Being in a same sex marriage, I often get asked what is it like for both of us having to cope with me going through menopause prematurely? How does my wife, Sarah, cope with all the different menopausal symptoms I suffer from? Does it make it easier because she is female? And does she understand a little more than a male ever could?
I entered into surgical menopause aged 30, almost five years ago. To say the speed at which nearly every symptom took hold of me was brutal would be an understatement; to say we weren’t prepared for it, even more so.
Sarah was 37 when I entered into surgical menopause. Fresh into a new and exciting relationship, why would we – at 30 and 37 years of age - have ever given the menopause a second thought? After all, it’s just hot flushes and a natural process of getting older, isn’t it?! Naively, this tired old cliché is pretty much what we both believed at the time …
We have certainly learnt the hard way but have gone from knowing absolutely nothing about menopause to where we are now: helping, educating and spreading awareness to anyone willing – and even not so willing – to listen.
I didn’t crash into my menopause until around 6 months after my surgery. I had a gradual worsening of symptoms: hot flushes in the day followed by night sweats with both creeping in with more frequency.
I struggled to work. I changed my hours to work 9am – 3pm as I would crash every day around 3:30/4pm and have to sleep for a couple of hours.
Alongside the extreme fatigue, which would often leave me in bed for days and sometimes even for weeks, I have to say the emotional and psychological symptoms that hit me were truly devastating and overwhelming. Alongside the night sweats, I would wake up in the night with a bang and be shaking all over. I would feel nauseous and not understand what was happening to me let alone why it was happening. Obviously, I now know that these were panic attacks.
With my history of struggling with hormones, PMS/PMDD, endometriosis I had always been used to mood swings and extremes but had never experienced them over such a sustained period. The anxiety that came after my hysterectomy was debilitating, awful and prolonged. It was like an intense fear that came from out of nowhere to stop me from working, seeing my family or friends and just living my life. A crippling low depression that led me to push everyone away and have a paranoid view of things.
I lost weight. I had no energy. And my mental state was the worse it had ever been. I would cry every day not understanding why I felt so awful. I didn’t look well. At my worse, I didn’t even want to be here anymore. It was a miserable existence …
But at my lowest ebb, this is when I opened up my laptop and began to research. I looked at everything I could get my hands on – not that there was much out there at the time. I quickly began to realise the importance of hormone replacement and knew I needed to get on it quickly. I finally went on HRT about 7 months following my hysterectomy. That is simply shocking knowing what I know now. It’s little wonder I felt as bad as I did.
For Sarah, in those first 6-12 months watching me lose my spark, and become this shell of a person was extremely heart breaking. She sat with me many evenings in the bedroom watching Netflix and just comforting me over and over. She would tell me not to give in and that it wouldn’t be like this forever. She got me through the initial recovery. She cooked healthy meals, helped me wash, bought me comfy loose clothing when I was suffering with swelly belly and took any pressure off me.
But most of all, alongside starting HRT, she saved my life. I was so close to giving in. I felt truly awful and it’s not a place I’d ever want to return to. Surgical menopause without any HRT at 30 was absolutely the worse thing I’ve ever been through and I’ve been through a lot of shitty moments in my life. Her relentless support and superwoman energy, taking care of the kids and me, was something else. And not once did she make me feel guilty despite my feeling like a burden.
Anything I learned in that time and going forward, Sarah learned with me. It became like a research project and we left no stone unturned. I had to arm myself with as much knowledge as possible and it became apparent that for me to feel well I would have to work really hard on my own well-being and become my own advocate.
Until I was introduced to hormone implants and testosterone (over 2 years after my hysterectomy) I never really had the confidence - or felt able and well enough - to speak up for myself at appointments. This is where Sarah came in. As she took the time to learn as much as she could from me, to listen to me and to try to understand me, she was able to speak for me when I couldn’t at appointments and she would attend every appointment without fail. It is true to say that I felt she could just understand better and have more empathy simply because she was female.
I do believe being with a woman through this time helped me. But maybe it is just more to do with the person Sarah is … Though I would say it is easier to talk to a woman about these sorts of things. When sex started to become painful, I could easily say “can we use some lube?” and there was no awkwardness - it just made it more fun. We discussed my symptoms of vaginal dryness and explored my options. She encouraged me to go along to a chat given by Diane Danzebrink and Jane Lewis. She drove for an hour to get us there just to listen to Jane. That’s the kind of person Sarah is - she knew I was struggling a bit and did what she could to help me get clued up on what I needed to do.
This dedication to help me is so admirable. What’s more admirable is that Sarah now uses all she has learnt to help her staff at work. If anyone is going through menopause and struggling she’s so supportive and knows how to help, what to say, how to listen and how to support.
It makes me so proud when she comes home and tells me she has helped someone who is struggling with menopausal symptoms.
