 2023 the financial pressures of private care and the introduction of the HRT prescription prepayment certificate (a one-off prescription fee giving annual access to HRT at a reduced cost on the NHS in England), led me to transition my treatment back to the NHS. My GP expressed concerns about my HRT dose – I was on 350mcg oestradiol patches – and ordered an oestradiol blood test. The test showed that my levels were in the normal range so although I was on a higher dose, I still wasn’t absorbing it all.

My doctor’s surgery said it was seeking guidance on my dose as it was above the licensed levels. My prescription was reduced without consultation – I only discovered the change when I picked up my prescription in May 2024.

I raised concerns about the potential impact of this reduction on my mental health, including the risk of suicidal ideation, and was referred to the gynaecology team. They advised against the drastic reduction in my dose, initiated further tests, including a womb scan and DEXA bone density scan, and confirmed that I was a poor absorber of transdermal HRT. They recommended continuing the 350mcg dose.

However, my surgery refused to prescribe it, citing concerns that this would place their clinicians outside of NICE guidance, which could invalidate their medical insurance. This was frustrating as

NICE guidelines acknowledge that some women with POI may require high doses of HRT for symptom relief. Both private and NHS specialists had recommended a course of treatment that works for my individual circumstances, yet I was having to fight to receive it.

The financial burden of private treatment, combined with the loss of earnings due to sick leave and reduced hours, has left me in significant debt totalling tens of thousands of pounds.

Thankfully, I’ve now been referred to secondary care in the NHS and they are prescribing the agreed dose of oestrogen. I believe 350mcg is the optimum dose for me. I might still have the odd fluctuation of hormone levels, but I can recognise the signs when I need extra oestrogen, which I can apply through my pump pack. These fluctuations are becoming less frequent as I get older and I know I can call my specialist so I’m not alone anymore.

I am living again – I’m achieving things outside of my career that I could only have dreamed of, I’m a much more energetic and engaged mum, and am trying to make as much noise as I can about the impact of menopause.

Contact the Samaritans for 24-hour, confidential support by calling 116 123 or email jo@samaritans.org.

RELATED: What is the right dose of HRT for you? Hormones and premature ovarian insufficiency

Resources

Newson Health: HRT is not a “one size fits all” treatment

Glynne S., Reisel D., Kamal A., Neville A., McColl L., Lewis R., Newson L. (2024), ‘The range and variation in serum estradiol concentration in perimenopausal and postmenopausal women treated with transdermal estradiol in a real-world setting: a cross-sectional study’, Menopause. DOI: 10.1097/GME.0000000000002459

The post ‘Specialists agree I need higher dose oestrogen, so why has it been such a fight?’ appeared first on Balance Menopause & Hormones.

On this week’s podcast, Dr Louise Newson is joined by Dr Rebecca Walker, a GP who specialises in headache medicine and migraines.

In this episode, Dr Rebecca and Dr Louise (who suffers from migraines herself) get back to basics, looking at what migraines are, why they can occur and management approaches, from lifestyle measures to medication. They also talk about how hormone changes during perimenopause and menopause can impact the frequency and severity of migraines, and bust some myths around taking HRT if you have a history of migraines.

Follow Dr Rebecca on Instagram @dr_rebeccawalker.

For more information on migraines, visit the National Migraine Centre here, and you can find resources about migraine and menopause on the balance website here.

You can also listen to an earlier episode of the Dr Louise Newson Podcast with Dr Katy Munro, author of Managing Your Migraine, by clicking here or searching for episode 115 on your favourite streaming app.

For more information on Newson Health, click here.

The post Migraines and menopause: what’s the connection? appeared first on Balance Menopause & Hormones.

• Headaches can be influenced by hormones and worsen during times of flux
• Lifestyle adjustments can help alleviate symptoms
• HRT can help manage menopause-related headaches

Most of us have experienced headaches at some point in our lives, and according to the World Health Organisation, up to 1 adult in 20 has a headache every, or nearly every, day [1]. They can vary enormously in type and cause, with some estimating there are as many as 150 different types of headache.

While a “brain freeze” headache from eating ice cream or experiencing a throbbing head the morning after drinking alcohol are thankfully short lived and pretty easy to prevent, other types of headache can be harder to pin down.

There are three main types of primary headache (where the headache itself is the main problem rather than a symptom of a disease or condition): tension, migraine and cluster.

Tension-type headaches, which can feel like a band of pain or pressure around the head that lasts from 30 minutes to a few hours, are the most common type of headache, affecting around 13 million people in the UK [2]. They are also more likely to affect women than men [3].

Migraines, which are moderate to severe headaches, feel like a throbbing pain and are usually accompanied by sensitivity to sound or light, and/or nausea. They are also more common in women (2-3 times so), with almost a quarter of women suffering from migraine, according to The Migraine Trust [4].

RELATED: migraines & menopause: GP & Menopause expert Dr Sarah Ball & Dr Louise Newson

Cluster headaches ­– a severe headache that can occur multiple times a day over a period of weeks or months – are more common in men in their 30s and 40s, although peak occurrence in women is around the age of 20, and then age 50-60.

What causes headaches in women?

A review of articles over 20 years found sex hormones, including oestrogen, progesterone and testosterone, can have an important influence on the course of primary headaches [5].

Hormone headaches can be triggered by hormone changes associated with periods, the combined contraceptive pill, pregnancy and perimenopause and menopause. During perimenopause, hormonal headaches can worsen – owing to both the disruption of the hormonal cycle, with fluctuations of oestrogen and progesterone levels, and because periods can come more often.

The majority of female cluster headache patients experience their first attack after menopause [6], and while the reason for this onset is unclear it’s assumed that the constant low oestrogen levels may provoke them.

Tension headaches are known to be caused by stress and muscle tension, and menopause in itself is known to be a stressful experience for some women.

RELATED: why is the menopause so stressful?

Fatigue and sleep disturbance can also trigger tension headaches but there is also a hormonal link. The 20-year review into the role of hormones found that in some women menstruation can trigger tension-type headaches and that perimenopausal women experience a higher prevalence of these headaches than premenopausal women.

Testosterone is another important hormone for women. Levels gradually decline with age and symptoms of testosterone deficiency can include headaches (as well as fatigue, loss of

concentration, impaired memory, brain fog, reduced energy, low mood, loss of muscle strength and reduced libido) [7].

How can I treat my headache?

If you are still having periods, keep a diary for at least three menstrual cycles to see if your headaches are linked – The Migraine Trust has a downloadable headache diary, which can help. Even if you are not having periods, it is worth keeping a diary to see if there are other triggers, including skipping meals, stress or lack of sleep.

Try to keep your blood sugar level stable by eating small, frequent snacks and avoid missing meals, which can lead to low blood sugar levels, which in turn can cause headaches. Get into a regular sleep pattern and try to manage stress as much as possible.

Regular exercise is thought to reduce the severity and frequency of headaches, including migraine – mild aerobic exercise may offer the most benefits.

Relaxation techniques can help with tension headaches, particularly massages that address any muscle tension around the neck and shoulders. Acupuncture can also help treat headaches and migraines.

RELATED: Acupuncture and menopause

HRT can help alleviate the symptoms of migraine, as well as the associated symptoms of menopause. It may also help with non-migraine headaches and it’s advised that continuous rather than cyclical doses is preferable where possible to keep hormone levels stable [8].   

A number of medications can help manage headaches and often target the underlying cause, for example perimenopause or neck arthritis. Speak to a healthcare professional with a symptom and explain your headache in detail. This will help with the diagnosis of tension, migraine or cluster headache, and therefore guide treatment.

In many cases, women find that their headaches are worse during perimenopause but stabilise after menopause when oestrogen levels are also stable.

