Experiences in West Essex of the Menopause and Perimenopause

Healthwatch Essex were asked by Hertfordshire and West Essex ICB to  undertake a series of projects focussing on the lived experiences of people in the area in relation to their health, care and wellbeing. Two projects are selected per calendar quarter for in depth engagement, with the production of a report based on this engagement.  In this project they undertook a survey and gathered case studies of women about their experiences of the menopause and perimenopause.  56 women answered the survey and they interviewed 7 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. Some felt there was a hesitancy in broaching the subject of women's health, and that their concerns were not always taken seriously. 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. This length of time to diagnose impacted the period of time during which women were suffering without appropriate support or medication, as well as extending the time for any necessary referrals. Many women were told that they were ‘too young’ to be experiencing the start of the menopause, comments like this make women feel that they are not being listened too. For a condition which affects the majority of the female population at some point in their lives, this is not adequate.

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 told us 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. It is concerning how many participants worried for long periods of time that they had a form of dementia due to the brain fog and memory issues, and also how many felt that the prescribing of antidepressants was the immediate solution offered by their GPs when they presented with mood swings, anxiety, tearfulness etc. 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. To be suddenly confronted with the menopause process with little or no prior education is frightening and unnecessary. There was also the feeling expressed that, to a large extent, males were not included in the knowledge and conversations that were taking place. With most men likely to have a menopausal partner, relative, friend or colleague at some point in their lives, it seems inadequate that there is no provision to inform and enable them to support and understand the process. A number of women did talk about how supportive their husbands/partners had been and some of them had conducted their own research to try and support their wives/partners.

Some of the greatest impact on women during and after the menopause was in their own levels of confidence and self-esteem. The menopause has a significant effect on not only physical health, but also mental and emotional wellbeing. It is period of great change which, understandably, women could benefit from more understanding and support with. Feelings of being alone, less attractive, less effective, less sexual, etc 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 nine recommendations about improving menopause care for women.