Hot Flush: How I Learned To Cope With The Menopause - The Gloss Magazine

Hot Flush: How I Learned To Cope With The Menopause

For some women it’s akin to living life under a black cloud, for others it’s a minor blip. SUSAN CONLEY looks at current thinking about the menopause and explains why she took the natural route

I’ll never forget my first hot flush: I was idly contemplating the discount picture frames in my local Tesco when my entire body erupted in heat from the inside out. There wasn’t even a cursory warning as in a few beads of sweat dotting my hairline or a tingle up my spine. It felt like watching a building being demolished: something interior explodes and the whole thing collapses. Only faster.

A heartbeat after the initial fire, I swore polysyllabically and muttered, “That was a hot flush!” I wandered home and I’d like to say I was duly humbled as it was a truly life-changing moment, but despite the drama of the sudden onset and possibly due to the extremely mundane surroundings, I didn’t feel much.

In a good way: it wasn’t denial (impossible to deny that I had gone from zero to soaked-through in exactly one second) or some class of helpless inevitability. It just was. What was strange was that though I had been consciously peri-menopausal for the previous two years, I hadn’t hit the books in preparation for The Menopause itself. I hadn’t asked my mother about her experience as my twelve-year-old self will reel in perpetuity from “the sex talk”. Post-flush, the internet told me to try sage tablets; I did and found them to be no use; a friend of a friend gave me a hand fan that I employed shamelessly like a character in a Jane Austen novel; I got a LadyCare Magnet and wore it faithfully. The flushes and night sweats passed within a year; my period never came back; I didn’t experience any of the other symptoms such as lack of libido, fractured sleep or bladder weakness. I laughed and laughed every time I rotated a handbag out of the archive and found its inner pockets full of tampons. I was done. I was okay.

There are countless women who do not find the process okay. Historically, all the way back to Aristotle, female physiology has been a source of mystification to men in power and shame in women. In Hormonal: A Conversation About Women’s Bodies, Mental Health and Why We Need To Be Heard, Eleanor Morgan harks back to the ancients, who set the tone of medical thought for centuries to come. “‘An animal within an animal’ is what Greek physician Aretaeus of Cappadocia considered the womb to be: an organ that ‘moved hither and thither in the flanks’,” she writes. It was literally, actually, seriously believed the womb wandered aimlessly around the body. It makes it difficult to believe things have improved when a study like the 2002 “Women’s Health Initiative Study” (WHI) found that HRT would kill us.

But will it? Dr Lucia Gannon is a practicing GP in Tipperary and the author of All in a Doctor’s Day: Memoirs of an Irish Country Practice. She says the WHI was extremely flawed. The study “stated that HRT put women at increased risk of breast cancer and cardiovascular disease,” she explains. “Since then, two of the authors of this study have apologised for the misinformation. The women in the study were all over 63 years of age and were using a type of HRT that we do not use now. Many were overweight or obese and so had other risk factors for cardiovascular disease. This data should never have been applied to a normal population of women less than 60 years old.”

Thanks for nothing, modern research. According to The Menopause Hub, an HRT regimen tailored specifically for a client is still one of the best ways to manage the symptoms. Gannon agrees. “HRT significantly improves the symptoms of hot flushes, sweats and mood swings,” she says. “It can reduce the progression of cardiovascular disease if started within ten years of menopause and it causes substantial increase in quality of life over 30 years when started in close proximity to the menopause. Some studies show a slightly increased risk of breast cancer with certain types of HRT, about the equivalent of having a glass of wine a night. Other studies indicate other forms of HRT reduce the risk of breast cancer slightly. Either way, there is no increased risk of death from breast cancer with HRT and the increase in incidence is slight, nothing near what was first indicated by the WHI study.”

Have the kind of menopause you can be proud of, because you made it yourself.

Personally, had I needed it, I would have found an alternative to HRT (it is derived from pregnant mare’s urine and PETA denounces the practice of its harvesting). Susan Zelouf, furniture maker and contributor to this magazine, has. “I’ll give you my bioidentical hormones when you pry them from my cold, dead, yet still incredibly youthful hands,” she vows.

