0:00:06 > 0:00:10On my 11th birthday, I went with some other girls to see a film.
0:00:10 > 0:00:12This was...you'd go to the pictures on your birthday,
0:00:12 > 0:00:14you were very grown-up. We went to see She,
0:00:14 > 0:00:18the Hammer film based on the H Rider Haggard book and I had read the
0:00:18 > 0:00:20H Rider Haggard books,
0:00:20 > 0:00:24and this is She, Aisha, looking for the elixir of life,
0:00:24 > 0:00:27finding it, going back into the fire a second time to take the man she
0:00:27 > 0:00:28loves with her.
0:00:31 > 0:00:36And she starts to age and she starts to crumble and she starts to turn to
0:00:36 > 0:00:41dust and it's absolutely terrifying, and it was probably my first real
0:00:41 > 0:00:43connection with old age.
0:00:43 > 0:00:46Bizarrely, in my head, ever since then, I thought,
0:00:46 > 0:00:48this is what the menopause is all about,
0:00:48 > 0:00:51this is getting really, really, old, this is turning to dust.
0:00:57 > 0:01:01It's nonsense, of course, and I have always associated it with this film.
0:01:18 > 0:01:21Every woman goes through the menopause and yet there is something about
0:01:21 > 0:01:24the word itself that has these negative connotations
0:01:24 > 0:01:27of ageing and atrophy which, in our youth obsessed culture,
0:01:27 > 0:01:29can be debilitating for women and even
0:01:29 > 0:01:33embarrassing, and yet we are all living longer and working longer and
0:01:33 > 0:01:36menopause is a feature of midlife.
0:01:36 > 0:01:38It's the start of a new chapter.
0:01:38 > 0:01:40So why the persistent taboo?
0:01:40 > 0:01:42It really is time for a change.
0:01:45 > 0:01:49I'm setting out to discover what the menopause actually is.
0:01:49 > 0:01:52I've never talked about vaginas so much in all my life
0:01:52 > 0:01:54since taking this on.
0:01:54 > 0:01:58I spoke to Joan Collins once and she said menopause is a myth.
0:01:58 > 0:02:00Find out the reality for some women.
0:02:00 > 0:02:04Then I would get hot spells and they would disappear and I would wonder
0:02:04 > 0:02:06what is happening to me?
0:02:06 > 0:02:09I was 14 and it was diagnosed at 16.
0:02:09 > 0:02:12I'd be making sandwiches with a knife in my hand and I would have to
0:02:12 > 0:02:14put the knife down and just walk away.
0:02:15 > 0:02:19Look at what we can do to help ourselves deal with the effects.
0:02:19 > 0:02:22I noticed the difference in my symptoms within a week.
0:02:22 > 0:02:26Then the hot flushes started and that was horrific.
0:02:26 > 0:02:31It was a bit more like adolescent sex, a lot of fun, really.
0:02:32 > 0:02:33Yeah.
0:02:35 > 0:02:38I meet scientists at the cutting edge of controversial research which
0:02:38 > 0:02:41could potentially reverse the menopause.
0:02:41 > 0:02:45I will look for any evidence of follicles and eggs being formed.
0:02:46 > 0:02:50And I'm curious to find out how older women have been portrayed over the
0:02:50 > 0:02:55centuries and the way that has shaped our modern attitudes to age and the menopause.
0:02:58 > 0:03:01In her award-winning book Hot Flushes, Cold Science
0:03:01 > 0:03:06historian Louise Foxcroft examined how society has treated older women through the millennia.
0:03:06 > 0:03:10Take us back to the Greeks, what was the menopause judged as then?
0:03:12 > 0:03:16First of all, I would say it was not really judged at all because women
0:03:16 > 0:03:18post menopause were just not interesting and, in fact,
0:03:18 > 0:03:23what happened to them, they became much more masculine.
0:03:23 > 0:03:27The female, she is pathological, she is deformed,
0:03:27 > 0:03:29she's a sort of mutilated male, in fact,
0:03:29 > 0:03:32and that is where the interest lies in her
0:03:32 > 0:03:36and her pathology and her reproductive system.
0:03:36 > 0:03:39Did the Greeks demonise then, women, post-menopause?
0:03:39 > 0:03:43No, they did not demonise them, but they didn't do anything with them.
0:03:43 > 0:03:44It's just not interesting.
0:03:44 > 0:03:46It's the gateway to death. That's the end of them.
0:03:46 > 0:03:49- They're finished.- The Victorians have the idea that there is a link
0:03:49 > 0:03:51between the womb and the brain.
