Fibro and the Perimenopaus

by Sarah Warburton

It’s been several months now since the fatigue, which had always been a feature of my fibro, took an abrupt turn for the worse. Some days, I’d be so exhausted that I’d have to head back to bed straight after breakfast as I just didn’t have the energy to do much of anything at all. The migraines I’d learned to get used to were now cropping up more and more frequently. I was becoming increasingly frustrated and low, the activities which would usually nourish me were just too much effort and my world was shrinking fast.

I tolerated all of this for a couple of months before booking a GP appointment, even though I thought that all of these unwelcome changes could easily have been attributed to fibromyalgia. Fortunately, I have an excellent GP who didn’t want to make any assumptions and so I was sent for a blood test to examine my hormone levels. A few days later, my GP called with the results, which she felt explained my changing symptoms and why I was feeling as I was…I was perimenopausal.

With the benefit of hindsight, this diagnosis was something I should have considered given I am in my early forties. But my periods were still regular and perimenopause wasn’t something I had been told about when I was younger and not something that I’d ever discussed with anyone either. A quick straw poll of my friends revealed I wasn’t the only one to be woefully uneducated about it.

Perimenopause isn’t talked about as much as it should be although slowly but surely, progress is being made. In May 2019, the BBC Breakfast television programme held a “Menopause Week” which discussed a different aspect of menopause each day to raise awareness of issues faced by women during this life stage and also to address the taboos surrounding it1. 2019 also saw the conclusion of a campaign led by the Menopause Support organisation, to ensure that future generations will be taught about menopause alongside periods and pregnancy in UK secondary schools2, which can only be a good thing from a health education perspective.

But given that, according to the NHS, there are around 7 times as many women affected by fibromyalgia as men3, it’s a topic which is very relevant to the majority of us fibro folk.

The menopause occurs when a woman’s level of oestrogen declines and the term means the time of a woman’s final menstrual period. Women are said to have gone through the menopause (i.e. they are postmenopausal) when they have not had a menstrual period for 12 months.

The term perimenopause refers to the phase during which a woman’s body transitions towards the menopause. The age at which a woman begins perimenopause varies but is usually between the ages of 45 and 55 with the average age to reach menopause in the UK Some women experience no menopausal symptoms at all, but amongst those who do, some of the most widespread ones are45:

· Changes to periods

· Night sweats

· Hot flushes

· Difficulty sleeping

· Low mood or anxiety

· Problems with memory and concentration

· Aches and pains

· Headaches

· Tiredness

· Palpitations

What’s interesting reading through the above list is just how many of these are also symptoms of fibromyalgia, meaning that, potentially, the onset of the perimenopause could go unnoticed by a woman with fibro, just like it did with me initially. Tiredness, headaches, concentration issues, aches and pains, depression and sleep problems will be very familiar to many of us as fibro symptoms as well, and so could mean that our fibro symptoms are exacerbated by the changes which occur throughout the perimenopause.

My GP told me that the perimenopause varies from woman to woman both in terms of its symptoms and its length, which can range from a few months to several years. Not every woman will need treatment for the symptoms of menopause. However if the symptoms do cause issues with day to day life, then the most common forms of treatment are6:

· Hormone Replacement Therapy (HRT) – this works by replacing the oestrogen hormone and can be taken in various forms including tablets and skin patches.

· Cognitive Behavioural Therapy (CBT) – a type of talking therapy which can address the anxiety and low mood aspects of the menopause.

· Diet and Exercise – a balance health diet coupled with regular exercise can help alleviate certain menopause symptoms.

My GP gave me plenty of information, advice and resources so that I could go and educate myself about the menopause. The Patient website and also Menopause Matters (see resources below) were recommended as reliable sources of advice and information.

I’m using this phase of my life as a good opportunity to reassess where I am with my fibro management plan. I’m trying a few different things – new herbal supplements, renewed focus on sticking to a healthy diet as much as possible (chocolate is a major downfall for me though!) and I’ve added some strength and flexibility exercises into my daily routine. At this stage, I’m not sure how the next few years will play out for me. It will undoubtedly be a challenge, based on my experiences to date, but forearmed, as they say, is forewarned.