Dear Doctor

Monday 3 March 2019. Day 51: Since becoming aware three months ago that I am in the menopause stage of my life, I decided to start writing this journal in the hope that writing my thoughts and feelings would help me cope with this mid-life transition and to hopefully connect with other meno women. What I didn’t know at the time (and even today), was just how very little I knew about this change. Yes, I’d seen my mum go through it, but as a mid-teen, I clearly thought that my growing pains far outweighed a few hot flushes.

At school, sex education consisted of the mechanics of intercourse, methods of contraception (condoms; no talk of the pill, coil etc) and the various STD’s (this was the early 80’s so no talk of HIV). Periods were something that happened to girls, but any discussion on that subject took place in a girls only environment by a Tampax consultant.

I’m am trying hard to wrack my brain but I really don’t remember any discussion on the menopause. Who therefore should have been making half the population aware of even some of the facts of this inevitable life change? Should this have been taught to us along with how to insert a tampon? Would we as teenage girls, whose fresh hormones were busy growing bumps in all the right places, taken any notice of something that was going to happen to us when we were old?

Whilst I don’t want to dump it all at the door of my GP, I do think that a certain amount of blame needs to be apportioned here as these are the health professionals that you see regularly throughout your life, especially when you’re pregnant and you’re offered a whole encyclopaedia of what to expect when you’re expecting.

I’ve just started listening to Liz Earle’s Wellbeing podcasts @lizearleme which are an absolute find, and she talks to the brilliant Dr Louise Newson of the @menopause_doctor – oh how I wish she was my GP! One good piece of advice given is to write down your symptoms prior to your GP appointment so that you don’t forget everything you’re struggling with (meno-brain fog is a bitch!). That of course is all well and good if you’ve actually made the connection with your symptoms and the menopause. At 49, I have been completely oblivious to the fact that I have been in the perimenopause phase for quite probably the last five years. I hadn’t even heard of this word until three months ago!

So instead of writing my symptoms down to discuss with my GP, I have decided instead to write a letter:

‘Dear Doctor,

I came to see you five years ago. My youngest daughter was suffering from a myriad of debilitating mental health issues and I was her main support/carer. You could visibly see how this was affecting me. You gave me antidepressants. You also gave me high strength migraine tablets for the days I could barely get out of bed in order for me to stop throwing up, get my daughter up and encourage her to go to school before I dragged myself to the office to do my paid job. You gave me tablets to help with the hideous agony of what was later diagnosed as IBS (they didn’t help by the way and still not sure it was IBS). You gave me beta-blockers to curb the physical effects of anxiety. You told me to join a local netball team to get active as this would help me sleep better. You suggested I take some glucosamine to help my aching joints.’

‘I came to see you again two months ago because I was then having hot flushes (and still not sleeping well, feeling flat, aching etc) and bingo! “You’re 49 now!” you said, “You’re probably in the menopause, but there’s no point in doing a blood test to confirm it because it won’t be accurate given the constant hormone fluctuations in your monthly cycle”‘.

‘Why, when I had my well-woman check three years ago, did you not talk about the perimenopause, saying only when I questioned the slight drop in my hormone levels from the blood test results “you’re too young for us to be discussing that yet”. Why wait until only three years later when I’m crying in your office because I can’t sleep or control my body temperature did you then say “Ooo, you’re the classic age for the menopause to start!” when you know (or should know) that the perimenopause starts much earlier but with so many of the full blown menopause symptoms? Why didn’t you ask me if I was suffering any of the symptoms associated with the menopause (you could have checked my notes) when I’ve been diligently been coming to you for my regular smear tests? Why don’t you have “Menopause Facts” posters in your practice waiting area or send out “Menopause Matters” flyers along with the the well-woman-check invite?’.

‘Thank you for the HRT advice you finally gave me two months ago – the patches have stopped the hot flushes. I am however making an appointment to see you again as my low mood, insomnia, aching joints, brain fog and general exhaustion is still making my daily life pretty hard work. May I suggest that you finally give me two blood tests (a couple of weeks apart) so that you can try to monitor my hormone levels (including testosterone) in order for you to prescribe a more accurate HRT dosage.’

‘Yours sincerely, a disappointed 49 year old menopausal patient of yours’

This is not a letter I will ever send. Reading it back to myself, it sounds harsh. That said, the last five years of my life have been tough. It’s not all the fault of our GP’s, although it’s clear to me since writing my journal that there are some brilliant and some not-so-brilliant doctors out there. Education is key and as women whose lives are completely turned upside down by this period of our lives, we are being very badly let down by educators and health professionals.

Until next time, if you you are experiencing any of the countless symptoms of the menopause (go check out www.menopausedoctor.co.uk for clues), make that GP appointment today!

Much love,

SJP xx

P.S. Don’t forget your list.

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