0:03:51 > 0:03:53That is an ancient idea.
0:03:53 > 0:03:57That goes back to the early modern period and before that where the womb
0:03:57 > 0:04:02is sort of a disreputable and wild organ that runs around the body and
0:04:02 > 0:04:06distributes blood. Of course blood is a bad idea.
0:04:06 > 0:04:09They thought at one point that the blood stayed in the body after
0:04:09 > 0:04:13menopause and then causes cancers and other degenerative illnesses.
0:04:15 > 0:04:19We had hoped that negative attitudes towards older women and the menopause
0:04:19 > 0:04:21might have changed over the last century,
0:04:21 > 0:04:25however, even if we don't talk about it much, we do laugh at it
0:04:25 > 0:04:29and the menopause has always provided fertile fodder for comedy.
0:04:31 > 0:04:33It's like a big tide of jam coming towards us
0:04:33 > 0:04:35but jam made out of old women.
0:04:37 > 0:04:38I've got a bad feeling about this.
0:04:38 > 0:04:42- I think we'd better get back in the house.- Go away. I don't want to catch the menopause.
0:04:45 > 0:04:49'And sometimes it even requires a man to take on woman's trouble.'
0:04:50 > 0:04:53I wouldn't tell another living soul this, of course.
0:04:55 > 0:04:57I'm approaching the change.
0:05:00 > 0:05:02Approaching the change?
0:05:02 > 0:05:03From which direction?
0:05:06 > 0:05:10The menopause like most things in life has its funny side.
0:05:10 > 0:05:15But sometimes, it just doesn't feel like a laughing matter.
0:05:15 > 0:05:21Despite the majority of women experiencing this transition between the ages of 45 and 55,
0:05:21 > 0:05:26we are still shockingly uninformed about what the menopause actually is
0:05:26 > 0:05:28and, more importantly, how to deal with it.
0:05:36 > 0:05:38We are headed towards Dumfries.
0:05:39 > 0:05:42Actually, funnily enough, I was born in Dumfries,
0:05:42 > 0:05:46which was instant, unlike the menopause, which we are going to talk about,
0:05:46 > 0:05:47which is anything but instant.
0:05:47 > 0:05:49It goes on for a very long time sometimes.
0:05:49 > 0:05:53It happens to all women so therefore why do we know so little about it
0:05:53 > 0:05:59and why are women so reluctant to do anything to alleviate the symptoms?
0:06:00 > 0:06:02These symptoms can be alleviated now, myself included.
0:06:02 > 0:06:07I haven't done enough to alleviate the symptoms so I am on a quest to
0:06:07 > 0:06:08find out more.
0:06:14 > 0:06:19I am here to see one woman who knows more about the menopause than most.
0:06:19 > 0:06:23Doctor Heather Currie chairs the British Menopause Society,
0:06:23 > 0:06:27which provides healthcare professionals with information and guidance.
0:06:28 > 0:06:32So it's normal process that our bodies go through.
0:06:32 > 0:06:36Sadly, our ovaries are only designed to last a certain number of years.
0:06:36 > 0:06:41We produce egg cells on average up until the late 40s, early 50s
0:06:41 > 0:06:44and by the age of 51, on average,
0:06:44 > 0:06:47women are stopping having periods and the reason they stop periods is
0:06:47 > 0:06:49because we run out of egg cells,
0:06:49 > 0:06:53but the complicated thing is we now live for many years beyond that.
0:06:53 > 0:06:55So when our ovaries are not working,
0:06:55 > 0:06:59the key hormone that we stop producing is oestrogen.
0:06:59 > 0:07:02Rather than it being just about periods stopping and flushing,
0:07:02 > 0:07:06it is around the consequences of the lack of oestrogen.
0:07:06 > 0:07:09There are lots of taboos about gynaecology in general
0:07:09 > 0:07:12and the menopause affects every single woman.
0:07:12 > 0:07:15So we really, really need to talk about it more.
0:07:18 > 0:07:19There are many aspects of the menopause
0:07:19 > 0:07:23that women can be embarrassed to talk about in public.
0:07:23 > 0:07:27I thought it would be interesting to see if I could encourage them to open up on radio.
0:07:29 > 0:07:32You're listing to Kaye Adams on BBC Radio Scotland
0:07:32 > 0:07:33here with you until 12.
0:07:33 > 0:07:36Coming up, we will be talking the menopause with Kirsty Wark,
0:07:36 > 0:07:39and we would love to hear from you. How was it for you?
