I always knew deep down that something was up with my periods. From day one, they were irregular and painful, radiating aches down my thighs and causing such extreme bloating that I couldn’t wear trousers. One of my most vivid childhood memories was being on a rounders pitch on a hot summer’s day wondering how to handle the sticky situation I found myself in as blood saturated my navy blues.
My doctor put me on the Pill and for the next five years I tried brand after brand, trying to find one that would make my symptoms bearable. The combined pill, the mini pill, high-oestrogen pills…nothing seemed to fit. Worst was the high-dose progesterone-only prescription, which unleashed a three-month period that I truly thought would never end. I was 19 when I decided I'd had enough – I had gained 2 stone in weight, I felt miserable – so I decided to go off the Pill, hoping I’d be better off with some control over my natural cycle.
But over the next five years, with the Pill no longer masking reality, my symptoms worsened. They became a constant companion, tagging along on my adventures at university, starting my first job, moving to Paris and finding love. By the end of 2014, the pain got so bad that my partner got used to seeing me doubled over, retching and shivering violently, and on one occasion even carried me to A&E.
At 24, after a lifetime of doctors’ visits, I had my first laparoscopy, and 10 years after first seeking answers, I had a diagnosis: endometriosis.
The disease is classified in four stages, from one (minimal) to four (severe). My surgery confirmed I was suffering from the most serious stage, which causes the uterine lining to grow outside of the uterus, binding to other organs and causing painful cysts and adhesions. A large cyst had grown inside my right ovary, leaving behind extensive scarring and damage, and which likely would have ruptured if we hadn’t operated. My insides were pockmarked with lesions that were painstakingly excised.
The month that followed my laparoscopy was difficult. Even as my body healed, my mental state deteriorated. I couldn’t ignore the voice screaming in my head: “WHAT IF YOU NEVER HAVE A BABY?” The question mark hanging over my fertility felt so oppressive at times I could feel the weight on my chest.
At first, I turned to clean eating and a positive mental attitude, desperate for a miracle cure. I took up hot yoga, stripped out refined sugars and carbohydrates and eventually went full earth-child vegan. But soon the pain was back, and my delusional reality that I could somehow manipulate my body into being “normal” went up in smoke.
I was rushed in for my second surgery almost exactly a year later. My doctor was concerned by how quickly the cyst on my ovary had recurred and we agreed more drastic intervention was needed to preserve my fertility. So when he suggested inducing the menopause, I accepted it, unfazed, as my best option.
I was signed up to a course of six monthly injections of a drug that would suppress my oestrogen levels temporarily, ceasing menstruation and reproductive capabilities in an imitation of the natural menopause.
Endometriosis growth is stimulated by a woman’s menstrual cycle, with the peaks and troughs in hormone levels causing the endometrium lining to grow each month. So inducing the menopause means no oestrogen, means no periods, means no endometriosis. I like to consider it in terms of baking: You can keep the eggs, the flour, the sugar, and the butter, but without the baking powder the cake ain’t going to rise.
Naively, I didn’t really consider the effects of tanking hormones but was relieved that my painful periods would be under lock and key for the foreseeable future. Within a week of my first injection, though, I realised I had underestimated what was in store.
Most women experiencing the natural menopause will gradually transition over a period of years, allowing their bodies time to adjust to a new rhythm and their minds crucial time to acclimatise. But for me, the full gravity of the treatment hit overnight.
Almost immediately, I developed hot flushes that would go from 0 to 100 in five seconds. Beads of sweat would collect on my upper lip, my T-shirt would stick to my back, and I would feel like I was being incinerated from the inside out.
Worse, I developed an unshakeable paranoia that everyone around me could see exactly what was going on. The physical symptoms caused my self-confidence to take such a hammering that my thoughts became increasingly insular.
From Friday drinks with friends, to work lunches or visits with my in-laws, a hot flush could hijack my train of thought at any moment as I found myself scrutinising whoever I was talking to for any sign they had noticed my face melting off, while simultaneously trying to subtly blow on my top lip, which I'm sure looked flawlessly discreet. I worried that the erratic behaviour behind my attempt to mask my daily personal saunas, my mood swings, and my withdrawal into myself was just as noticeable as the symptoms themselves.
