11 April 2023
Perimenopause: “The idea that there could be a way to resolve this, or even just a name for it, gave me a huge sense of great relief”
Writer: Lauren Jackson
Photographer: Claire Mossong
Sarah Lewis, 45, lives in Papamoa with her partner, Glenn, and her eight-year-old daughter, Willow. After receiving support to help manage some of the symptoms of perimenopause, she hopes more women will recognise the signs and find support early on during what can be a challenging season of life. She spoke to Shepherdess about her experience.
What even is perimenopause? Many women don’t really know, despite the fact that almost all of us will go through it eventually. Because until very recently, it hasn’t been talked about much. Women are said to be in menopause when they haven’t had a period for twelve months in a row, however, the transition into menopause – perimenopause – can begin years earlier. Symptoms vary from one person to the next, and there can be ‘normal’ months and months where things feel completely out of whack. Classic perimenopausal symptoms are irregular periods and night sweats, but can include more wide-ranging symptoms such as poor sleep patterns, low or irritable mood, and ‘brain fog’.
Sarah thinks she began going through perimenopause a year ago, and admits she thought fluctuating hormones was something she wouldn’t have to contend with until her fifties. “Perimenopause affected me for quite a while before I realised what it was,” Sarah explains. “My tolerance for everything diminished. I actually thought I was turning into a horrible person.” Although it is being talked about more now than it was with her mother’s generation, there’s still a way to go. “I would have been a teenager when my mum was going through menopause,” Sarah reflects, “and it really affected our relationship. There are a lot of people suffering quietly.”
For Sarah, the problem was that she suffered a bout of Covid-19 around the time she went into perimenopause and she attributed a lot of her symptoms to the virus. “For me it started out as night sweats – really extreme – and then it was just really low patience,” she recalls. “Then I had brain fog. You have to really focus to recall things that would normally be instant. You’re easily distracted, whereas normally you’d be able to cognitively fight through that clutter and find the thing you’re trying to remember. Trying to concentrate makes you very tired.” The night sweats disrupted her sleep and compounded the brain fog, and she was left feeling overwhelmed and exhausted.
“I just sort of dug in and carried on, but it took a lot of mental fortitude to do that. Every day was a little bit like running through fog,” Sarah remembers. “I lost all my filters and started to have people up about things. I was like, ‘Wow, I can’t seem to control what I’m saying.’” Sarah lost some friends, who couldn’t understand what she was going through. To be fair, Sarah barely understood it herself. “Things I would normally have been able to brush off really upset me. I’m normally a really happy-go-lucky person,” she says.
Sarah went to her GP to have a Mirena fitted, hoping this would ease her premenstrual tension. Upon hearing Sarah’s list of symptoms, her GP explained that she was going through perimenopause. “I was gobsmacked. It just hadn’t entered my mind. I don’t know why,” Sarah says. After the initial shock had subsided, her spirits lifted. “The idea that there could be a way to resolve this, or even just a name for it, gave me a sense of great relief.”
Sarah was prescribed oestrogen patches in conjunction with the Mirena. “Very quickly – within a week, I think – I started to feel a little bit more energetic and a lot less grumpy. The night sweats stopped almost instantly, which was a game changer for me,” she recalls. “I’ve now been prescribed sleeping medication to help with my insomnia, and I’m much more focused on my personal wellness than I used to be,” Sarah adds. “I was so busy running businesses and caring for my daughter – you just don’t look after yourself. That’s become a priority for me.” Sarah is now reviewing her diet and nutrition, as changes in appetite and weight often go hand-in-hand with perimenopause.
Sarah’s advice to anyone who thinks they might be experiencing perimenopausal or menopausal symptoms is to “get to your GP and do your homework through reliable, reputable sources”. Finding a sympathetic GP with some knowledge and expertise in the area of menopause and hormone treatment may be more challenging in rural areas where there are fewer doctors to choose from, Sarah points out. If local options are limited, women can ask their GP to refer them to a menopause physician (a GP with specific expertise in menopause) or an endocrinologist with an interest in menopause, most of whom will offer remote consultations. Sarah feels lucky – her GP was going through perimenopause herself and was “brilliant” to deal with.
Sarah draws hope and knowledge from others who share similar experiences. “While everyone has their own journey, I’m looking for those stories to help me understand what to expect.” We’ve actually started a menopause group in my office. There are quite a few of us going through it. We were joking that we can’t get the temperature right for the air con – someone’s either too hot or too cold, and that’s what started the conversation,” Sarah laughs. “We share resources, which is amazing.”
When Sarah’s perimenopausal symptoms set in, her confidence took a huge knock. This coincided with the pressure the pandemic put on her communications and events business, coupled with catching Covid-19 herself. She believes that the workplace flexibility that came with Covid, however, will help keep perimenopausal and menopausal women in the workforce. As well as running her own business, Sarah works as a copywriter for a supportive boss in a workplace that openly discusses mental health. She is welcome to work from home, where she can control the temperature and enjoy a quieter environment. “I find noise really distracting at the moment,” she explains. “I would hope that with women in senior leadership roles, probably going through a similar experience, there is an opportunity for better education and information in the workplace.
Sarah brings this transparent approach to her parenting, too. “I’m a very open mum. I always think honesty is the best policy. Hopefully, by the time our girls are our age, it will all be open and just part of normal life for men and women. I say things like, ‘Look, I’m sweating; I’m grumpy; I’ve got the menopause. Please don’t press my buttons today!’” she laughs.
Her experience has inspired her to start her own podcast, where she’ll be exploring topics that effect women in their forties – a phase of life where some high-achievers can start to feel invisible, despite their valuable contribution to society. “It’s an exciting new adventure for me,” she smiles. Treatment and knowledge have restored Sarah’s confidence and shown her that “there is light at the end of the tunnel.”
The Australasian Menopause Society website is a doctor-recommended patient resource for information about perimenopause and menopause.
This story is part of THREAD, a year-long project by Shepherdess made possible thanks to the Public Interest Journalism Fund through NZ On Air.
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