In the last part of the first session of Kitty’s Menopals Meetup menopause class, she talks about hormones, hydration, and a few little lifestyle tweaks that could make a big difference. (By the way, this chapter is based on the first session of my own Menopals Magic course, available here.)

‘Good. So, I thought I’d give you some more facts and figures about menopause next. There’s a lot of information out there these days about it, and some of it’s quite alarming, but it’s not all bad.’

She leaned forward. ‘People talk a lot about the physical symptoms, but the psychological effects of menopause can be severe and life-changing. As I said, this is the time of life when women are most likely to file for divorce, and the rate of suicidal ideation leaps by seven times.

‘Some women have it really rough in menopause, and many have no idea it’s their hormones that are causing it. The woman I did my menopause coach training with, Lauren Chiren, founded her company* to train menopause coaches after her own terrible experiences with early-onset menopause. Until her doctor told her that’s what it was, she honestly thought she had early dementia. She was 37 and a single mother to a small boy with health challenges. She gave up her high-flying corporate job before she found out it was menopause, because she felt she couldn’t hack it any more. She’s now on a mission to train 20,000 menopause coaches before she dies or retires, whichever comes first.’

‘Wow, that’s a lot! Good luck to her!’ This heartfelt comment came from Carol.

Kitty smiled. ‘Indeed! As I said, many women have it really bad, but what’s sadder is that many suffer in silence. When I asked my mother about her menopause, she gave me a one-word answer – terrible! And many have no idea it’s The Change that’s causing their problems.

‘And yet it happens to all women! How do we not know about this? There are 13 million women in peri- and menopause in the UK. How many of them understand what’s happening to them, and have strategies to cope? We don’t know, but I’m betting it’s way fewer than half those 13 million.

She glanced at her screen. ‘The stats are awful, and there are women suffering behind every percentage point. In a recent report by the Benenden Group*, nearly half of menopausal women have made or are considering making changes to their work life because of their symptoms. 92% of HR departments think they support menopause pretty well, yet most don’t provide any “reasonable adjustments”. GPs don’t always provide the necessary support either. Most have little to no understanding of menopause, and women often feel dismissed, unheard, and unsupported, and they’re more likely to be offered anti-depressants than HRT.

‘41% of women in menopause felt unheard, invisible, lonely and supported.’

‘That’s terrible!’ Kelley’s rich tenor had risen a notch in indignation. ‘I mean, the support for trans people is even worse, but there are far fewer of us, so you’d expect that. But you’d think a doctor would know how to help with something every woman goes through!’

‘You would. And it’s been said many times that if menopause was a male condition, there’d be far more research and support for it.’

The class sniggered. 

‘Too right!’ boomed Gretchen.

‘It’s changing now, of course, but it’s a slow process. Most women still know little to nothing about menopause, and of course, their partners, children, colleagues, employers know even less.

‘What’s happening in physical terms is that our production of sex hormones from the ovaries is slowly reducing to almost nothing. Those hormones serve us in many ways that aren’t always connected with reproduction, so the changes cut across all areas of the body.

‘The loss of progesterone can leave us vulnerable to issues like anxiety, depression, insomnia, headaches and migraines, and weight gain. It’s also what leaves you feeling puffy and bloated and makes you retain more water.

‘Your fat cells have a store of oestrogen, so your body will go looking there for more when levels decline. That’s why you often make more fat at this time – to store more oestrogen. Oestrogen loss can lead to issues like hot flushes and night sweats, vaginal dryness and loss of libido, mood swings, fatigue, weight gain, joint pain, brain fog – and dryness in our skin, hair and nails.

‘Many women experience huge relief from taking HRT, once the dosages are right for them, and that can take some experimenting to get right. It may not even be a dosage issue, you’re not getting the relief you need, but the way it’s delivered. So if you’re having HRT and  not seeing results, go back to your doctor and ask them to make changes until you’re getting the reduction in symptoms you want.

‘If you ever have or are having HRT, make sure it’s the bio-identical version, not the synthetic. There was a big scare in the 70s after a research paper suggested HRT could increase the risk of cancer, particularly breast cancer, but the study was flawed and a retraction was published a year later. Unfortunately, most people weren’t aware of that, and still aren’t. The risk is still there with bio-identical, but much less so than with the synthetic version.’

‘OK, that makes sense,’ Laura nodded. ‘My mother had breast cancer that they said was from HRT, but it was a lot of years ago. She most probably had the synthetic version. They wouldn’t let her have HRT after that, though.’

‘No, it’s one of the contra-indications for HRT, unfortunately. It’s probably not that much of an issue if you have the bio-identical version, but they do like to err on the side of caution, understandably.’ ‘Oh yes.’

‘Other symptoms of hormone decline can include loss of bone density, causing conditions such as osteoporosis; heart issues; and muscle loss, known as sarcopenia. However, it’s my belief, from research I’ve seen talked about by people I trust, that these symptoms can be mitigated or even reversed with a change of eating habits and increased exercise. But we’ll come to those things later in the course.’

‘The other sex hormone we have, which many doctors don’t even know about, is testosterone. For women who have too much of it, the syndrome is called PCOS – polycystic ovary syndrome – which gives women a more masculine look and tends to make them more muscular and hairy. It can also cause infertility or at least difficulty getting pregnant.