Bioidentical what now? Manmade hormones cultivated from plant estrogens, bioidentical hormones more closely mimic the chemical structure made by the human body. Some are the product of Big Pharma, others are compounded in a chemist’s according to doctor’s orders. Zelouf discovered them in relation to one of menopause’s most disheartening symptoms: pain during sex.

“I had a year of living sexlessly, when my vaginal walls became as thin as tightly stretched lamb nappa that had been left in an Egyptian tomb,” Zelouf says. “I couldn’t put anything inside bigger than a Q-tip. I thought there was something wrong with me, like cancer. Apparently not, said the gynecologist: ‘You are menopausal; your vaginal walls have thinned.’ The only thin part of me, damn it!”

Chats with a pal led to the former Three’s Company star Suzanne Somer’s book I’m Too Young for This!: The Natural Hormone Solution to Enjoy Perimenopause, and from there, an appointment with a “really expensive doctor” in Santa Barbara. “I eventually found an inexpensive clinic in Palm Springs, and get six-month supplies of the cream I need, a combination of progesterone, and testosterone/estrogen bioidentical creams,” she explains. “I put the testi/esti where the sun don’t shine, and get a nice warm feeling in my vulva. Never had a hot flush since; my vaginal walls are now as supple and fun as a bouncy castle.”

It’s a commitment above and beyond the application, and Zelouf is all in. An annual pilgrimage to the west coast of America is required for a check-up mammogram and smear, and while a local option would be welcome, the financial outlay works out to be the same, even with travel. Is this a lifelong enterprise? “Recently, the clinic encouraged me to wean myself off them,” Zelouf says. She’s resistant, though. “I am convinced they are keeping me juicy.”

Does a less conventional approach appeal? Maeve O’Sullivan is co-founder of Escapada Clinic, (Fitzwilliam Square, Dublin 2) which offers individualised natural medicine. She had been nursing in western medicine “for quite a few years and the next natural step was to specialise,” she says. “Natural medicine was always something that was in my head, even when I was much younger and Chinese Medicine resonated with me the most. It looked beyond the physical symptoms, towards treating the root of the problem and not just popping a plaster on. It doesn’t chop and change information, it lives on solid principles and when adapted they give individuals a lifelong individualised health care system.”

O’Sullivan has a deep well of advice for those who may like a natural approach. I had unwittingly been following some of the advice in that I spontaneously changed my diet in my peri-menopausal years and as she suggests, had started eating herbal estrogens such as soy products, cashew nuts, apples and almonds; peanuts, oats, and corn are also excellent. “These will support and balance the body during its process of hormonal change,” she says.

Other recommendations include exercise twice a week in 40-minute instalments (thanks, horseriding twice a week!) to “help reduce stress, improve your mood and increase your bone density”, O’Sullivan explains. “If you have joint problems, Qi Gong is a good alternative.”

Most of all? “Remember to take some time out for yourself to de-stress and do the things you like to do and to relax. Practicing breathing techniques or taking up gentle yoga and mediation will promote deep relaxation and increase sleep.”

“Every woman knows it is coming but not every woman takes the time to be kind to herself during that phase of life,” says Dr Gannon. “Those who do can often find their wellbeing increases significantly as they embrace the cessation of periods, the end of the need for contraception and take time to reflect and appreciate how well their bodies have served them – and how they can continue to do so, provided their bodies get the care and attention they deserve.”

I told the opening anecdote in reply to a friend who, whispering over cocktails, asked me if I knew when I had had my first hot flush. “Girl,” I concluded, “it’s unmistakable, even though you’ve never experienced it.” That may be the knowledge of that hither-and-thithering, wandering womb in practice, the part of us that seeks wisdom everywhere. Trust your instincts, talk to your pals, consult your GP and have the kind of menopause you can be proud of because you made it yourself.

This feature first appeared on thegloss.ie in 2019. 

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