Finally, seek advice from a healthcare profession is your headache:

• Progressively worsens
• Has a sudden onset
• Wakes you up from sleep
• Is accompanied by a high fever or rash, or confusion, dizziness, or weakness
• Is experienced alongside unexplained weight loss
• Is different from all previous headaches you’ve experienced

RELATED: dizziness and the menopause

References

1. WHO: headache disorders: how common are headaches
2. Brain Research UK
3. Cairns, B. E., & Gazerani, P. (2009), ‘Sex-related differences in pain’, Maturitas, 63(4), pp. 292-296. Doi: https://doi.org/10.1016/j.maturitas.2009.06.004
4. Migraine Trust: women’s experience of migraine
5. Delaruelle, Z., Ivanova, T.A., Khan, S. et al. (2018), ‘Male and female sex hormones in primary headaches’, J Headache Pain, 19, 117. https://doi.org/10.1186/s10194-018-0922-7
6. Lieba-Samal, D. & Wöber, C. (2011), ‘Sex hormones and primary headaches other than migraine’, Current pain and headache reports, 15: pp. 407-414. Doi:10.1007/s11916-011-0211-5
7. Glaser, R., Dimitrakakis, C. (2013), ‘Testosterone therapy in women: myths and misconceptions’, Maturitas, 74 (3), pp. 230–4. doi: 10.1016/j.maturitas.2013.01.003
8. Lauritsen, C.G., Chua, A.L. & Nahas, S.J. (2018), ‘Current Treatment Options: Headache Related to Menopause—Diagnosis and Management’, Curr Treat Options Neurol, 20, 7, https://doi.org/10.1007/s11940-018-0492-7

The post Headaches and the menopause: what’s the link? appeared first on Balance Menopause & Hormones.

• What is pain?
• Why pain can be a surprising symptom of the perimenopause and menopause
• Advice on pain management and how to seek help for your symptoms

If you have recently started suffering from new or worsened aches and pains, you are not alone. Many women report an increase in pain around the perimenopause and menopause, and for some it has a huge impact on their everyday life. Here we look into why that may happen and what can help.

What is pain?

Pain is a critical issue for women. Women report more recurrent pain, more severe pain and longer lasting pain than men [1]. Chronic pain impacts an estimated 34% of adults in England, and is experienced by more women than men [2].

Pain is described ‘as an unpleasant sensory and emotional experience’ by international pain experts [3]. Importantly, these experts stress pain is a deeply personal experience, and how you describe your pain should be respected and listened to by others.

Chronic pain, which is defined as pain lasting longer than six months, affects women more than men. Painful conditions that disproportionately affect women include fibromyalgia, (which causes widespread pain throughout the body), irritable bowel syndrome, rheumatoid arthritis, osteoarthritis, chronic pelvic pain and migraine headache [4].

Can menopause lead to pain?

Many women report an increase in pain around their menopause – but also say they were not prepared or expecting the symptom.

In a survey of 5,800 women carried out by balance founder Dr Louise Newson, pain was reported as the most common unexpected symptom by more than a third (34%) of women [5]. As you may not be expecting it, it can be easy to miss this as a sign of your menopause.

Women experiencing menopausal symptoms are almost twice as likely to have chronic pain, a large US study with 200,000 women found. [6]

Researchers have found that 71% of women in the perimenopause report joint and muscle pain. While overall rates dropped after menopause, women are then at higher risk of severe joint and muscle pain [7].

Why does perimenopause and menopause cause pain?

Levels of your hormones oestrogen, progesterone and testosterone fluctuate and fall. There are receptors for these hormones throughout your body, and they play important roles in pain.

These hormones influence your pain in complex ways that are still being understood. But it seems that oestrogen can both change how you feel pain, by making you more sensitive to it, and may also cause or contribute to issues that cause pain. This means if you already have a chronic pain condition, like fibromyalgia, you may find it gets worse during the perimenopause.

Hormonal changes may also worsen your sleep, cause an increase in your weight and lead to mood changes that may all have a negative impact on your life, especially if you are living with chronic pain.

Oestrogen, progesterone and testosterone can all alter the way the body responds to pain and lower levels in the body can lead to more pain [8].

There is also a link between depression and chronic pain conditions, and the same chemical messengers in the brain influence both mood and pain [9]. As perimenopause and menopause is a time when you may be at higher risk of depression and anxiety, this could also have a negative impact on your pain. 

Another chronic condition that you may notice worsen during your perimenopause is migraine. You may have found that your periods influenced when you had migraines before perimenopause as your changing hormone levels can trigger them. During the perimenopause, migraines can occur more frequently and be worse, as your hormones fluctuate.

Why do my joints and muscles ache?

Oestrogen, progesterone and testosterone work as anti-inflammatory agents in your muscles, and also help to lubricate your joints [10].

So during the perimenopause and menopause, when hormone levels fall, it can cause muscle and joint pains. This is usually most common in the mornings, as this is when hormone levels tend to be lowest.

One woman told Dr Louise’s survey that her pain was so severe it stopped her doing the activities she loved.

 ‘My unexpected symptoms were mainly joint pain, muscle pain and tendon pain all of which hugely affected my life,’ she said.

‘I like to be active and play sport and these symptoms stopped me for months at a time.’

It is also likely that oestrogen has an important role in reducing incidence and severity of osteoarthritis, when joints become painful and swollen [11].

RELATED: Dr Louise Newson video on unexpected menopause symptoms

How can I manage pain?

Being overweight puts you at higher risk of pain, with those who are obese being four times more likely to report pain [12]. So maintaining a healthy weight and being active can help with a range of issues that contribute to pain, including by reducing pressure on joints, strengthening muscles that support your bones and reducing inflammatory factors that can contribute to pain conditions. You can read more about healthy eating,  getting active and exercise on the balance website.

Get to know the 3 Ps

If you live with chronic pain, you may find that using the three Ps:

• Pace
• Plan
• Prioritise

Can help manage your condition. The Royal College of Occupational Therapists (RCOT) recommends this approach if you’re recovering from an illness or have a long-term health condition [13]. It involves:

Pace: pacing yourself will help you have enough energy to complete an activity. You’ll recover faster if you work on a task until you are tired rather than exhausted. Break activities up into smaller tasks and spread them throughout the day.

Plan: look at the activities you normally do on a daily and weekly basis and develop a plan for how you can spread these activities out.

Prioritise: some daily activities are necessary, but others aren’t. Try and create a balance between those you need and want to do. Find out more at RCOT.

Will HRT help me?

Your menopause and your pain is unique to you and therefore needs a personalised approach. If you think that your menopause could be contributing to your pain, make an appointment with your healthcare professional to discuss HRT.

Your doctors will discuss the benefits you could get from HRT in balance with any risk factors you may have. It is likely that taking the right dose and type of HRT, often with testosterone, will improve pain you are experiencing.

Research has found that HRT may influence joint health. The Women’s Health Initiative, a large study mainly looking at older forms of HRT, found that women taking oestrogen-only HRT had lower rates of hip and knee replacements than those who didn’t [14].

How can I best prepare for my healthcare appointment?

Keeping a symptom diary before you go will help guide you and your healthcare professional to finding the best approach for pain.

Recording when, where in your body and how severe your pain is, along with tracking other signs of your menopause and your periods (if you’re having them) can help build a picture of the role of your hormones on your pain. Balance has a free app with a symptom tracker that you can use to build a healthcare report ahead of an appointment.

