Experiences in North East Essex of the menopause and perimenopause

Healthwatch Essex wanted to understand the experiences of women in North East Essex about the menopause and perimenopause to understand how services could be improved.  They undertook a survey and interviews.  Altogether they spoke to 80 women.

The women who participated in this project provided candid accounts of their experiences of the menopause and perimenopause, with most acknowledging that every experience is unique and individual. For some, the menopause was almost a welcome change after years of struggling with difficult periods, endometriosis and other conditions. However, many found the process challenging in various ways, and felt a significant impact on different areas of their lives.

Many women cited an unsatisfactory response from primary care providers, especially GPs who are frequently the first line of support consulted for any health issues. There were many instances of women not feeling listened to by their GP or receiving a supportive response to the symptoms they were experiencing. A significant number of women felt that, when the subject of menopause was raised, their GP did not appear to have sufficient knowledge about it, and that other diagnoses were offered, often inaccurately, before the menopause was addressed.  As a result, they spent long periods without appropriate support or medication.

There were a high proportion of participants who discussed how deeply the menopause had affected their working life, ranging from the impact of symptoms such as fatigue and brain fog presenting them as being less effective in their roles, to employers not demonstrating the understanding and flexibility to work with women going through a natural process beyond their control. Indeed, many participants explained how the menopause brought about a change in their career path because they did not feel supported or understood by their existing employers, whilst others were put through disciplinary action or sacked because they were unable to perform to the accepted norm.

The wide range of symptoms associated with the menopause and perimenopause is confusing and concerning for women, but this is further exacerbated when healthcare professionals appear uncertain or unconfident about diagnosis. Many participants worried that they had a form of dementia due to the brain fog and memory issues.  GPs often offered antidepressants when women presented with mood swings, anxiety or tearfulness. Many accepted this because it was advised by the GP, but in hindsight felt that it was not appropriate and were then either stuck on the medication or had to be weaned off of it.

It was clear from our engagement that there still exists in society the idea that menopause and perimenopause are ‘women’s problems’ which often do not get openly discussed. This of course hinders the passing of knowledge and experience through general conversation. Respondents felt strongly that menopause should be taught in school at least to the same level as puberty and reproduction, as it will be experienced by the majority of females during their life. They felt that men should also be included in the conversation as they will need to be able to support their partners.

The menopause has a significant effect on not only physical health, but also mental and emotional wellbeing, confidence and self esteem. Feelings of being alone, less attractive, less effective, contribute to loneliness, depression and ‘being invisible as a woman over forty’, but with decades left of life, there should be more resources put into encouraging post-menopausal women to embrace and promote what they have to offer.

The report contains recommendations on training for GPs, adequate support at work, access to support and information.