My body changed rapidly, too. I gained weight in the hips and my upper arms, and I started recognising parts of my mum and my grandma in my new shape. My hair thinned and became coarse, and I felt like I had completely lost my sense of identity – an otherwise healthy 25-year-old, with plenty to offer and a promising future.
Even after I started taking hormone replacement therapy, a drug that adds back a small amount of synthetic oestrogen to ease menopausal symptoms, I felt just as bizarre.
The insomnia that had started after the first injection became increasingly unbearable. Every night I would find myself thrashing around under the covers as the hot flushes ebbed and flowed, drenching my pyjamas. In the daytime I was a walking zombie.
My treatment coincided with me undertaking a career change, so what would already have been an extremely intense time became gruelling. A week after my second operation, I was in a new job, chasing stories down all over London, while the stitches in my stomach were still healing and my hormones were flatlining.
But how do you confide in your fortysomething, male employer that you’re not on top form because you feel like your feminine lifeblood is slowly being drained from you and you have lost your sense of self?
How do you tell your new work colleagues that you won’t be going for after-work drinks because the 5-inch needle that was plunged into your stomach earlier in the afternoon has left you sore and bruised and set off so much adrenaline that you are still weepy and trembling?
One of my most striking realisations during the experience was how isolating it was. If periods are taboo then mentioning the menopause is practically an arrestable offence.
The gaping mouths, the eyes that flit nervously, the few seconds of silence that neither of you know how to fill: The menopause derails conversations. Those I told didn't know how to react or what to say. Some were kind and caring and compassionate, but others visibly squirmed.
With my twentysomething friends, I felt painfully embarrassed by what was happening. To me, they embodied young, vibrant, dewy-skinned confidence while I felt rounded, haggard, and withering from the inside out. I felt convinced they were uncomfortable discussing the subject so I addressed it fleetingly, with a good dose of self-deprecating humour, when actually I wasn’t finding it funny.
The experience opened my eyes to the stigma of the menopause, not just from others but also my own. One in four women will experience debilitating symptoms that can last up to 15 years, but without menopause on the agenda, how can we push for better support from employers and healthcare providers, and greater understanding from partners and friends? How can we hope for change if the realities of the menopause aren’t laid bare for all to see a little more often? We are failing women if we can’t normalise open discussion and face the reality head-on.
Now I’m out the other side. My six-month course is finished and I’m slowly starting to regain my sense of self, albeit with some pretty important questions to consider for the future. With my ovaries waking up from their long slumber, it’s a waiting game to see what will happen next.
The best possible scenario would be that the menopause caused any residual endometriosis cells to shrivel and die, curing me of the disease temporarily, possibly even completely. Another, less attractive reality is that it could come back. Endometriosis has a high rate of recurrence and that’s something I have to accept.
The last six months forced me to confront the future in a very real way. It’s made me doggedly determined to succeed in the things that matter to me now, not later. It’s made me fiercely proud and grateful to have a partner who offered such unwavering support and acceptance throughout this most surreal and challenging hurdle. And it’s made me a more resilient, flexible, and open person.
While I still don’t tell my employers the nitty-gritty, I’m pushing myself to share more intimate details about myself to fight against the culture of silence. I turned down a great job during my treatment that would have forced me to relocate, and I was honest about why that wasn’t an option for me. After all, why should I feel embarrassed?
I’ve been forced to accept that the future is uncertain. There are no guarantees of what life will look like five years from now. My doctor has warned that if the cyst in my right ovary recurs for a third time, then removal of the ovary is the next option. If that happens, then maybe I’ll need to think about fast-tracking starting a family. Or maybe there will be no family at all. Either way, I’ll cross that bridge when I come to it. And despite living with a health condition that can be desperately challenging, I’ll continue to remind myself my fertility does not define me.