Early menopause was not a particular focus of my cancer after-care. But recovery, recuperation, and adjustment of life after cancer created a new me: tiring so easily after small amounts of exercise and bouncing from different HRTs, with varying successes that ultimately felt like being on an extremely un-fun, emotional roller coaster.
The adjustments that came with this transition, the hormonal imbalances, the badgering of consultants and GPs, the focus on long term side effects of radiotherapy, and the idea that HRT can be prescribed as a one size fits all, regardless of age or circumstance, all bear the marks of a medical system focused on male bodies and male interests, despite the fairly female dominated environment. That testosterone is prescribed off label based primarily on libido ought to be an indication of this.
Nevertheless, in my often garbled and confused way, I have tried to explain my symptoms in terms of menopause, which, I was once told, has been treated – meaning my increasing dizziness, soreness, anxiety and insomnia could not be menopause related, despite my certainty that it was. My self-awareness is in question, it seems, because of my having been at the centre of various invasive treatments that have no-doubt radically changed my body. Thankfully there are wonderful menopause specialists able to help shift gears on a woman’s quality of life so that debilitating symptoms can be better managed. An example of that would be my current GP, whose recent prescription for Clonidine, a ‘marmite’ – you either love it or hate it – remedy for hot sweats and my CSN.
However, life after treatment can be a jolt when you come to realise that your mind and body are somehow altered and that doctors are now less interested in refining my meds, and more interested in treating new cancer patients that require their attention as a matter of urgency.
This is, of course, a vital and appropriate prioritisation.
For those who haven’t gone through menopause or who may have learnt about menopause indirectly, hot flushes are the most recognisable complaints, an almost universal indication, which is easy to relate to as everyone knows what it’s like to be hot and sweaty. I was prepared for this. In fact, I was almost looking forward to it, happy to live without periods, stomach cramps and back ache, and not much inclined to wonder whether medically induced menopause would lead to a gradual change or a sudden thump. But, like cancer, early menopause is a process of transitioning, understanding that there are a number of changes going on in my body that are reliant on shaky HRT supply chains and public opinion, and that can make explaining my own experiences hard, even just to myself.
Fertility is estimated at higher value because the main objective of a young woman’s body is – biologically at least – to procreate. I have of course discussed egg preservation, which is a pressing decision when faced with imminent radio-chemotherapy, and which I opted out of, in my hurry to press on with treatment. But how do I define myself as a young woman without a functioning womb, and do I still have the same value as before? Unless it is gender-identity driven, this seems to have little news-worthy relevance, in terms of value or lack thereof, to the fact that an early menopausal woman is still a functioning and productive woman. It is true that the menopause has affected the way people look at me: this childless ex-cancer patient who has now lost the ability to have kids, is very easily fatigued, and is currently working through a few side-effects and symptoms. But since I have my whole life ahead of me it is worth pointing out that there are no grounds for regarding me as deviating from my gender.
I will put aside an opinion that is personal to me: that adopting a child always seemed to make more sense, even when I was fertile. This is an opinion I still stand by. But, like any other woman, like anybody who identifies as being a woman, fertility has no doubt been used as a defining characteristic. We sometimes must leave it to other, louder people to define gender – a phrase that by many accounts is highly politicised and fought over. At best, these others don’t acknowledge age appropriate menopause as a natural transition, referring it more in terms of a disease that needs to be cured. Neither do they allow it any of the traits that would distinguish normal female life-cycles from a chemically induced approximation of being fertile. Nevertheless, it remains true that being infertile is not mutually exclusive to being a woman.
I think part of the problem is clear: that talking about menopause, even among age-appropriate women, is a laughing matter. Honestly, it is a laughing matter – I now sleep on the floor on a glorified dog – or ‘menopause’ – mat, recommended to me by my GP. But it’s one thing making light of a situation, another thing entirely is to have this humour negate any attempts at public awareness. On TV, on Twitter, in films, amongst colleagues the menopause must always be accompanied by a joke. Women undermine themselves by selling cutesy and diminutive badges on Etsy – “Out of Oestrogen: Approach at Your Own Risk” one badge declares. All this erodes the realities that women experience – that public health research finds a lack of knowledge to be the cause of many poor experiences related to menopause, and that concerns raised in a recent PHE report have persisted over the ages. The argument against our current way of educating women about the menopause is that the same concerns and worries exist for each approaching generation of women going through the same, inevitable health transition.
Clearly, I sometimes struggle to feel womanly and – due to the earliness of this transition – on a fast-track to old age. There is pressure to transform yourself as a woman so that as more time goes by less of the aging process is revealed. As such things are often bull-dozed over, oversimplified, or laughed off. That this mentality is so prominent in society ought to make it easier for premature menopausal women to access support, but it often feels like the problem has simply been brought forward – with the default position being that women’s aging bodies are unfathomable, even to ourselves. It obscures the fact that it’s painful to hanker after the energy and vigour you once had before, and undermines the sometimes positive experiences of confronting what it means to be a woman. If I seem to be struggling to highlight any positives to this experience, that may be because I have forgotten what my body is for, why the world is built for exploring and looking forward to a happier future. There is always an opportunity to develop and grow, and I sometimes feel very hopeful for the things to come, out of the unforeseen and unfair circumstances that are not yet behind me there are moments are clarity. They are a motivating factor behind writing this blog, to not be ashamed of this transition, and to start a conversation about early menopause.
Features Image Credit: Artist Diana Ong, 2007.