References

1. International Association for the Study of Pain ‘Global year against pain in women’

2. Pavlović J., Derby C. (2022), ‘Pain in midlife women: a growing problem in need of further research’, Womens Midlife Health, 8 (1): doi: 10.1186/s40695-022-00074-x

3. The British Pain Society ‘What is Pain?’

4. International Association for the Study of Pain ‘Pain in women’

5. Newson L. et al (2023), ‘Distressing, debilitating and embarrassing: surprising symptoms and the need for holistic approach to menopause care’, Abstract at 14th European Congress on Menopause and Andropause

6. Gibson C.J. et al (2019), ‘Menopause symptoms and chronic pain in a national sample of midlife women veterans’, Menopause, 26(7):708-713. doi: 10.1097/GME.0000000000001312

7. Lu C.B. et al (2020), ‘Musculoskeletal pain during the menopausal transition: a systematic review and meta-analysis’, Neural Plast, 25;2020:8842110. doi: 10.1155/2020/8842110.

8. Athnaiel O., Cantillo S., Paredes S., Knezevic N. (2023), ‘The role of sex hormones in pain-related conditions’, Int J Mol Sci, 24 (3): 1866. Doi: 10.3390/ijms24031866

9. Trivedi M.H. (2004), ‘The link between depression and physical symptoms’, Prim Care Companion J Clin Psychiatry, 6(Suppl 1):12-6. PMID: 1600109

10. Hussain S.M. et al (2018), ‘Female hormonal factors and osteoarthritis of the knee, hip and hand: a narrative review’, Climacteric, 21(2), pp. 132–9. doi: 10.1080/13697137.2017.1421926

11. Dennison E.M. (2022), Osteoarthritis: the importance of hormonal status in midlife women’, Maturitas, 165, pp. 8–11. doi:10.1016/j. maturitas.2022.07.002

12. Okifuji A., Hare B.D. (2015), The association between chronic pain and obesity, J Pain Res, 14;8:399-408. doi: 10.2147/JPR.S55598.

13. Royal College of Occupational Therapists ‘How to Manage your Energy Levels’

14. Cirillo D.J. et al (2006), ‘Effect of hormone therapy on risk of hip and knee joint replacement in the Women’s Health Initiative’, Arthritis Rheum, 54(10):3194-204. doi: 10.1002/art.22138.

The post Perimenopause, menopause, aches and pains appeared first on Balance Menopause & Hormones.

What is a stroke?

A stroke is a life-threatening medical emergency that happens when the blood supply to part of your brain is cut off or restricted. This can lead to brain injury, disability and death. In most cases this is caused by a blood clot in a vessel stopping your blood supply, called an ischaemic stroke. In a haemorrhagic stroke, a weakened blood vessel supplying your brain ruptures [1].

What symptoms can a stroke cause?

Symptoms of a stroke depend on which part of your brain is affected. These can include your face dropping on one side, you may not be able to lift one or both arms or they may feel weak. Speech may become slurred or garbled, there can be confusion, dizziness and changes to your vision. If you suspect you or someone else is experiencing a stroke, dial 999.

Are women at higher risk of stroke?

About 100,000 people have strokes every year in the UK [2]. While men do have slightly more strokes, it is one of the four leading causes of death in women in the UK, according to the Stroke Association [3].

Women tend to have strokes at a later age than men, and nearly half of all strokes (45%) in women happen past the age of 80.

Your risk also increases during pregnancy and immediately after giving birth, when your blood is more likely to clot.

More women than men are affected by a very rare and serious form of stroke called cavernous sinus thrombosis: this is when a blood clot forms in a large vein carrying blood away from the brain through a hollow space behind the eye [4].

What can increase the risk of having a stroke?

Age increases your risk, as your blood vessels become harder and narrower, and more likely to become blocked. Certain health conditions will also increase your odds, like high blood pressure, high cholesterol, diabetes and atrial fibrillation (irregular heartbeat).

Smoking and a lack of exercise can also increase your risk.

There are a number of medical conditions that slightly increase stroke risk that affect women more than men. One is migraine with aura, which is when, along with the head pain, you also experience symptoms that can include changes to your vision, numbness or tingling in parts of your body, dizziness and speech difficulties. While migraine, which affects a lot more women than men, is not thought to cause stroke, this form does seem to slightly increase the risk of having one, although it is not known why, according to the Migraine Trust [5].

Another condition that increases risk is systemic lupus erythematosus, which mainly affects women below the age of 50, and is more common in people of African, Caribbean or South Asian origin [3].

Does menopause increase risk of stroke?

Your risk of stroke increases post-menopause and there are a number of factors involved.

Partly it is down to a reduction of oestrogen. This hormone helps protect your blood vessels, by keeping them relaxed and open, which reduces the risk of stroke-causing blockages.

Research has found that if you go through menopause under 40, your risk of stroke increases, when compared to those who experience it between 50 and 54 [6].

For each year after 50 that passed before a woman entered menopause, the risk of a stroke dropped by 2%, probably due to the extra time with oestrogen in your body.

Also some of the risk factors that increase stroke can go up around the time of your menopause. More women develop type 2 diabetes during and after menopause as changes in your hormones can lead to more weight around the middle of your body and your blood pressure increasing, according to Diabetes UK [7].

Studies have shown that women who experience frequent vasomotor symptoms (hot flushes and night sweats) are more likely to develop heart disease and stroke compared to those who do not, although it is not fully understood why this happens [8].

Can I take HRT if I have a history of stroke?

In most cases, yes. But this is where a detailed conversation with a healthcare professional is needed to look at your individual risk and the best options for you.

The NICE menopause guidance states there is a small increase in the risk of stroke from taking oestrogen tablets, but not when it is taken through the skin in patches or gel [9].

This is because oestrogen used in this way goes straight into your bloodstream, so bypasses the liver, which produces your clotting factors. When oestrogen is taken orally, it is metabolised in the liver, so stimulates the clotting factors.

NICE guidance also stresses that the risk of stroke in women under 60 is very low, regardless of whether you take HRT or not [9].

There is some evidence that HRT may reduce some of the risk factors that increase your risk of stroke, including type 2 diabetes, high blood pressure and high cholesterol.

The Stroke Association states patches, gels and vaginal oestrogen could all be suitable options, depending on your other personal risk factors. 

So if you’re experiencing menopausal symptoms, book an appointment with a healthcare professional to find out which could be the best options for you.

Keeping a diary of your cycle and symptoms before you go can help your healthcare professional work out the best HRT approach for you.

What about the pill?

Using the combined oral contraceptive pill (combined pill) is linked to a small increase in risk of stroke and blood clots for some people [3]. The majority of combined pills contain older synthetic types of oestrogen, and when oestrogen is taken orally, it is metabolised in the liver, so stimulates the clotting factors.

A combined contraceptive patch is also available. While this does also contain synthetic hormones, oestrogen used in this way goes straight into your bloodstream, so bypasses the liver, which produces your clotting factors.

As with HRT, discuss your options with your healthcare professional who will prescribe contraception which takes into account your risk factors.

What should I do to reduce my risk of stroke?

Taking steps that can developing risk factors, like high blood pressure, type 2 diabetes and high cholesterol, can help you avoid a stroke.

Being active, stopping smoking, drinking within safe limits, eating a balanced diet and staying at a healthy weight can help with these conditions.

Take any medication your prescribed to manage these health conditions, and take up any checks that can help pick them up.

If you’re aged between 40 and 74, you are entitled to an NHS Health Check every five years which can help pick up these conditions.

If you’re from South Asian, Chinese, African-Caribbean, black African and other high-risk groups, you can have a diabetes assessment from 25 [10].

