Menopause Diaries – Living with Oesteophenia (weak bones)

 
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Menopause and me…

When Wendy asked me to write about my personal experience of the menopause –rather than shy away, I realised I wanted to do it. To share (but not overshare!), spread the word and to open up the conversation. 

By Mandy Oxley Swan

Lets set the scene. I’ll be 51 in a few weeks time. From my mid-twenties I experienced painful periods and occasional faints. After years of being fobbed off with tablets, I was finally diagnosed with endometriosis and a cyst. The endometriosis is a whole other story (or blog). I met my husband in 2002 and we married in 2003 – no point messing around! We started trying for a baby in 2004. I didn’t expect it to be easy but I wasn’t quite prepared for the length of our journey and the many twists: 3 IUI, and 7 IVF.

Our long awaited daughter arrived in July 2011. My periods had always been as regular as clockwork but I noticed they were every 3 months or so. My last period was October 2013, five years ago when I was 45. My mother had her menopause in her early 40’s and given my history, I wasn’t too surprised. I decided to get pro-active. The best thing about getting older is that you don’t accept any s***. I didn’t want to get fobbed off again and I wanted to feel in control of this thing happening to me. I demanded a blood test to check my hormone levels which confirmed I was in the menopause. Officially it’s defined by not having a period for one year. My blood tests revealed that my AMH (Anti-Mullerian Hormone) and oestrogen levels were negligible.

Doctors at that time recommended HRT but I wanted to do more research so I read a lot of articles and books on hormones and menopause and requested a bone scan/DEXA scan. This showed I had Oesteopenia – a precursor to Osteoporosis and I was recommended calcium and vitamin D, which I had always taken. I’ve never smoked, I walk everywhere (never drive) and am not overweight. So all those risk factors were not applicable to me. The Osteopenia was purely a result of very low oestrogen levels. My gut feeling was telling me not to go on HRT. This was because predominantly Endometriosis can be oestrogen receptive and the added oestrogen in HRT could fire up my endometriosis symptoms so I was in a bit of a quandary. I also have friends who’ve had breast cancer which was a worry.

Strangely I didn’t have too many symptoms from the menopause – I only ever had one or two hot sweats and I don’t think I suffered too badly from moodiness etc, although my husband may beg to differ. The menopause is mostly categorised by hot sweats, insomnia and increased anxiety. Everyone’s experience is different and my menopause story is about weak bones. That’s why its good to talk about it.

A couple of years went by and in January 2017 I asked for another scan and unfortunately my bone health had deteriorated slightly so my quest to find the best treatment had begun. I started with a private hormone specialist in March. He never really looked at me, didn’t ask many questions and seemed to have a one size fits all solution of topical oestrogen with a bit of testosterone and all for the princely sum of £750. He also explained my hip measurement was of a 70 year old! My calcium infusions were not good and that HRT in some form or another was the only solution. I was also told I’d be contacted within the year to see how I’m getting on – to date no contact.

My GP is a woman and was excellent, she listened to me and gave good advice. I asked to be referred to a bone specialist, a rheumatologist. Unfortunately he couldn’t personally advise me but he was informative and gave me a FRAX assessment – inputting age, etc and found I had a 5% chance of a major fracture. Oh joy! So now it was a choice of taking HRT for the osteopenia or something called Bisphosphonates –  drugs that can help prevent or slow down Osteoporosis. You can take them as pills, orally or they can be given as an intravenous injection once a year. At this time however, I was suffering from stomach irritation and mild gastritis so Bisphosphonates was not a viable option for me. 

The lure of HRT was calling. I had an ultrasound scan first to ensure there was no evidence of endometriosis before I started HRT. Perversely with endometriosis it can be very difficult to get pregnant but once you’ve had a baby it can sometimes clear up the symptoms and luckily for me I was all clear. I started taking Elleste Duet Conti – a combined pill with oestrogen and a little progesterone to protect the womb lining in July 2017. I wanted to take a continuous pill, as in my mind one benefit of the menopause was not dealing with periods every month. You’ve got to find the silver lining in that cloud! 

The menopause is a moving target. It’s constantly changing and at the back of my mind still was the tenuous link with breast cancer and HRT. I investigated having a mammogram and spoke to a private clinic but was advised I should be on HRT for at least a year to obtain a clearer reading/scan. In May’18 I asked for another bone scan and it showed a slight improvement in bone density and both the radiographer and my GP recommended staying on the HRT for another 6-12months to reap more benefits.

One of the symptoms of the menopause I really wasn’t expecting was a recent intolerance to alcohol – mostly white wine. This was a peculiar development as in my twenties I was often the last one on the dance floor asking the DJ for one last tune. How things have changed. I know now that the liver is busy metabolising hormones so that added alcohol can be too much. Another strange thing is getting headaches/migraines and a feeling of queasiness. It’s hard to know if they’re linked to the menopause/HRT but I didn’t have them before?!

Ironically whilst writing this blog I chased my mammogram as I’m very nearly 51. I was depending on the local authorities and I should have been contacted by the NHS. Things took another unexpected turn - the doctor found some ‘irregularities' and referred me immediately to my local hospital which could take up to two weeks. She also advised to stop taking the HRT until I got the results. I panicked and went to a private clinic that a friend had recommended and I had an agonising 4 days wait for the results. Luckily they came back clear. I will go back to taking HRT but needed a few weeks to digest it all. I’ve read the research that there is a very small link between breast cancer and taking HRT and that the link is higher if overweight, drinking and smoking. Also that osteoporosis and heart attacks are more risky if not on HRT. As I’ve said before the menopause really is a rollercoaster ride!

Tips

  • For me what worked was the feeling of taking control of the situation. Being aware of triggers which aren’t rocket science – reducing stress and reducing caffeine to help with any anxiety. 

  • I eat well and I’ve been a Pescatarian for 30 years. 

  • I take supplements – I’ve been taking Udo’s Oil – for about 20 years now. It contains Omegas, linseed and flax seed oils and is excellent against the war against dryness (in all areas!). 

  • I also take a good quality Multi Vitamin & Mineral (with plenty of calcium) – I like Biocare or Solar

  • Most importantly for my bone density I take Better You a high strength vitamin D spray. Spraying this directly on your tongue for quicker absorption. 

  • Lastly I use Better You magnesium oil spray which I apply topically for tight neck & shoulders muscles to help with the headaches/migraines. 

  • Strangely I only ever got one or two hot sweats. But what did help was spraying Balance Me’s hyaluronic plumping Mist over my face to calm down heat and redness. Also to protect against additional pigmentation due to hormonal fluctuations I used their BB natural perfection SPF25 to help conceal redness and protect against UV.

    I’ve also got an army of helpers. I’ve come to realise now that these are not a luxury but a necessity as I’m ageing and my body needs these regular MOT’s. 

  • Regular massages – Coco de Bunsen.

  • Oesteopathy – Richard Emerson at Pure Dynamic Oesteopathy in Crouch End.

  • Belle –  One Yoga

  • Friday morning running class. I love this as its a group of women-running and chatting.

  • For further bone strengthening I follow Jump & Juice-an Online Health Club – using their workouts and general lifestyle tips.

  • Accupuncture – Marion Fixler. I’ve seen her for 10 years. She worked wonders whilst trying to conceive and whilst suffering from hideous morning sickness and the migraines. 

  • I also really like Dr Louise Newson – Menopause doctor. She posts brilliant advice and in her words is trying to break the menopause taboo. Likewise Megs menopause for no nonsense suggestions.