Katie’s Perimenopause Story
“The doctor informed me that my previous blood test results had indicated possible perimenopause and suggested that I try HRT. I was raging. Why hadn’t anyone told me about my results earlier? ”
It all started with some spotting.
I had been taking the progesterone-only mini-pill Cerelle for over a decade, with a few breaks when I was pregnant or trying to conceive. The pill had stopped my periods completely, so I was a bit surprised when I started to get random spotting. It would last for a few days, stop briefly, then come back a few days later. I could never predict when I’d start bleeding again. After several months, I contacted my GP.
‘Is your smear test up to date?’ she asked.
‘Yes,’ I replied.
‘Well, that’s all right then,’ she said as if that was the end of the discussion.
‘But…it’s not. I’m bleeding all the time,’ I said.
She replied: ‘Spotting is quite common for women on the pill.’
‘But it isn’t for me,’ I told her. I had been taking Cerelle for most of my adult life and I didn’t bleed. That was how my body worked on Cerelle, and I loved not having a period, as it meant I didn’t have to deal with cramps or leaking due to heavy bleeding.
She shrugged and told me to keep an eye on it. I went home and continued bleeding randomly. I also started to feel bloated all the time. I would eat a bowl of cereal for breakfast and feel full for the rest of the day. I went back to the GP and asked whether the spotting and bloating could be signs of perimenopause.
‘You’re too young,’ I was told.
I was in my late 30s - younger than when many people start perimenopause, but both my mother and grandmother went through menopause in their 40s. I explained this to her.
‘There’s really no way to test your hormones while you’re on the pill, You’ll have to come off it for at least a month before we can do a blood test.’
She also referred me for a scan of my ovaries at the hospital, because bloating can be a sign of ovarian cancer. I went home and threw my pills in the bin.
Getting night sweats
Over the next month or two my periods returned, the random spotting stopped and the bloating eased. I went back to the GP and they did blood work, but they never called me with the results, so I assumed they were normal, and I thought that coming off the mini-pill had solved any issues.
And then the night sweats started.
I’d wake up in the middle of the night with my pyjamas drenched in sweat. The only other times I’d experienced night sweats were after I gave birth and after I’d stopped breastfeeding when my hormones plummeted.
There IS something going on with my hormones, I thought. At first I didn’t make the connection between stopping the pill and the night sweats starting, but it’s possible they were related. I hesitated to contact my GP again, because I was afraid she’d dismiss me, and I continued to sweat through the night. Even when I wasn’t sweating, I would often be awake in the middle of the night for no reason. I was so exhausted during the day that I would have to lie down in the middle of work because I didn’t have the energy to hold up my head at my computer. Thankfully I was working from home, so no one knew that I was taking my meetings from the sofa bed.
I was beyond tired.
This wasn’t just I-didn’t-get-enough-sleep-last-night tired. This was I-can’t-move-at-all tired. This was I-feel-like-someone-stuffed-cotton-wool-in-my-brain tired. I started coming up with games I could play with my two young children where I didn’t have to move. One of them involved me lying on the floor while they covered me in their clothes. As they buried me under tiny cardigans and cartoon t-shirts, I closed my eyes and thought, ‘This is the best I can do.’
When I met with my therapist, I struggled to find anything to talk about. I’d had issues with anxiety since childhood, but I was too tired to be anxious about anything now.
‘How are you feeling?’ she’d ask, as she always did.
‘Tired,’ I’d say. ‘But…maybe that’s a good thing? Because I’m too tired to care about anything?’
‘No,’ she said, gently. ‘You should probably speak to your GP.’
I decided that she was right. The fact that I was too exhausted to worry, should be the most worrying symptom of all.
Starting HRT
I phoned up my GP and explained my symptoms.
‘Are your periods normal?’ the doctor asked, a different one this time.
‘Yes,’ I said. ‘But nothing else is. I sweat every night. I can’t sleep. I can’t think. I have no energy. I have heart palpitations every day.’
The doctor informed me that my previous blood test results had indicated possible perimenopause and suggested that I try HRT. I was raging. Why hadn’t anyone told me about my results earlier? I knew blood tests alone weren’t a reliable indication of whether or not you’re perimenopausal, because hormone levels fluctuate all the time, but even so, it was relevant information about my health that I should have known. I didn’t push it though - I was just relieved that someone was finally listening to me.
I started using the Evorel Sequi patches, which slowly release oestrogen and progesterone into your bloodstream through your skin. You alternate between using oestrogen-only patches and patches with oestrogen and progesterone. The doctor also had me in to check my heart rate and blood pressure because of the palpitations but everything seemed normal.
My brain fog cleared somewhat, and my energy levels started to improve within a few weeks, but I was still getting night sweats right before and during my period. My doctor suggested that my body might cope better with a steady dose of progesterone, so I should try the Mirena coil. She also suggested increasing the oestrogen dosage of my patches.
Getting the Mirena coil
I had heard horror stories about how painful getting the Mirena coil could be, so I wasn’t surprised when getting my coil implanted felt like someone scraping my uterus with acrylic nails. It was extraordinarily painful, and the paracetamol that the NHS website suggested I take beforehand barely touched the sides. The nurse who did the procedure was lovely about it though.
‘I’m so sorry!’ she said. ‘The things we women go through.’
The things we go through indeed.
She had warned me that it may take a while for my body to adjust to the coil. What this meant in my case was that I bled for 6 weeks straight. I thought wistfully back to the days when I only had spotting. Luckily, after 6 weeks the bleeding eased off, and I’ve only had one period since. Is it the coil or the menopause? It’s impossible to know, but I’m glad to be rid of my period again.
Getting some relief
I finally had a scan of my ovaries at the hospital and everything was normal. Since getting used to the coil and increasing my oestrogen dosage, my symptoms have definitely improved. I’m still pretty tired, but it’s the normal sort of tiredness that comes with being a full-time working parent with two young kids. Most importantly, I feel like myself again. I still discover new symptoms occasionally as my body changes (hot flushes at breakfast are a new development), but now I’m aware of perimenopause and how it can impact your body.
I’ve also found that exercise helps me manage my symptoms. I once came home after a workout, dripping in sweat, and said to my husband, ‘I had no energy before I exercised, but now that I have, I feel great! It’s like exercise makes you feel better!’
He just stared at me.
‘I know everyone already knows that, but wow! Endorphins! Science!’ I bounded upstairs to the shower, free from the perimenopausal exhaustion and brain fog I’d experienced a few months ago.
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