References

1. NHS.uk (2022) ‘Stroke’

2. Stroke Association ‘Stroke statistics’

3. Stroke Association ‘Women and stroke’

4. NHS.uk (2021) ‘Cavernous sinus thrombosis’

5. The Migraine Trust ‘Migraine and stroke’

6. Tschiderer L et al (2023), ‘Age at menopause and the risk of stroke: observational and Mendelian randomization analysis in 204 244 Postmenopausal Women’, Journal of the American Heart Association, 12(18), e030280. doi: 10.1161/JAHA.123.030280.

7. Diabetes UK ‘Menopause and Diabetes’

8. Thurston, R. C. et al. (2021), ‘Menopausal vasomotor symptoms and risk of incident cardiovascular disease events in SWAN’, Journal of the American Heart Association, 10 (3), e017416. doi:10.1161/JAHA.120.017416

9. NICE (2015) ‘Menopause: Diagnosis and Management’

10. NICE (2012) ‘Type 2 diabetes: prevention in people at high risk’

The post Stroke, menopause and HRT: what you need to know appeared first on Balance Menopause & Hormones.

Content advisory: this podcast episode contains themes of mental health and suicide*

It’s a family affair on this week’s podcast as Dr Louise is joined by her eldest daughter Jessica for a special episode on the eve of World Menopause Day.

Jessica talks frankly about the impact of PMS and coping with hormone changes with migraine, as well as the strategies that helped her. Mother and daughter also discuss the importance of demystifying menopause and hormone changes through honest conversations between families, friends – and even complete strangers.

This World Menopause Month, help us start the most menopause conversations – ever. Everyone’s menopause is individual and to help others understand and manage their menopause, we must break taboos, educate and start the conversation.

How to get involved

Have a conversation about the menopause

Log your conversation on the balance app or website

Share that you’ve got involved by tagging us on social media, using the hashtag #PauseToTalk

*Contact the Samaritans for 24-hour, confidential support by calling 116 123 or email jo@samaritans.org

Transcript

Transcript

Dr Louise Newson: [00:00:11] Hello, I’m Dr Louise Newson. I’m a GP and menopause specialist and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford upon Avon. I’m also the founder of the free balance App. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. Some on the podcast today because it’s close to World Menopause Day I thought I would do something a little bit different and speak to one of my children. So I have three daughters and my eldest daughter, Jessica, has kindly agreed to join the podcast to really break more taboos, talk about hormones from the views of a 20, nearly 21 year old, which are quite different to me as a 53-year-old. So welcome, Jessica, to the podcast. [00:01:27][77.0]

Jessica Anderson: [00:01:29] Thank you. Thank you for having me. [00:01:30][1.7]

Dr Louise Newson: [00:01:31] So a few years ago, if I said to you, I’m going to get you on to a podcast that’s had nearly five million downloads and you’re going to be talking about menopause and hormones, what would you have said a few years ago? [00:01:42][11.0]

Jessica Anderson: [00:01:44] I think about how when you first tried to get us to do a family podcast with your podcast, it started and no-one could keep a straight face and we couldn’t do it. And I remember you going, Right, that’s it. We’re never going to do a podcast together. And here we are. [00:02:00][16.1]

Dr Louise Newson: [00:02:00] Here we are. [00:02:01][0.4]

Jessica Anderson: [00:02:02] Trying to do a podcast together, so let’s see what happens. [00:02:03][1.5]

Dr Louise Newson: [00:02:04] So that was about five years ago because I had the three of you on a sofa in my room at the clinic. You just giggled the whole time. But since that time, since that time, you’ve learned more about hormones in a personal way. And also just because that’s all I do is talk about hormones. [00:02:19][15.5]

Jessica Anderson: [00:02:21] Of course. [00:02:21][0.4]

Dr Louise Newson: [00:02:22] I’m really keen to just listen and think about what it must be like for someone in their teens and 20s, because your generation is very different to our generation, and my generation is very different to your grandmother’s generation. And one of the things that’s really different is you learn more about things seemingly on social media than you do from your mother or your parents or your peers sometimes, which is great, but not all the information is accurate. But also you talk a lot more openly to your friends than I ever did when I was your age. When I was at university, we did talk a little bit more because we were medics, but we still didn’t share even things about our periods or what it was like to have a period or even what contraception we were on. Whereas now you talk quite openly talking about all sorts to your friends. [00:03:10][48.3]

Jessica Anderson: [00:03:11] Well, yeah, I think in general, like the conversation is a lot more open with people of my generation. But also I think the way that I approach these conversations is always very open. I’m very much, Oh, did you know, like fun facts? You don’t have to struggle with like X, Y, and Z, or did you know that this is linked to your hormones? And I find that the way that I approach those sorts of conversations with my friends or even just like people that I meet day to day, it means that there’s a very open conversation and a very honest communication and respectful communication between people. And I think the more I’ve learned about the menopause and about hormones and about how it can affect your day to day functioning, the more I’ve been able to positively impact people talking to them and guiding them towards some of your work and things that we’ve read and like balance and everything like that. [00:04:03][51.7]

Dr Louise Newson: [00:04:03] Because you’ve had some really empowering conversations with people your age and people my age as well, haven’t you? [00:04:09][5.3]

Jessica Anderson: [00:04:09] Yeah, definitely. Definitely. I think everyone seems to have a connection to the menopause. Or maybe they’ve got their own story with their hormones or with their periods. Everyone has something to talk about. Everyone’s had a period where they’ve been misinformed and I think a lot of people, I think most people I talk to, are just confused. So it’s always nice to bring some clarity. [00:04:34][25.3]

Dr Louise Newson: [00:04:35] Well, you’re absolutely right, because when you’re confused, you can just sort of get overwhelmed and then you don’t know where to believe or where to go or who to trust. And I sort of learned quite a lot about your own hormones in lockdown, didn’t I? Because we were living together very closely. And I realised then that not only were your periods very heavy, but you were also very flat at the beginning of every month. Weren’t you in your mood? [00:04:59][23.6]

Jessica Anderson: [00:05:00] Yeah, and I think it took about three months for you to notice and be like, Can we do something about this? [00:05:06][6.0]

Dr Louise Newson: [00:05:06] Yes. Because you’re a trombonist, aren’t you? You can say what you do. Where are you a student? [00:05:10][4.3]

Jessica Anderson: [00:05:11] I am studying classical trombone at the moment at the Royal Academy of Music. So I’m going into my second year of my undergrad degree. [00:05:18][7.0]

Dr Louise Newson: [00:05:19] And you’re also a really good artist as well. [00:05:21][2.3]

Jessica Anderson: [00:05:21] Yeah. If anyone visits my mum’s clinic Newson Health, you’ll see all of my artwork on the walls, where I’m artist in residence. [00:05:30][8.1]

Dr Louise Newson: [00:05:30] You are indeed. And you’ve got your use of colours is really bold and wonderful and really quite empowering. But I realised when you were at home in COVID, when there was little to do and you were playing trombone a lot, you were practicing a lot. You were also doing a lot of painting and drawing. There were a few days every month that you didn’t, and I remember you once, you walked past the study here and you just said, Oh, what’s the point of playing music? I was like, What? What are you all about? And then I sat you down and said, Um, it really seems to be a pattern because it’s always the first few days of the calendar month. And your periods were quite regular then, but you were obviously getting very heavy periods and then the sort of penny drop that it was a few days before your periods, you were feeling quite low and couldn’t be bothered to do anything really. Is that right? [00:06:14][43.9]

Jessica Anderson: [00:06:15] Yeah, I remember the conversation because we were sat on the brown leather sofa in the kitchen and I just remember feeling I was just so just disattached from myself. I just felt this weird weight that came from nowhere and I never had sort of any negative thoughts attached to it. But then when you’re feeling negative and so down, it’s like super confusing because you don’t know what it’s connected to. And then you’re over thinking all the interactions that you’ve had or, you know, Oh, maybe I don’t actually like trombone, but maybe actually I don’t enjoy painting. And then you realise, Oh, it’s just because you have low oestrogen, because that’s what it’s like at that point in your cycle. Everything like, makes way more sense. [00:06:53][37.9]

