As women navigating through midlife in all its glorious gifts and challenges, describing our experiences can be both empowering and relatable. Here I share my own journey in managing and advocating for my health during perimenopause, and some of the difficulties and limiting attitudes (my own and those of health professionals) I faced whilst seeking support.
As I approached my late forties, I noticed subtle changes in my body and mood. At first, I brushed them off as just another part of getting older and perhaps a response to the isolation we collectively felt, coinciding with the height of COVID in Singapore. But soon, the symptoms became impossible to ignore. I was experiencing physical symptoms such as hot flushes throughout the day and restless nights that left me drenched in sweat, aching joints, dry skin, ringing ears and a noticeable change in body odour. Mood swings that ranged from irrational bursts of anger to crippling anxiety overwhelmed me. Most unsettling of all was the sense that I simply wasn’t myself anymore. Everyday challenges that I’d once handled with ease suddenly felt insurmountable.
At first, I felt uncertain and overwhelmed. I hesitated to share my struggles, even with close friends and family, worried that I might be judged or dismissed. My mother’s generation had gone through menopause and appeared to have managed without support. I realised I’d never really asked my mother about her experience, and she rarely mentioned it, apart from being bemused by the inconvenience of a hot flush while out and about. I realised how little I truly understood about this stage of life.
After months of struggling in silence, I reached a turning point. I realised I needed support to feel like myself again. Encouraged by discussions with my older sister in Australia, and my dear friend and walking buddy, who had both started using Hormone Replacement Therapy (HRT) to manage their symptoms, I decided to seek help. The first step was daunting – where to start, and who to trust? I began by researching my symptoms online, but the sheer volume of information was overwhelming, and not all of it was reliable.
My first attempt to manage my symptoms led me to try a herbal supplement that was heavily advertised online to women like me, claiming to “balance mood and enhance energy” during menopause. Influenced by online recommendations and a friend’s positive experience, I ordered the supplement and gave it a go. Unfortunately, it didn’t make much of a difference for me, other than feeling slightly less bloated.
Back to the drawing board, I happened upon a couple of health and wellbeing podcasts and found two advocates in the women’s health space – Dr Louise Newson, a GP from the UK, and Dr Susan Davis, an endocrinologist from Australia (I’ve since added OBGYN Dr Marie Claire Haver from the US to form my menopause-management expert trio).
These experts in the field of menopause research and treatment were able to demystify HRT – describing its history, simplifying the research, and putting potential risks into context. It was through them that I discovered the benefits of HRT beyond relief of menopause symptoms such as night sweats and mood swings. I had not even considered the protective effect of estrogen (when started in perimenopause) for women’s heart and bone health, and even brain function.
Eventually, I made an appointment with my GP, hoping for guidance and understanding. My first consultation didn’t go as I’d hoped. My (elderly male) GP seemed to downplay my symptoms, remarking, “We only give hormone therapy to women who are severely depressed.” I left feeling unheard and discouraged. But I didn’t give up.
I sought a second opinion, this time with a female GP. She listened carefully (generously extending her standard 15-minute consultation to one hour), validated my experience, and together we discussed treatment options. She prescribed HRT in the form of estrogen gel (I would not require progesterone as I underwent a hysterectomy at age 39). Within weeks of nightly application, the night sweats and hot flushes eased. For the first time in months, I felt my mood improve and felt hopeful again.
I have continued taking HRT since then and looking back, I’m grateful I found the courage to seek help and advocate for myself. Menopause is a natural phase of life, but that doesn’t mean we have to endure it alone or in silence, as our mothers did. By sharing my story, I hope to encourage other women to reach out, ask questions, and seek the support they deserve – and to work with a doctor who is willing to listen and help. There is hope, and with the right support, it’s possible to feel like yourself again.
