We’re talking about menopause more and more, thanks to celebrities such as Davina McCall, who have used their own transition to help empower us with education and support. 

Usually something that occurs gradually over several years (typically in our 40s), we can spend up to 12 years in perimenopause – the stage when our hormone levels start to change and we experience symptoms including hot flushes, insomnia and anxiety.

However, rather than going through the lengthy process of gradual oestrogen decline, I was just 31 when my body was forced into menopause, following a hysterectomy.

My experience of living with endometriosis began at 14, when I collapsed watching TV and was rushed to hospital in intense pain. It would be a further nine years before endometriosis was diagnosed during an investigative operation; the average time it takes between first visiting a doctor and receiving a diagnosis is currently over seven years according to Endometriosis UK.

From my teens onwards, I regularly missed social events and was managed out of most jobs due to mounting sick days. The excruciating pain made me feel extremely isolated from my peers, and its uncontrollable sharp, stabbing waves left me completely exhausted. 

By the time I was diagnosed, A&E trips for morphine were a regular occurrence, and endometriosis had steadily permeated most parts of my life, from my relationships to my finances. At 24, I started on a hormonal treatment to temporarily stop my ovaries from working, with the aim of easing the awful symptoms. 

Within hours, the hot flushes caused by this false menopause began, and my bones ached. Unable to explain it, I’d try to hide stripping off layers of clothing mid-hot flush from my work colleagues and sought relief by putting my face near an open freezer. But as rough as these side effects were, I did receive respite from the extremely heavy bleeding that at times meant I was unable to even leave the house. 

At 25 and 27, after being warned my fertility may be limited to my 20s, I had my daughter and son. The pregnancies and births were fraught with frightening complications and I was very poorly with bleeding and infections after having both babies. I spent numerous nights of their infancy being rushed to hospital in agony, as the endo pain and bleeding intensified. I’d developed adenomyosis by this stage too, a related condition that involves the growth of cells in the uterine wall. It felt like I was carrying a lead boulder in my pelvis. By 29, I’d had so many hormonal treatments and surgeries for endometriosis that doctors recommended a hysterectomy. It’s important to say there is no cure for endometriosis, but a hysterectomy can stop its heavy bleeding and get rid of adenomyosis.

I was plunged into anticipatory grief at the prospect, as this was (and still is) the last thing I wanted. But by 31, I was living on a combination of daily painkillers, including morphine, and found myself unable to walk far due to the agony. Some days I was bedbound, and the hormonal treatment that caused the temporary menopause had stopped working. So I was left with no other option than to hope this would bring a better quality of life for me and my family.

As the surgeon removed my ovaries to try to halt the endo growing, I was plunged straight into menopause. Although already well versed in some symptoms and having taken one type of hormone replacement therapy (HRT) during my endo treatment, nothing could’ve prepared me for surgical menopause. I had no idea which way to turn in terms of the right HRT, and I was warned by doctors that we’d have to be cautious about oestrogen replacement levels so as not to kickstart the endometriosis symptoms again.

At first, I wasn’t taking enough oestrogen and progesterone to replace what I’d lost, and the night sweats, hot flushes, anxiety, insomnia and exhaustion were unbearable. I bought a cooling mattress protector and swore by frozen gel eye masks and keeping a face mist in the fridge. Looking back, I just didn’t have enough support or knowledge to get the best HRT match, and I was terrified the endo would return. 

After a five-year journey of trying every hormonal pill, patch and gel available and, most importantly, finding a supportive GP, I perfected the balance and my symptoms diminished. Because I was in my 30s, I need to protect my bone, heart and brain health by having enough oestrogen, and the lack of progesterone was causing insomnia and anxiety. As I’ve found, getting the right level of HRT is not a one-size-fits-all process, so speaking to a doctor who is a hormone specialist is key.

Emma Bardwell, a specialist menopause nutritionist and author of The Perimenopause Solution, tells Stylist: “It’s important that you have a discussion about HRT and whether it’s recommended for your individual circumstances or not. Sometimes it’s helpful to get a second or even third opinion where possible.” Bardwell also emphasises the importance of looking for evidence-based healthcare practitioners: “If your team aren’t forthcoming, ask to be referred to a specialist menopause clinic.”

I sought talking therapy to come to terms with the loss I so keenly felt, and the women’s health psychologist who guided me through offered invaluable support in terms of the trauma wrapped up in this premature change. Bardwell says: “The symptoms of surgical menopause are the same as those that occur at the average age, but the psychological impact can be immense.”

Equally, having a tight-knit group of female friends who’ve held me through the darkest moments is a daily help throughout the mental and physical pain endured. Some days still feel hard because I’m at odds with my peers, and current HRT shortages have been scary, reducing me to tears in the pharmacy while I desperately explain that I need that prescription to function as a 38-year-old. 

1. Prioritise self-care

“Self-care should be given equal importance to medication, diet and exercise,” says Bardwell. This can include talking therapy, counselling and journaling, while “putting in boundaries and saying no to things you don’t want to do is vital, as is curating your social media feeds to make sure you’re surrounded by messages and images you want to see.”

Bardwell adds: “CBT can be very helpful, not just for helping women to change the way they feel psychologically but also for symptoms like hot flushes and insomnia. Movement, breath work, crying, laughter, wild water swimming, getting creative, cuddling pets, yoga, volunteering, guided meditation and meeting up with a good friend are all worth trying too.”

2. Share what you’re going through with friends and family

“Sharing resources with friends and family can help them to understand what you’re going through,” Bardwell recommends, highlighting the importance of not feeling you’re carrying this alone. 

3. Look for additional support

“A support network is crucial for all women going through the menopause transition, but it can be especially important for women who’ve experienced surgical menopause,” shares Bardwell. “The Daisy Network, IAPMD, NAPS, Together in Surgical Menopause, A Survivor’s Guide to Surgical Menopause, Endometriosis UK, Menopause Cafe and Women’s Health Concern (the patient arm of The British Menopause Society) are all good resources.”

4. Focus on movement

“We need to address the long-term health risks associated with early/surgical menopause, so I’d advise really concentrating on heart, bones and brain health,” says Bardwell. Movement such as resistance training is vital for bone health, while yoga supports relaxation.

5. Nourish yourself with menopause-friendly foods

“Soy-based foods such as tofu, tempeh and edamame beans can be helpful for menopause symptoms,” Bardwell says, “and it is a good source of complete protein which is important for bones.” In addition, Bardwell adds: “Protein is a powerhouse at this time and many aren’t getting enough. It’s needed for everything including strong bones. Think lean meat, fish, dairy, tofu, beans, lentils, tempeh and seitan.”

Meanwhile look for omega-3 fatty acids for brain, skin and heart health, Bardwell says, recommending “a couple of portions of oily fish (mackerel, salmon, herring, pilchards, anchovies, sardines) a week or, if you’re vegan or veggie, look to an algae oil. 

“Bolstering your gut health with fermented foods and lots of plant fibre and having an anti-inflammatory Mediterranean-style diet that’s plant-focused (though doesn’t need to be completely vegan) are all useful general tips,” finishes Bardwell.

Images: Getty