Dr Louise Newson: [00:06:53] Yes. But at the time you didn’t realise, you just thought it was a phase that was happening? [00:06:57][3.2]

Jessica Anderson: [00:06:57] No, not at all. [00:06:58][0.8]

Dr Louise Newson: [00:06:58] And so then knowing it was related to your hormones, obviously was a discussion. But before we talk about how we’ve helped you to improve your symptoms it’s also many people who follow me on Instagram will know that you suffer with chronic migraine. And I feel very guilty because I’ve given you the gene that clearly I have, my mother’s got, my grandmother had we’ve all had migraines and still have migraines. But each generation, it seems to have got worse. And you’ve definitely really had a very difficult time. You’ve tried so many different treatments with your hormones, and as many people know, migraines just don’t like any change. Our brains like homeostasis. They like everything the same. And so when hormones change, then some people, not everybody, but a lot of people find their migraines can be worse, don’t they? [00:07:46][48.0]

Jessica Anderson: [00:07:48] Yeah, completely. I mean, with migraine, it’s all about keeping things consistent and making sure that everything is controlled and managed, whether that’s hormones or whether that’s your blood sugar levels. So things like I only eat food with a low glycemic index or how much exercise you’re doing or, you know, like I’m teetotal. We’re both teetotal. Both of us don’t drink because of our migraine and we feel so much better for it. So, yeah, I think you have to manage things to keep this sort of homeostasis across the board. I think about a lot of things that people don’t normally have to think about. [00:08:21][33.3]

Dr Louise Newson: [00:08:22] No, no, because certainly your middle, well, my middle daughter, your younger sister can do what she likes, eat what she likes, and she doesn’t get migraines. She’s really, really lucky. But we constantly have to think if we’re going to have a late night, the impact it will have on us and everything else. So there’s a hormonal change and obviously that hormonal change gets exaggerated during the perimenopause. And a lot of people I was listening to a podcast today, I’ll share it with you later about migraines. And the expert was saying, yes, migraines are far more common in women than men, especially around the time of the 40s and also teenage years. We don’t know why. Well, let’s just use some common sense because our hormones fluctuate. But also, I hope you don’t mind me saying that age 20, lots of 20-year-olds need contraception, so your contraceptive choices are more limited when you have migraines as well, aren’t they? [00:09:13][50.6]

Jessica Anderson: [00:09:13] Yeah. I can’t have the pill. [00:09:14][0.9]

Dr Louise Newson: [00:09:14] Yeah. So because they combined oral contraceptive pill and actually the progestogen-only pill have a very small risk of clot with them. With migraines there is a small risk of stroke only very small. But obviously in medicine you don’t want to give two small risks to somebody. So the general consensus, especially when someone has migraine with aura or more severe migraine is we try and avoid oral contraception. So when I was trying to decide what would be the best advice to give you, obviously I’ve already said you had heavy periods and you need a contraception and you’ve got migraine and you want something that’s really reliable, then actually the choice is really do narrow. And I know you did try one of the progestogen only pills, but it brought a lot of spots to your face and you felt quite low. [00:10:01][46.3]

Jessica Anderson: [00:10:01] I had such bad side effects. [00:10:01][0.0]

Dr Louise Newson: [00:10:02] Yeah. [00:10:02][0.0]

Jessica Anderson: [00:10:03] It was not good. [00:10:04][1.1]

Dr Louise Newson: [00:10:04] So that wasn’t right. So then I thought, well the implants, once it’s in, it’s harder to reverse. And I thought, well you’ll probably get side effects with it. And I am, as many listeners probably know, I’m a bit concerned about the implant because it’s switching off your ovaries working. Therefore you get low oestrogen and probably low testosterone as well. And what side effects would that cause? [00:10:24][20.3]

Jessica Anderson: [00:10:25] I think more than a bit concerned with that. [00:10:28][2.3]

Dr Louise Newson: [00:10:28] Yeah. And I think, you know, a lot of this like the conversation at the beginning it’s your body, it’s your choice. You have to help decide what’s right for you. And, you know, we’re not saying on this podcast that what you’re doing is right for everybody, but everyone deserves to know the information and then they can choose what’s right. [00:10:44][15.6]

Jessica Anderson: [00:10:44] Yeah, what I do, it’s right for me and works incredibly well for me. [00:10:47][3.1]

Dr Louise Newson: [00:10:47] Absolutely. So. So then you decided to have this low dose coil, didn’t you? [00:10:52][4.8]

Jessica Anderson: [00:10:53] Yeah. So it’s the Mirena coil which has localised progesterone, which stops the lining of the womb building up. And I’ve had a coil maybe three, four years now. And it’s amazing. I mean, the main reason why I got it was, it wasn’t for contraception. It was the management of my periods because they were so heavy, they were so awful. And now I don’t have a period at all. I maybe bleed. So maybe like one to three days a year and that’s it. [00:11:22][28.8]

Dr Louise Newson: [00:11:22] Yeah. [00:11:22][0.0]

Jessica Anderson: [00:11:22] Which is amazing. [00:11:23][0.3]

Dr Louise Newson: [00:11:23] Which is incredible, isn’t it? And you actually have a low dose Mirena so it’s a Jaydess one. So it’s, yeah, it’s a small one. It only last three years but you’ve had yours replaced so it’s still in date and so it just produces a small amount of this synthetic progestogen into the lining of your wombs. It keeps it thin. If the lining of your womb is thin, then you don’t shred it. So you don’t have periods. So that in itself it’s really lovely and it is a treatment for heavy periods. So even if you didn’t need contraception, then it’s still a really good choice. And it’s quite liberating, isn’t it, to not have periods? [00:11:52][29.4]

Jessica Anderson: [00:11:53] Yeah, completely. It’s amazing. [00:11:55][1.2]

Dr Louise Newson: [00:11:56] So you had that and then with your migraines, obviously there are lots of reasons why people can have migraines and lots of triggers and there are lots and lots of different treatments. Some people respond very quickly to a treatment, what’s called a prophylactic treatment, so it stops the migraines being triggered. But a lot of these medications have side effects with them. And you are someone that’s supersensitive to any medication. So you’ve been under four different neurologists. You’ve now got the most amazing neurologist in London who coincidentally I went to medical school with, and he is a complete saint and hero. He’s incredible. But yeah, but what, you’ve tried seven or eight prophylactic treatments, haven’t you, over the past and you’ve given them good time to try. They’ve caused all sorts of side effects. So you’ve been given other treatments as well, and you’ve also really managed your lifestyle. You’ve looked at your posture, you’ve looked at your sleep, you’ve looked at your stress, you’ve looked at everything. I mean, your lifestyle is far better, I think the most 20-year-olds on the planet. But the other thing that we sort of talked about together was about your hormones, because not only were you feeling flat and the Jaydess might stop some ovulation, but we don’t know. But you were still getting this sort of feeling very flat. And obviously migraines can make you feel very low. We know that. But it was also to try and stop any hormonal variation, to try and smooth things out. So one of the things you do is to use oestrogen, isn’t it? [00:13:24][88.2]

Jessica Anderson: [00:13:24] Yeah, that’s amazing. [00:13:25][1.1]

Dr Louise Newson: [00:13:26] So how do you use the oestrogen? [00:13:27][1.0]

