- Having to concentrate really hard in the mornings so that you don’t pour boiling water on your breakfast cereal.
- Stumbling around the house looking for a lost phone before realising that the cat is standing on your keyboard.
- Saying “What?” when there is a gap in the conversation that you forgot you were part of.
- Saying “What?” when there is no conversation happening at all.
- Worrying that your intelligence is gone and you might never get it back.
- Stocking up on T-shirts, because you wake up sheathed in sweat at least once every 24 hours.
- Undignified. (Although, luckily for me, I don’t really give a crap about that and I’ve never been particularly dignified anyway.)
- Emotionally draining.
- Sometimes hilarious; sometimes, the exact opposite.
- Different for every woman.
- Not talked about enough.
I should perhaps tweak that last statement. Menopause is, thankfully, talked about more now than it has ever been. When I developed the myriad symptoms that led to my diagnosis of endometriosis, I joined a couple of menopause support groups. I was, after all, 42 at the time and I figured: maybe wonky hormones are what’s causing all of this and, even if it’s not wonky hormones, they will be going wonky soon enough anyway. Might as well start learning. I’m still a member of those groups and they are such a boost for me, as well as a real eye-opener. So many women are living with their menopause, right now! (That’s … what percentage of the population? Like, 50% divided by eight or so? … I don’t know, I’m exhausted, please cut me some slack.) It can last for ten years or more! You can keep having hot flushes, well into your 60s! And so on.
In addition to those fantastic groups, there has also recently been a fantastic documentary, Sex, Myths and the Menopause. Presented by Davina McCall, it was aired on the UK’s Channel 4 in May this year and featured numerous women, including the presenter herself, speaking frankly about their experiences of the menopause. For me, it could not possibly have come at a better time. I had just been fitted with a coil that releases the synthetic hormone, levonorgestrel, in an attempt to manage my endo symptoms that were making an unwelcome return from the previous year’s laparoscopy. Within a few weeks, it had become clear that, yes, my periods and the associated debilitating cyclical pain and exhaustion had stopped; however, the fatigue, headaches and migraines were brutal, I had different pains, and I was experiencing depression on a level that I had never known before.
I’ve been in a pseudo-menopausal state for three months now. By ‘pseudo-menopausal’, I mean that my periods have stopped, albeit not (yet) for 6 months or 12 months or whatever it’s supposed to be, but nonetheless, they have stopped, and I’m living with a whole bunch of new and very unwelcome symptoms. I feel like a confused, uncomfortable, weirdly disconnected version of myself. And it’s not just me dealing with this – it’s affecting others in my life too; not least my family, my work colleagues, and my husband (who married me just on the cusp of all this crap. Sorry darling. At least we had some good years together.)
But; guess what – the fun doesn’t stop there. Bear with me and I’ll elaborate: when the fatigue and depression became unbearable, my GP took bloods (the results were normal, as is – boringly – so common for endo warriors) and referred me back to the gynaecologist, whom I have now seen, two days ago. She and I talked symptoms, science, sweating, sex, surgery, sickness, suggestions, solutions, lots of other words beginning with ‘s’, and plenty more besides. Our conversation reached the conclusion that I had suspected, but also feared, it would: Decapeptyl.
Decapeptyl is a brand name for triptorelin, which is a GnRH (gonadotropin-releasing hormone) analogue*. In women, GnRH analogues mimic the menopause, by stopping the ovaries from producing oestrogen. No more oestrogen = no more aggravation of endometriosis = (hopefully) no more pain. Brilliant, right?! Erm, sadly, not quite. Here, copied directly from the Decapeptyl ® leaflet that the gynaecologist gave me, are just some of the (common, or very common) side effects: depression, nervousness, abdominal pain, dizziness, headache, decreased libido, mood swings, breast disorder (as if they weren’t disordered enough already!), ovarian hyperstimulation syndrome (wtf is that?!!), excessive sweating, acne, oily skin and hot flushes. In other words: more menopause. Lots more.
The weird thing is, when your ovaries get ‘switched off’ (as she put it), you are straight away put on HRT, including progestogen and oestrogen. When I asked the gynaecologist the rationale behind ‘switching off’ the oestrogen, only to switch it back on (artificially) again, she nodded sagely and explained to me that a) the body needs those hormones, and b) the process will regulate the amounts of those hormones, as my body is currently producing incorrect, fluctuating amounts. She’s not wrong there.
Also included in the Decapeptyl ® leaflet is a warning pertaining to the loss of bone density that accompanies the long-term use of GnRH analogues. Other sources, such as endometriosis-uk.org and bnf.nice.org.uk** are clearer, stating that the drug is not to be used for longer than six months. And here’s another thing about Decapeptyl: google it, and one of the first hits you get relates to prostate cancer†. Turns out, the drug is used to treat prostate cancer and gender dysphoria, as well as uterine fibroids and also endometriosis.
Needless to say, I’m giving this some very careful thought. In theory, the use of Decapeptyl (also referred to as a form of ‘chemical menopause’) precedes surgical menopause. It’s a pretty extreme step to be considering, and I wouldn’t be doing so if there were better options. What I’d really like is to get back a bit closer to normal; that is, enjoying short walks, long days, and far fewer painkillers. And I’d like my bones to stay as dense as possible for as long as possible – I’d rather not go through the agony that I witnessed my mother experiencing, of a hip break and a subsequent staph infection, in my 60s.
To all of the menopause warriors out there: I salute you. I had no idea. You are amazing. I really welcome any advice you can give me on how to continue functioning. To Davina McCall, who introduced me to the word ‘menopausing’, along with several other handy pieces of information: thank you. Please keep up the great work you’re doing. I’d also like to propose a new word to be added to the lexicon, for those of us who are endo warriors as well: ‘mendopausing’. Because I think you gotta at least try to have some fun with all this.
** Sources: https://www.endometriosis-uk.org/sites/endometriosis-uk.org/files/files/Information/Treatment-information-pack.pdf and https://bnf.nice.org.uk/drug/triptorelin.html
† Source: https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/triptorelin
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