‘Testosterone is vital for many functions in our body, including muscle-building and calorie burning, although women only typically need around one tenth of what men need.’

‘I’m actually taking testosterone blockers,’ Kelly murmured, ‘because of that.’

‘Thank you, Kelley. I didn’t know that was a thing. The issue can be that lower testosterone can cause muscle loss, slow your metabolism, and make you gain weight.’

‘Hey, that means I can blame my “man hormones” for my spare tyre!’ joked Gwen.

Kitty grinned. ‘You certainly can – although of course, that’s only part of the picture.’

She continued. ‘Testosterone is available as part of HRT, but many doctors don’t know that. It’s also important for hair and skin, and to ease joint pain. If we don’t have enough, we can feel fatigued, mentally foggy, and older than we really are. So optimising your hormones can make a huge difference to menopausal symptoms.’

Carol’s hand went up.

‘Yes, Carol?’

‘I went to my doctor and said I thought I needed HRT, and he fobbed me off with anti-depressants, like you said. I think I need to have another conversation with him.’

‘I’d say so, yes. Do your research, go armed with information, and educate him. You’ll be doing all his female patients a favour!’

Carol’s eyes sparkled. ‘I’ll do that. Thank you.’

‘There are other ways to ease symptoms, other than HRT, and again, we’ll cover these in a later session. For now, I want to end with a tip that could help you feel heaps better with one simple change.’

‘Great! Thanks, Teach!’

‘We’re constantly being told to drink more water, and there is something in that for most of us. I was shocked to discover that even being 1-2% dehydrated can cause fatigue, brain fog, and stiffness in the joints.’ The class all looked shocked too. 

‘I know, right? Who knew? And they’re all menopausal symptoms, too. Well, presumably the people who’ve been telling us this forever. Knew, but what I find odd is that they rarely tell you why you should do as they say. I find knowing a reason makes me more likely to do it, so why don’t they tell you that? ‘

‘Because they don’t actually want you to do it?’ Gretchen suggested.

‘You gotta wonder, don’t you? So does anyone here think they drink enough water?’

Gretchen’s hand went up. No-one else ventured to join her.

‘I definitely don’t,’ Gwen said, with feeling. ‘If I’m not in the classroom, I’m on playground duty or writing lesson plans, or dealing with little Jonny’s irate mother who wants to know what I’m going to do about the fact that little Jessie bit him.’

‘Could you have a bottle of water on your desk?’

Gwen blinked. ‘Never thought of that. I suppose I could.’ She looked uncomfortable. ‘I actually confiscated a water bottle last week. Mind, that was because the little darling was using it to spray his next-door neighbour. I feel a little bit guilty about that now.’

Kitty grinned. ‘There are limits! Perhaps best give it back, though, and think of a different punishment if he does it again.’

‘I always have a bottle with me when I’m teaching,’ Gretchen said. ‘It gets very hot and sweaty on construction sites in warm weather, so I always encourage my students to keep hydrated. And I’m not one of those “do what I say, not what I do” people.’

‘Good for you! So, for those who don’t drink enough – it doesn’t have to be plain water, by the way – how do you think you could drink a little more throughout the day?’

After a short silence, Dolly said, ‘I don’t think I’d remember, that’s the trouble.’

Laura swivelled to look at her. ‘How about you set a reminder on your phone?’

‘That’s definitely an option,’ Kitty agreed.

‘Um, I don’t know how to do that,’ Dolly admitted.

‘Oh, I can show you,’ Gwen volunteered.

‘Thank you.’

Kelly was smiling. ‘If coffee’s allowed, I probably do drink enough.’

‘Coffee’s OK, but caffeine can be dehydrating. You might consider drinking decaf or having something else as well during the day.’

‘Ah, OK.’

Laura was nodding thoughtfully. ‘A friend of mine has replaced her first drink of the day with warm water and lemon. It’s made quite a difference, she said.’

‘Ugh, sounds revolting!’ Kelly made a face.

Laura chuckled. ‘It does, doesn’t it? I tried it, and it was OK, but the habit didn’t stick. So I tried having fizzy cold water with lemon, and that makes it nicer, but it’s probably a bit tangy for some people.’

‘Ooh, I like lemonade! I could try that.’ Kelly wrote it down.

‘If it’s not sweet enough,’ Kitty said, ‘try adding some glycine.’

 What’s glycine?’ Laura asked.

‘It’s an amino acid – one of the building blocks of protein. I watched a video recently that suggested most people are short of glycine, and also said it’s vital for reducing inflammation and joint pain, and has a lot of other uses in the body. It’s sweet – slightly sweeter than sugar – and you can get it in granulated form so you can use it exactly as you’d use sugar.’

‘That sounds like the easiest change I could possibly make! I’ll get some ordered tonight – you can get it from Amazon?’ Kelly enquired.

‘Yes – I have it on Subscribe and Save.’

‘Fab. How do you spell it?’

‘G-l-y-c-i-n-e.’ Kelley wasn’t the only person writing it down, Kitty noticed.

She glanced at the clock. ‘Well, thank you, ladies, that’s it for this week. Your homework is to do the thing you’ve diarised, and if your positive statement isn’t 100% inspiring, have another look at it and see if you can make it better.

‘Thank you all for coming, and I’ll see you next week.’

* Womenofacertainstage.com 

* https://www.benenden.co.uk/newsroom/missing-in-the-workplace/