Jessica Anderson: [00:13:28] So I use oestrogen patches, which I change twice a week and they’re amazing. They’ve completely changed my life. And, you know, I went through quite a lot, which, you know, obviously over the last couple years with migraine and I’ve seen migraine causing severe depression and all that kind of stuff. You know, my migraine is far better managed now, which is really lovely. However, I know that I would not have got through everything that I went through if my mood had not been stabilised through taking oestrogen at all, because I was so…I was in such a rough place and I was so low and flat. And I just know if I hadn’t’ve had oestrogen to sort of maintain my mood consistently. So I felt the same day to day, and I didn’t have like random dips or just this complete heaviness added onto me that I don’t think I’d be like here talking today on this podcast. Yeah, You know, that’s why I think it’s so important to talk about this and to raise that sort of awareness, because I think you can’t underestimate the impact the hormones can have on someone’s life. [00:14:34][66.0]

Dr Louise Newson: [00:14:35] So that’s so important isn’t it? And for people listening might be a bit confused, thinking, goodness me, a 20-year-old is not menopausal and she’s using HRT. And HRT is just hormone replacement. Three letters meaning and it doesn’t always replace. All you’re doing is topping up your hormones. And what’s interesting is that, you know, you’re having the 17 beta estradiol, the natural oestrogen that your ovaries produce and actually 100 mcg, the maximum dose patches is still a low dose compared to if you were having the contraceptive pill. We know that HRT can’t be used as a contraceptive because it doesn’t always switch off the ovaries because the dose is low. But what we are doing is enabling you to have enough so you have a steady state all the time. And I know there’s been a few times when your migraines have been bad and your mood has been low. And then I phoned you and spoken to you and I’ve said, Have you changed your patch? It’s Friday. Did you change it yesterday? And there have been a few times, haven’t there, where you said, No I haven’t? [00:15:35][60.1]

Jessica Anderson: [00:15:36] Yeah. Well you know, throwback to when I had memory loss from migraine and, you know, I couldn’t really function very well. And as soon as you sort of reminded me of that, it just because you have this amazing ability that whenever I phone you, whenever I say, you know, hello, how are you or something? Or you go, Why are you calling? And I’m like I’m just calling to say hello. And you can hear exactly in my voice like, what’s going on. So you go, ah you haven’t eaten, have you? No. You need to eat now. Have you drink enough water, you just know, you can just hear it. It’s like some psychic ability. [00:16:09][32.8]

Dr Louise Newson: [00:16:09] Maybe I am a secret witch, but, you know, doing a lot of GP training really teaches you about consultations. And it’s the non-verbal clues that actually have enabled me to diagnose so much more. So someone might be telling you one thing, and you’re looking at the way that they’re positioning themselves or the way they’re not giving you eye contact or the way their voice is changing. And that’s what I’ve learned over the last 25 years. So on the phone, I can still hear. [00:16:36][26.4]

Jessica Anderson: [00:16:36] And also obviously from knowing me so well. [00:16:39][2.5]

Dr Louise Newson: [00:16:39] Absolutely. And, you know, and it has made a really big difference. But then one of the medications you were on, actually, you have asthma as well, and you were given an asthma medication, which actually caused a lot of your mucous membranes to be really affected and you were getting a lot of dry skin, dry eyes, dry mouth, but also some vaginal dryness as well. But also before that time, you were getting some urinary symptoms and frequency to them. And I don’t mind telling people, but I use vaginal pessaries since after having a hysterectomy, I was getting a lot of irritation, recurrent urinary tract infections. And so I use something called into Intrarosa, which is DHEA, which converts to oestrogen and testosterone in the vagina.

Jessica Anderson: [00:17:30] Well, it was awful. Like I walking was painful. Like I was so aware of the dryness in my vagina all the time. It was really, really painful because obviously the the tissues are the same in your lungs as for your vagina. So if you’re doing something which will impact your lungs, it will also impact your vagina. So yeah, it was awful. But as soon as I have the pessaries prescribed, that wasn’t an issue anymore at all. It’s amazing the impact that it had. [00:18:01][30.9]

Dr Louise Newson: [00:18:01] Yeah. And then you stopped the inhaler because you saw a respiratory consultant who changed your inhaler because of the side effects everywhere else. Of course. [00:18:07][6.1]

Jessica Anderson: [00:18:08] Yeah, different side effects. [00:18:09][0.9]

Dr Louise Newson: [00:18:10] And then you didn’t use the pessaries and then you still experienced some of those symptoms, didn’t you? So now you’re using them again regularly? [00:18:17][6.9]

Jessica Anderson: [00:18:18] Yeah. And then it’s great. [00:18:18][0.8]

Dr Louise Newson: [00:18:19] Yeah. And it’s very interesting because the more we learn about sort of vaginal dryness, but we call it in the menopause GSM, genitourinary syndrome of the menopause. But actually it’s not just of the menopause, it’s of the perimenopause. It’s of hormonal changes. We know postpartum when someone’s had a baby, they can get these changes. But there’s a lot of young people who are more, it’s not so much dryness, but just more aware of their vulva and vagina. We shouldn’t be aware of it. [00:18:44][25.3]

Jessica Anderson: [00:18:44] Well, I also know, like a lot of people that consistently struggle with things like UTIs and cystitis and things like that, which, you know, can be helped by using vaginal pessaries. [00:18:56][11.6]

Dr Louise Newson: [00:18:56] Yes. Yeah. So there’s the oestrogen-only vaginal pessaries or this Intrarosa. So they can be transformational for a lot of people. And it’s quite shocking how few people know about them at all. So and I know that you obviously talk very closely and openly to your friends, but you’ve had various conversations in toilets with people you don’t know about hormones, haven’t you? You told me not that long ago you were in the toilet, a public toilet, and two girls were getting quite upset having a conversation, weren’t they? [00:19:25][28.1]

Jessica Anderson: [00:19:25] Oh, yeah. I remember this. Yeah, I was in the cubicle, and both of these girls were just. They were very upset, very emotional. And they were talking about how their mums were massively struggling with their menopause and that their moods were changing. You know, they were really depressed, really anxious. I think one of them was unable to get out the house, that sort of thing, you know, memory starting to go. And they would just, you know, they kept on saying, God, it’s just such a shame because obviously you can’t do anything about it other than watch. And I sort of like really quickly came out the cubicle and I was like, look, I’m so sorry to interrupt. I don’t want to intrude at all, but I just wanted to let you know that that doesn’t have to be the case because obviously, you know, the menopause is just a long term hormone deficiency. So if you supplement those hormones, you’re not going to have all of the symptoms. And obviously, I spoke about your work and everything like that, and they were both just so grateful. They were like, please, can I give you a hug? And that happens quite a lot. And I just think it’s so sad that there’s barely anyone that I talk to about the menopause or hormones, and they go, Oh my God, yeah, I knew that too. Everyone’s just like constantly misinformed and misled, which it’s such a shame. [00:20:33][67.7]

Dr Louise Newson: [00:20:33] It’s so awful, isn’t it? So much unnecessary suffering. And you volunteer sometimes at the Tate as well. Sadly, they’ve changed the lightbulbs, so you can’t go there at the minute. But the last time you went, there was somebody who was really suffering as well, who was probably my age, really a bit older. And, and she was so grateful to have spoken to you wasn’t she? [00:20:53][19.5]

Jessica Anderson: [00:20:53] Yeah. I constantly when I have conversations like that people just go oh my gosh, you’ve made my week. That’s incredible. I’m so grateful to have met you, that sort of thing. But I just think it’s such a shame that it shouldn’t have to take me overhearing a conversation in the street to then go up and talk to them about it. And, you know, obviously, I approach it in a very respectful way. But it shouldn’t take me overhearing to then talk to them. It shouldn’t be like that. People should just be informed. [00:21:22][28.2]

