The ‘change’ isn’t easy at the best of times — throw in a pandemic, and it’s no surprise that some women are finding that symptoms are even worse during lockdown, writes Emily Hourican
It isn't a competition - who can have the 'worst' Covid-crisis experience? - but a recent survey conducted by the Menopause Hub clearly shows that women who were already experiencing symptoms of menopause are finding the current crisis - and the ways in which it impacts on their physical health, psychological well-being, and availability of healthcare - tough.
The survey was conducted among women aged between 35 and 64 years old, 84pc of whom described themselves as peri-menopausal or post-menopausal. Of those, 70pc have symptoms and 65pc describe their symptoms as moderate to severe.
Thirty per cent of women surveyed describe their symptoms as worse during the recent crisis. Within that, 66pc reported increased anxiety, 40pc reported increased mood swings, 54pc reported increased fatigue, 50pc reported increased insomnia, 47pc reported increased weight gain and 45pc a negative impact on relationships from menopausal symptoms during Covid-19, with 48pc reporting a negative impact on their relationship with their partner, and 35pc reporting a negative impact on their relationship with their children.
As for why these women are experiencing issues, the answer seems to be that this is a kind of perfect storm: a combination of significant external pressures, with pre-existing symptoms - psychological and physical - along with difficulties and uncertainty over accessing medication.
For Lynda Nolan (48), "One of the biggest things, as somebody who's trying to work from home as well as home-school and keep all the other bits in the air, is the brain fog. It is more apparent, because I'm not in my usual routine. Brain fog is one of the over-riding symptoms I struggle with. It's like a mental block, like someone pulled the blinds down. I have anxiety around it that I didn't maybe look at before, because I didn't have time, but now, I am looking at it because I have time to be reflective, but also, because I'm doing so much more than I was."
Lynda's son is in sixth class, so she is home-schooling in preparation for the transition to secondary school. She has an older daughter who has returned home from the UK to live since the crisis began. And at the same time, she and her husband run their own business, Nolans Group, a construction and restoration company, and employ 27 people. "We've been through the recession and it nearly broke us, so to be here, with this uncertainty, is really very testing."
Lynda went into surgical menopause last year ago, after a hysterectomy. "It was like being in a car crash," she says. "Sudden and shocking. And women don't talk about it. That was the hardest for me, going through this. The post-operation stuff was hard itself, but compounded by the drop in hormones, and not knowing what the hell was going on with me, because no one talks about it. I was told I'd be back at work within eight weeks, and six months later I could barely get up and go for a walk let alone run 5K, which I had been doing."
"I'm very holistic, very into yoga, thinking 'walnuts will get me through this…' I'm also very pragmatic too, I was determined I was going to get back to work fast. But I had to realise I was in a different place, that I needed to accept the changes to myself and my body. That I wasn't just going to snap back, I needed to be kinder to myself."
Lynda started on HRT, "at first, I went through a bit of grief process - 'this confirms I am in menopause' - but within a few weeks, I did a hike. Then I was back running. I felt great. Starting HRT gave me back a bit of me. Then the country started going crazy with Brexit, then with lockdown, and now the patches are nowhere to be got. That's added to my anxiety. I'm taking a different form of the medication, I'm really not happy about that. I'd been feeling so good. It's hard to have that taken away. I think I'd be dealing so much better with this if I didn't have to chop and change."
Right now she is, she says, "Hanging in there, trying to be positive for the people who work for us, and then trying to multi-task and home-school as well. My husband and I work together, so there are stresses there anyway, given the economic situation. I really don't need brain fog on top of that. Plus, the way things are, there isn't a lot of room for my off-days.
"I can be irritable and snappy, and he doesn't understand. I have days where I'm trying to home-school - and that is really stressful; I'm not a teacher, and my son is going into secondary school, they are missing out on so much already, which is adding pressure - I'm feeling guilty the dog hadn't been walked, falling behind in what I have to do at work… I nearly gave myself an aneurysm. Women are amazing. We come into our own in these situations. But it frustrates me that we aren't talking about menopause and what it means for us. I'm open and I talk about it, because so many women won't, and I think it can be a very lonely place to be."
Gillian Murdiff (46) is, she suspects, peri-menopausal, and very keen to investigate this possibility. But because of the Covid crisis, she can't do that. "I'd say at least two years ago I started to experience symptoms, including mood swings, loss of libido, night sweats, mad dreams and weight gain. I've got a 16-year-old and a six-year-old, and I found I had no patience whatsoever. I'd be happy one minute, angry the next, and that's not me, I'm normally a patient person. I found had no patience at all." The weight gain, Gillian says, was "inexplicable. I'm a yoga teacher, I'm fit and healthy and I eat well, and there's no reason for it."
So she went to a GP and said 'I think I might be in peri-menopause,' and I was told, 'there's no such thing.' "I had put on nearly two stone, and I was told, 'oh that's not a big thing.' And same with the loss of libido. It wasn't taken seriously. I'm with my husband 32 years, now, we're teenage sweethearts, and I refuse to lose my relationship because of hormones. I have friends in their 50s, and they have these relationships with their partners that are drifting and they don't even talk about it. I can't let that happen to me. But the GP did a blood test, said there was nothing wrong with me, and put me on a low dose of SSRI [antidepressants]."
It wasn't a solution Gillian felt happy with. "So I did my own research, and I'm positive this is peri-menopause. I went looking for somewhere I could discuss this, and found two options of clinics I could go, where I would be taken seriously, but both have been closed because of Covid-19.
"My search for answers has been delayed by the crisis. I want to sit down and talk to someone who will take this seriously. And at the same time, my symptoms are worse because I feel trapped and I can't get out and do normal things."
⬤ Check out themenopausehub.ie for more helpful advice
So what is it about the particular combination of internal and external circumstances that is so tricky for women with menopausal symptoms?
"Women are facing a lot of challenges at the moment, and I think particularly menopausal women,' says Dr Caoimhe Hartley, GP at the Menopause Hub (themenopausehub.ie) and accredited menopause specialist. "There's a lot of misconception around menopause. Even women who are still having regular periods may find their hormones start to fluctuate, they have dropping levels of oestrogen, and they get menopausal symptoms as a consequence. What really takes people by surprise are the psychological symptoms. What I hear most commonly is a feeling of being really irritable and short tempered. Low mood, low self-esteem and anxiety are also very common."
As Dr Hartley says, "We're all feeling more anxious than usual, we're all feeling out of our routines and disconnected. If your baseline before all this happened was that you were already anxious and having mood swings, feeling overwhelmed and tearful - throw a global pandemic on top of it, and it exacerbates everything."
So what can women who find themselves in this situation do?
"Talking is probably the most important thing. The majority of these women are having psychological symptoms - they are overwhelmed and anxious - so addressing that is probably the most important thing to take in hand at the moment.
"There are really good CBT programmes online. If they have seen a psychologist before, maybe make contact with that person again. Talk to their GP if these symptoms are really impacting on their personal lives, working lives, and relationships."
Clare Quinn is counting down the days until gyms reopen. She does exercises you have possibly never heard of: chair aerobics, weights with a rollator, stretches targeting specific feet muscles.