The personal aspect
I knew I had to do something about my menopause symptoms when I froze in front of a large audience, unable to remember the title of my presentation on the gender pay gap. The cause was brain fog brought on by the menopause. I was 51 at the time and had had menopausal symptoms for about two years. They had begun with irregular periods and weight gain. Low mood and debilitating sleep disruption caused by night sweats followed – I couldn’t sleep through the night. Then came the brain fog. Even then, I thought I could hang on until the symptoms abated, but freezing during an important presentation was my wake-up call. In my high-octane job as a Global HR Director for a multinational investment bank I needed to bring my A-game to work each day. Now my brain was letting me down, which was scary. It was time to act.
I’d met Dr Kalentzi at a corporate talk for my company a couple of years earlier and had been very impressed by her. Less than a month after my gender-pay-gap presentation, I was in her office. I had always prided myself on my good health and the fact that I took no medication, but when she told me that my symptoms could continue for another ten years, I realised I needed to think differently. I also naively thought that a blood test would be able to tell me ‘how far through’ the menopause I was, I realise now I didn’t have the right level of knowledge or understanding, which was to my detriment.
It was clear to me during that first meeting that Dr Kalentzi was special. She spent more than an hour with me, gently taking my history and educating me about the menopause. We went through everything and it was an eye-opener. I hadn’t realised that there are more than 40 symptoms for the menopause. I had really only heard of hot flushes and as I didn’t suffer from those I think that delayed me seeking help.
Dr Kalentzi took blood tests which confirmed that my oestrogen was really low and started me on a low dose of HRT, a 25mcg patch. HRT takes a little while to have an effect but after a few weeks my sleep improved, my low mood started to ease, and the brain fog was better. Soon it became clear that the treatment was a massive help.
One of the wonderful things about Dr Kalentzi is that the relationship is a partnership, a dialogue about whether and how your symptoms are changing. I felt my mental acuity wasn’t quite right – I was forgetful about names, which isn’t me – so we added testosterone cream to the regime and this gave me back my edge. I’ve seen Dr Kalentzi twice a year now for the last eight years. Her careful symptom tracking means that sometimes my dosage has increased or decreased. It’s a balancing act between not taking a higher dose than you need but taking enough to keep symptoms in check. It’s so good seeing someone who knows you and your history.
Initially, I felt embarrassed about taking HRT. Inexplicably, I didn’t tell my husband. I felt that maybe I’d copped out in some way and I wanted to keep things private. However, I’m now completely open about it. I think it’s important to raise general awareness for other women who are coming behind me. I’m now post-menopausal – my last period was some time ago and I’ve decided that while I’m working for a big corporate I’m going to stick with HRT, even if we bring the dose down. I may keep taking HRT for the long term as there are important long-term health benefits with regard to heart and bone health. I’d describe myself as an advocate.
The professional aspect
I’m proud that the Bank I work for was the first accredited menopause-friendly employer in the UK. There is so much more companies can do for women going through the menopause. We know from the data that while 20% of women sail through the menopause with no symptoms, another 20% will have such chronic symptoms that it’s utterly debilitating. I’ve spoken to women with senior corporate jobs who after 30 years driving lack the confidence to park their car. They worry they have early dementia but it’s the menopause. The NHS, with its short appointments and lack of menopausal training for GPs, can fall short of what women need. For example, menopausal symptoms such as low mood can be misdiagnosed and treated with anti-depressants. Women with really debilitating symptoms are likely to consider quitting the work force because they just can’t cope, but they don’t need to quit, they just need support. These are often women with 30 years of professional corporate experience. Apart from the 20% who are symptom free, better education and support, which for many will include HRT, is a key enabler for retaining women in the workforce and therefore retaining their leadership contribution and life experience. Additionally, women who leave their careers early suffer the obvious financial loss of income but also an additional impact to pensions as those final years of earning are significant.
Women have gone through the menopause for millennia but this generation is the first with women in senior positions at any kind of scale. My mother gave up her job when she got pregnant. In my grandmother’s generation, women mostly stayed at home. Today’s menopausal women are often caught in the dilemma of the crunch of still caring for dependent teenagers and the increasing burden of eldercare, all whilst holding down an important job that brings much needed income to the family. Add perimenopause into the mix and it can be the final straw. But it doesn’t have to be.
Every woman will experience the menopause differently, and I feel very passionate about better signposting and education for younger women about what’s coming for them. If I’d known more, not only would I have got help sooner, I also wouldn’t have felt that light tinge of shame. As I’ve said, I’m very open now. The perimenopause likely starts in your forties. The average age of menopause is 52 – I was 51 when I entered Dr Kalentzi’s office. I’ve spent a lot of time talking to women in career situations and I often talk about the perimenopause when a woman in her forties tells me she’s struggling. Sisterhood, sharing the experience is vital – we must get the word out.