Dr Louise Newson: [00:21:22] Well, people shouldn’t be suffering in the first instance. That’s what I get so frustated about. [00:21:26][4.3]

Jessica Anderson: [00:21:27] But I think it’s the fact that it’s unnecessary suffering as well. It’s just so unjust. [00:21:31][4.1]

Dr Louise Newson: [00:21:32] Absolutely. And and I need to thank you. Actually, because of you, I’ve got this Instagram account, because because of your artistic talents and because I suppose I was, well I still am really shocked and saddened with all the stories I hear in the clinic. And it was you that said, set up the menopause doctor account, wasn’t it? [00:21:58][26.0]

Jessica Anderson: [00:21:58] Yeah. And I just it’s so cute because back then you were like, when you have maybe 20 followers and you’re saying, Oh, I need to post every day, I’ve get the word out to help out all these people. And still now you think, Oh, I need to post every day, I have got to get the word out, I’ve got to help all these people. And it’s so true. Like your message hasn’t changed. Your you know, your core morals are exactly the same, but you’re such a kind and loving person and none of that has changed at all, you know? [00:22:25][27.5]

Dr Louise Newson: [00:22:26] No, I suppose the only my problem is I always think I’m not very good mother because my work is just all consuming [00:22:31][5.1]

Jessica Anderson: [00:22:31] Which isn’t true at all. [00:22:31][0.3]

Dr Louise Newson: [00:22:34] To me it is a group effort because, you know, you are all involved. But actually I remember when I first started, you might remember this, my Instagram. After a few weeks, I put a post about vaginal dryness on and Sophie texted me on the train coming home. She went will you take down your Instagram account? She said, The boys are making fun of me. This is awful. And I said, Yeah, you’re more important than my Instagram account. Of course I. And she went, Oh, hang on. I think you are helping peoplem, there’s some really nice comments. [00:23:03][28.6]

Jessica Anderson: [00:23:03] Yeah. I don’t think Sophie would mind now. [00:23:05][1.3]

Dr Louise Newson: [00:23:06] No, she’s a real supporter. [00:23:07][1.2]

Jessica Anderson: [00:23:08] Yeah, of course we all are. [00:23:09][1.0]

Dr Louise Newson: [00:23:09] Yeah. So, but it is uncomfortable sometimes having these conversations. But, and I think actually as a doctor it’s easy to have conversations, but it’s also easier for people, your generation, to have conversations because for a lot of people, even just mentioning the word vagina is really awful, whereas you guys are just so much more open. [00:23:29][19.9]

Jessica Anderson: [00:23:30] But I think though, you know, if I approach a conversation with someone and it’s obviously I’m not quite secure talking while I am secure talking about it, I am comfortable talking about it and it sort of lets them know that yeah, it’s a safe space to talk and it doesn’t need to have this sort of whispered tone around it. And if I sort of talk blatantly about that sort of thing, I think that helps other people develop confidence. And talking about that. [00:23:53][23.5]

Dr Louise Newson: [00:23:53] I think is so and it’s so crucial when we think our mental health. As you know, I’m going to Australia when this is out. I would have been to Australia talking about mental health. [00:24:01][7.3]

Jessica Anderson: [00:24:01] Very exciting. [00:24:01][0.0]

Dr Louise Newson: [00:24:01] And hormones. Very exciting. But I mean, spending the whole weekend actually going down this rabbit hole, looking at the role of neurotransmitters and the role of oestrogen and hormones in our brain. And actually oestrogen is made in our brain as well. It’s not just made in our ovaries. And I bet lots of people don’t even know that. [00:24:18][16.5]

Jessica Anderson: [00:24:18] There’s an oestrogen receptor on every cell in the body. [00:24:20][1.6]

Dr Louise Newson: [00:24:20] Well, there is, but we’ve always been taught that oestrogen is made in our ovaries, which it is, but it’s also made in our brain. So I think that’s absolutely fascinating showing that how important oestrogen is in our brain. And for some women, like you say, they can become very flat, very low. And as you know, there is a increased risk of suicide. And some people with very, very low moods out there. And sometimes it can run in families as well, this hormonal sensitivity. So people that have PMS [prementral syndrome] are more likely to have postnatal depression, more likely to have a severe time in the perimenopause and menopause. And Grandma, so my mother in law has been on the podcast, well in fact my mother has as well. But Grandma very clearly talks about this dark cloud growing over her and she wasn’t enjoying her life. She wasn’t enjoying her children. She didn’t know what was going on and being married to your grandad, who was a GP. He still didn’t know what was going on. But I think what’s really sad, as you know, is that her sister actually took her own life one New Year’s Eve and for many years it was blamed on the boyfriend that she had because they argued a bit. But then Grandma recently, a few years ago said, Oh my goodness, Auntie had a hysterectomy as well. We never thought about that link. And that’s, as you know, the thing that keeps me going all the time, thinking about how can we explain to people that hormones are not just about periods, they’re not just about bleeding, they’re not just about contraception, they’re about mental health as well. And it’s not just about perimenopause and menopause. People who have PMS and PMDD can be really, really affected. And some people say. Well, it’s only a few days a month, but a few days a month is a lot of time when you’re young and it shouldn’t happen. [00:26:07][106.9]

Jessica Anderson: [00:26:08] Well, yeah. And it’s also it’s not just. Yeah, maybe it’s it’s few days and months where you’re, like, severely affected, but actually you’re going to be reflecting on not worrying about those few days a month for the rest of the month. You know, and even if it I know it’s not, but let’s say it’s just about periods and contraception, which it isn’t, obviously there’s so many other things attached to that. But even if it is just about that, that should still be taken far more seriously than it is. [00:26:33][24.4]

Dr Louise Newson: [00:26:33] I totally agree. So many people are missing out on school, university, their jobs just because of heavy, I’m not saying just, because of heavy periods. And then when we look at PMS and PMDD, as you say, just before our periods, is when our hormone levels are low, so are oestrogen, but also progesterone as well. And some of you might have listened to my podcast I did with Dr hannah Ward talking about the importance of progesterone. So for many women actually having a higher dose of vaginal progesterone as well as oestrogen can be very transformational. And the way that we respond to hormones is very individualised. So the way we respond, the dose that we have and that’s why it’s so important and I really strongly feel well I know in medicine, we’ve always been taught to treat the underlying cause. So if it’s a hormonal cause, why would you want an antidepressant or why would you want some other medication? You know, it’s different in migraine because we don’t always know what the cause is. But even with your migraine, what you’ve done is stripped it right back and worked out the triggers and remove those triggers rather than having layers and layers of drugs. And some of the drugs that you were offered really had a lot of side effects. But even one you mentioned earlier gave you memory loss. I mean, you migraines might be better, but if you can’t remember anything… and remember how to play music. [00:27:48][75.2]

Jessica Anderson: [00:27:49] It was awful. Yeah, I couldn’t read music. I couldn’t read full stop. I forgot things like how to walk up and down stairs. I’ve forgot how to play trombone. I didn’t know the words for different colours. Things like that have a massive impact. And I remember, you know, you saying about a study which has been approved for women who were menopausal to have a trial with this drug, which I was on to see if it improves their symptoms. And I, I remember when you told me that I just burst into tears because the side effects are so awful and I feel emotional talking about it now. The fact that women are being given that rather than just supplementing the hormones that they’re, you know, missing or have a decline in, it’s not fair at all. [00:28:38][49.4]

Dr Louise Newson: [00:28:39] Absolutely. So there’s so much to change. But, you know, you’re quite a kickass generation and I think you won’t allow things to happen like that. I think one of the things that we’re really trying to do, obviously with balance and the work I do is empower women and then they can make a choice if they want a medication that has side effects, absolutely fine. If they don’t want hormones, absolutely fine. But actually, if they know the important role of hormones, then of course trying them is absolutely fine as well. [00:29:02][22.7]