For the last year or so, Sarah has been experiencing peri-menopausal symptoms. I spotted the signs quite early on - most noticeably her PMS was worsening and my trying to tell her that was not easy! In fairness, I don’t think my grinning about it helped as I found some humour in her now being the one having some mood swings!
My friend and surgical menopause sister, Sophie, recently suggested that I write about Sarah and me navigating through the menopause together. I said of course I will but it mostly entails me behaving unreasonably and Sarah having to let more go than I do! To which Sarah looked at me and nodded in agreement. . .a little too strongly for my liking!
With regards to Sarah’s symptoms, I encouraged her to be proactive in addressing them. Her periods were getting really heavy, painful and quite erratic. She was developing PMS a few days before her period and had vaginal dryness/bladder issues which were slowly worsening.
But it was the emotional PMS/peri menopausal symptoms that were probably more obvious to me quite early on. Sarah is usually quite a calm, rational person with a very high threshold for stress (unlike me!). Yet, she was the one having a few outbursts and I was the one left thinking “where did that come from?!“
Sarah and I often have a bath together in the evening. It’s where we catch up and just talk. With 3 boys in the house, it’s our time where we know we won’t get interrupted!
It was during one of our baths together that I suggested she speak to her GP about the possibility of going on the Mirena coil and also adding in some oestrogen to help with her symptoms. I also advised her to use local oestrogen to help with her vaginal dryness issues since it can be used alongside systemic as the dose really is tiny.
Getting the GP to go ahead with the Mirena coil was fairly straight forward as Sarah was having heavy periods and a lot of pain with them. Sarah had a few routine gynae tests as is standard just to rule out other causes.
She was very apprehensive about having the Mirena Coil fitted and almost bailed. I encouraged her and said what she had often told me: “it won’t be as bad as you think.” Afterwards, she said it hurt but nowhere near as badly as she’d been picturing.
Over time the coil has really helped with heavy periods and the pain Sarah was getting. However, the PMS then became the main issue. It wasn’t all the time but did seem to be getting increasingly noticeable. I was adamant she needed some HRT in the form of oestrogen. Her threshold to cope with things wasn’t as good and she was getting snappier than usual.
Suddenly we had reversed roles and I went along with her to see her GP. The GP was not really educated in menopause and wanted to try oral HRT or maybe patches. Sarah wanted the oestrogen gel. I could see Sarah getting frustrated as she couldn’t get her point across so I stepped in. I spoke about body identical HRT (which the GP made a note to research). I then explained that Sarah has done her own research and that the gel allows for flexibility in adjusting the dose easily if necessary and would give Sarah more control. The GP then let on that she was a bit reluctant due to the cost implication of this type of HRT but did agree to do a prescription.
She wouldn’t prescribe any local oestrogen until Sarah had tried systemic oestrogen first as this can help with vaginal dryness issues.
Since being on HRT, Sarah's menopausal symptoms have eased and she seems more like her old self. The HRT has definitely helped and getting on it so quickly prevented her from suffering for a lengthy period of time. We both agree that if it hadn’t been for my experience, Sarah would not be where she is now: managing her peri-menopausal symptoms with a view to protecting her long-term bone, heart and brain health with oestrogen replacement.
Sarah is also using local oestrogen now as it helps manage her most troublesome symptoms.
I have to say it was not easy navigating these moments when I was having dips in my HRT. At times, when my oestrogen dips or I experience fluctuations, it presents in extremes in moods not dissimilar to my PMDD days. Occasionally, our moods would clash, but still Sarah would be the one trying to rise above how she felt to help me as she knew when I was ‘on one’ I can quickly lose the plot and in a big way!
This could lead to Sarah feeling forgotten sometimes. When she’s having symptoms at the same time as me, she quite rightly wants to be cared for and looked after and I feel as if I have let her down at those times when I have been struggling myself. But this is something we’ve navigated through together and we are always learning. Most importantly we talk to each other and we listen. I always listen to what Sarah says even if it hurts me and makes me feel like I’m letting her down. If it’s making her feel bad, it’s valid. So I write notes down as a way to remember to put myself in her shoes and remember in my busy hormonal brain that there is a person here who has done her best for me at all times, and now she needs my support, my patience, understanding and my knowledge.
It is because what we have been through together that we are able to have the fun, loving and resilient relationship we have despite the chaos of menopause. I think this is because we talk so openly and we have a great sense of humour. My humour can be a bit risky and I push the boundaries sometimes, but most importantly we can laugh at ourselves after the crazy moments and learn from our mistakes.
It may sound obvious but we have learnt that it is important to make time for just us so that we can just be a couple and have some fun.
Being in a same sex marriage and navigating menopause has many advantages in my opinion but on the flipside, it can be easy to get sucked into a reactive, emotionally driven atmosphere – open conversation and accountability is something that helps us both to keep our relationship on a more rational footing.