Memory problems, which lead to other problems — at the very least you land in hot water with the kids and your partner for tidying things away and then forgetting where you put them.
And don’t even mention the shock of looking in the mirror and discovering that, despite your fond belief that this was something that only happened to wicked witches, hairs really have start to sprout on your chinny-chin-chin.
That’s only a taste of what millions of women endure in the perimenopause, that awful, years-long, endless-seeming lead-up to the menopause. But unlike many of the other major changes in life — infancy, childhood, adolescence, parenthood — hardly anybody talks about the perimenopause and the menopause and what they mean for women. It’s been a taboo subject for generations. And because, until very recently, nobody talked openly about it — other than to refer fleetingly and in hushed whispers, to this phase in a woman’s life as The Change — a lot of women are ignorant of the consequences and aren’t ready for it when it arrives.
But thank God, the taboo on menopause is finally being broken.
Ten years ago could you have imagined a Menopause Café taking place in Dublin? It happened yesterday. For the first time in Ireland a Menopause Café was held for women to come together and learn about the whole thing and what it means.
Finally! We’re getting over ourselves and pulling aside the veil. Because what all this silence meant was that for generations, women weren’t just forced to navigate a massively stressful period in their lives alone; they were also left in complete ignorance about natural changes in their bodies which put them at a higher risk of developing a range of serious health problems.
Put simply, perimenopause is a time of intense hormonal upheaval, which usually, but not always, begins in the mid-forties (it can start earlier or later) and can last for between four and 12 years. It’s a phase which is not at all well understood by many women or even their doctors; yet it’s rockier and often more difficult terrain than menopause, something which is made even worse by the lack of discussion, warnings, and solid information about it.
Basically, during perimenopause, your ovaries start to sputter. This means they no longer manufacture the same, predictable, consistent levels of the sex hormones, oestrogen and progesterone, that they did previously which leads to all sorts of physical and emotional upheavals (see above).
To make matters worse, your brain is less responsive to the hormones your ovaries still do produce. Science has only recently discovered that the brain runs low on oestrogen before the rest of the body in women over 40 which leads to low brain energy since oestrogen is involved in how your brain uses fuel.
Given the traditional taboo about it, perimenopause and its symptoms were often ignored, dismissed or neglected.
After all, this is also a period when many women are too busy dealing with their career, the housework, managing angst-ridden teenagers and, in some cases, helping to support ageing parents to be navel-gazing about why they feel more cranky and anxious than usual.
It’s yes to feeling depressed, yes to waking up in the middle of the night covered in sweat and yes to worrying intensely about the most trivial things imaginable. Yes to snappy, stressed, moody, forgetful and being prone to tears over next nothing. But these women have jobs to get to, dinners to cook, kids facing State examinations to look after, the house to get straight, the shopping to get done and God knows what else. They’ve got no time to think about what’s happening inside themselves. Instead they grab a glass of wine and turn to Netflix.
Of course when perimenopause kicks in and the crazy intensifies (and given that we’re completely ignorant about the root cause of our misery anyway) it’s all too tempting to put it down to a bad day, week, month — and reach for the wine or the beer, which of course is only going to make things worse. But then, how can you know any of that if you don’t even know you’re in perimenopause?
Renowned US expert Dr Sara Gottfried strongly advises either reducing alcohol intake or giving it up altogether around this time. As we get older, she says, alcohol negatively impacts most things from sleep to weight around the waist.
“Compared with menopause, when a woman’s sex hormones (oestrogen and progesterone) are low but stable, hormones in perimenopause fluctuate greatly from month to month,” Dr Gottfried told me when I interviewed her.
“Our hormones affect everything from our mood, to our energy levels to our metabolism, so you can imagine how wildly fluctuating hormones can make a woman feel like she is going crazy as she struggles to understand her sudden mood swings, flashes of rage, exhaustion and weight gain that seemed to appear overnight.”
And that’s not nearly the end of it, girls. That’s only the mad day-to-day stuff. There are some long-term health problems as well. Once your oestrogen levels decline, for intance, your risk of cardiovascular disease — which, by the way, is the leading cause of death in women as well as in men — increases. Yet, if you don’t know about the risk why would you be concerned about getting regular exercise, having a healthy diet and maintaining a normal weight through your forties into your fifties and beyond — not to mention getting regular cholesterol and blood pressure checks at this chaotic, busy and otherwise deeply stressful time of life?
Then there’s osteoporosis; nasty, sneaky, silent and very dangerous, a condition which causes bones to become brittle and weak and leads to an increased risk of fractures. During the first few years after menopause, you can lose bone density at a rapid rate, increasing your risk of osteoporosis.
Postmenopausal women with osteoporosis are especially susceptible to fractures of their spine, hips and wrists. You’ll need to see your doctor and get a DXA scan — but, sure, why would you do that if you never heard about the risks?
And then there’s the often-inevitable weight gain. So depressing. All of it. But finally, women can look around and see they’re not alone. That everyone else goes through the perimenopause and the menopause too, (though not everyone has the worst symptoms.)
And now this very difficult phase in a woman’s life is no longer a taboo subject to be whispered about. Three cheers for the Menopause Café and World Menopause Day.