Jessica Anderson: [00:29:02] Know, it’s all about the evidence based decision making. [00:29:05][2.5]

Dr Louise Newson: [00:29:05] Indeed. And when you don’t have the evidence, then you go on any clinical evidence that you have. And also you can use the knowledge and know that it might be limited. And then you try and individualise it to you as a person. So there’s lots we need to do. And I hope in 20 years time, when you come back on the podcast, when you’re older, wiser, I’m going to be very old then. [00:29:25][19.5]

Jessica Anderson: [00:29:25] Am I not going to be invited in any of that time period? 20 years, this is it. [00:29:30][4.3]

Dr Louise Newson: [00:29:30] No. But I mean, in the next generation, when you’ve got other generations coming on that you’re all going to be so much more empowered. It’s going to be easier to get treatment. It won’t be the minority of women who are menopausal and receiving treatment and actually a handful of women with PMS receiving hormones. I hope it will be more mainstream. But one of the ways that will help is, you know, your knowledge, your information, that what you’re doing actually is more important in some ways than what I’m doing, because you’re going to be able to really impact on so many people in different ways. So before we end, just I’m going to throw something on you, which you haven’t been prepared for, is I always ask three. I always ask for three take home tips for my guests and you’re no exception. So three things that you think are really important for people, men and women or boys and girls of your age that should know now about their hormones rather than waiting till they’re older. [00:30:22][52.5]

Jessica Anderson: [00:30:23] Okay, let’s have a think. I mean, I think one of the most important things is for people to realise that it’s not a taboo topic. It’s okay to talk about those sorts of things. And I think actually a lot of people, let’s say my friends have brought that topic with their parents and a lot of their parents are grateful that they’ve had the initiative to bring up that topic. So I think that’s really important. I think the key phrase of saying I know it’s, you know, it’s not applicable to me and my hormones, but knowing that the menopause is a long term hormone deficiency is incredibly important. And I think it completely refrains the way that you think about it. And I met someone the other day. Actually, I didn’t tell you about this. And this woman said that she thought the menopause for her was always just called the curse and you didn’t even talk about it, you know. So I think seeing it as a long term hormone deficiency is a lot better and a lot more factually correct as well. And the third take home tip is also that PMS can be treated. You don’t have to live with it. You don’t have to deal with it. You don’t have to just accept that you’re going to feel rubbish for a few days, a month or however long it is. And actually I feel the same every single day of the month. Like mood wise, I am completely stable and I think a lot of people are very shocked when they hear me say that. And you know, hopefully as more and more people develop an awareness, people will be less shocked and go, Yeah, I know, like I feel the same accident. So there we go, my three take homes. [00:31:57][93.4]

Dr Louise Newson: [00:31:57] Very wise words from a 20 year old. So thank you so much, Jessica, for your time and hopefully I would invite you back within 20 years so you can give us an update. But what you’ve shared today, I thank you. It’s always quite hard sometimes sharing personal stories, but that’s the way we learn as well. So thank you for your time. [00:32:15][18.1]

Jessica Anderson: [00:32:16] Well, yeah, of course. So I’m very open about all that sort of stuff as well, because how else I think people learn a lot from hearing about other people’s experiences. So if I can, you know, positively influence someone with something that, you know, at the time was negative for me then it’s a win win. [00:32:31][14.8]

Dr Louise Newson: [00:32:32] Totally, so thank you very much. [00:32:33][0.5]

Jessica Anderson: [00:32:33] Very welcome. [00:32:33][0.2]

Dr Louise Newson: [00:32:38] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk and you can download the free balance up on the App Store or Google Play.

ENDS

The post From PMS to menopause: why we need to talk about hormones appeared first on Balance Menopause & Hormones.

“A decade ago, I’d just hit my 30s and life was pretty good – but there was one problem. I was unbearably tired and falling asleep on the sofa at 6pm every evening because it was impossible to fight the overwhelming fatigue. I also started getting migraines like clockwork every month.

At first I put this down to my stressful job. I was working in international events and having a busy time working on lots of different projects and travelling across time zones. As I was single, with very little time for a relationship, I decided to take a break from the pill to see if that would stop the migraines. But three months later I felt even worse – I was absolutely exhausted, had started having hot flushes, and hadn’t had a period since I stopped taking the pill. In hindsight, it’s clear that the pill had been compensating for my lack of hormones.

I made an appointment to see my GP, who was sure that it was nothing to worry about. But he explained that in rare cases it could mean that I was experiencing an early menopause, so he ordered some tests just to be sure. He assured me that this was very unusual, so I wasn’t especially worried.

So I was shocked when my results came in: my thyroid levels were in serious decline and my levels of estrogen and follicle stimulating hormone (FSH) weren’t what they should be. I was prescribed thyroxine immediately, which I’ll need to take for the rest of my life, and referred to an endocrinologist (hormone specialist) and gynaecologist for further investigation.

I’d always assumed that having my first ultrasound scan would be a magical moment where I’d get to see my baby for the first time, while a supportive partner held my hand. Instead, I found myself scared and alone in a hospital waiting room, surrounded by expectant mothers, waiting to find out what was wrong.

Then, after lots of poking and prodding, I was diagnosed with POI, basically an early menopause. I sat in the gynaecologist’s office in absolute disbelief, feeling my heart break with every word she spoke. It hit me that the future I had planned was crumbling into oblivion, and she handed me a box of tissues as the tears started to flow.

POI and infertility are often considered to be part and parcel of the same condition, but that’s not necessarily the case. Some people with POI may still have irregular or infrequent periods and may even be able to conceive. But, in some cases – like mine – POI can lead to periods stopping altogether and results in infertility.

After my diagnosis I just wanted to hide away. Dealing with the emotional fallout was so much harder than fixing the physical symptoms. But, after about six months, I decided that it was time to investigate my options. A doctor explained that the only way for me to carry a baby to full term would be through egg donation. This would need to be privately funded, as the NHS doesn’t offer this treatment to single people.

I investigated IVF privately, but with costs of around £10,000 it was out of my reach. So I decided to concentrate on work and put aside any thoughts of having a family of my own. As a result, I started to push people away. I had started dating again but I struggled with how to explain my diagnosis to a potential partner. And whenever I was invited to a baby shower, christening or a child’s birthday party, I’d come away feeling sad and deflated.

Finally, two years after my diagnosis, I accepted that I really wanted to be a mum – even more than I wanted to be someone’s wife or girlfriend. That’s when I decided to look at other options. For me, adoption was the obvious choice, and I made the terrifying decision to adopt as a single parent. Going through the adoption process alone was isolating at times, but I had an amazing support network, and I met some incredible people who were going through the same process.

After going in front of a panel, I was finally approved as an adopter but it took five more months, and two failed matches, before I was united with a six-month-old baby – my son. He came home with me a month later, and six months after that we officially became a family in the eyes of the courts.

It’s now almost 10 years since my diagnosis of POI, and I’m mum to a bright an active son who I believe I was destined to have in my life. My journey to motherhood wasn’t easy or conventional, but it gave me the strength I needed to become the woman I am today. Some people talk about menopause being the end of a chapter – but for me it was just the beginning.”

Read more about POI.

Would you like to share your experience of perimenopause or menopause? Write to us at shareyourstory@balance-app.com

The post My story: POI & having a family appeared first on Balance Menopause & Hormones.

The post What is the menopause and when does it begin? [Skill Boosters Video] appeared first on Balance Menopause & Hormones.

The post Symptoms of the menopause [Skill Boosters Video] appeared first on Balance Menopause & Hormones.