0:07:39 > 0:07:41Maybe you're still going through it. Did you consult your GP,
0:07:41 > 0:07:45your family, your friends, your work colleagues? Do give us a call.
0:07:45 > 0:07:48We are also joined by Doctor Fiona Kennan,
0:07:48 > 0:07:50but we would love to hear from you this morning.
0:07:50 > 0:07:53Kirsty, can I ask how was it for you?
0:07:53 > 0:07:56Not great, really. Absolutely.
0:07:56 > 0:07:57Not great medically induced,
0:07:57 > 0:08:00hysterectomy at 47, everything whipped out,
0:08:00 > 0:08:03HRT for three years and then came the big boom scare.
0:08:05 > 0:08:07And suddenly HRT was taboo
0:08:07 > 0:08:14and I came off HRT and actually my symptoms have not really gone away in the last ten years.
0:08:14 > 0:08:18- What about you?- I don't seem to have been affected.
0:08:18 > 0:08:22- I know that I annoy people. - You're not annoying me at all.
0:08:22 > 0:08:26Virtually 100% will experience some symptoms, Kaye.
0:08:26 > 0:08:28You're wonderful, you and my mother.
0:08:28 > 0:08:31I do stick my leg out of the bed at night.
0:08:31 > 0:08:33Hot, hot flushes.
0:08:33 > 0:08:35I think that is a symptom, Kaye.
0:08:35 > 0:08:37Even if it is only one leg.
0:08:37 > 0:08:41- Only one leg.- The menopause would affect your urogenital system,
0:08:41 > 0:08:44so you might get dryness down below, problems passing urine,
0:08:44 > 0:08:47discomfort during intercourse, loss of libido.
0:08:47 > 0:08:50People don't want to talk about that stuff with their doctors.
0:08:50 > 0:08:55I want to hear from women about how detrimental that is to their lives.
0:08:55 > 0:08:57What you want to hear from people,
0:08:57 > 0:09:00you get what you want because we've got lots of them.
0:09:00 > 0:09:03Let's speak to Nan. Good morning, Nan.
0:09:03 > 0:09:06- 'Good morning.' - How are you this morning?
0:09:06 > 0:09:08'I'm OK.
0:09:08 > 0:09:11'I've had a horrible, horrible night with hot flushes.'
0:09:11 > 0:09:14- Oh.- 'Yes.'- Does it affect you every night, Nan?
0:09:14 > 0:09:17'Every single night.
0:09:17 > 0:09:24'What I would like to ask is, I am 78, am I too old to go back on HRT?'
0:09:24 > 0:09:26You may also want to consider other options,
0:09:26 > 0:09:31non-hormonal options which can be helpful in some cases to control hot
0:09:31 > 0:09:35flushes and which we sometimes use for ladies who are not so suitable for HRT.
0:09:35 > 0:09:39Just a wee second, we talk about going through the menopause
0:09:39 > 0:09:42as if it is a discrete period of time.
0:09:42 > 0:09:49You have been experiencing menopausal symptoms for more than 30 years.
0:09:49 > 0:09:51'Yes, I have.'
0:09:51 > 0:09:54The average figures are that ladies will go through the menopause symptoms
0:09:54 > 0:09:56in about four years, but the range,
0:09:56 > 0:09:59we would normally quote a range of up to about 12 years.
0:09:59 > 0:10:02Actually, we have Margaret on the line who I think is in a similar boat.
0:10:02 > 0:10:05Margaret, just for people who are not at this stage of your life,
0:10:05 > 0:10:08when you say sweats, it doesn't always sound that dramatic.
0:10:08 > 0:10:12'It is terrible, I'd throw the covers back, get out of bed,
0:10:12 > 0:10:15'cool myself down, onto the tiles in the bathroom,
0:10:15 > 0:10:19'walk about there and cool down and then back to bed, and then up again.'
0:10:20 > 0:10:21Aside from all the other symptoms,
0:10:21 > 0:10:24the sleep disruption associated with that is huge.
0:10:24 > 0:10:26'Sleep disruption's a big problem.'
0:10:26 > 0:10:28Coming up to five to 12.
0:10:28 > 0:10:30Time is against us.
0:10:30 > 0:10:33We are talking about the menopause, let's speak to Angus.
0:10:33 > 0:10:34Good morning.
0:10:35 > 0:10:38'Good morning, Kaye. I saw my mother when she was going through all of this.
0:10:38 > 0:10:41'I did not understand it, I was about 11. She was so depressed, etc,
0:10:41 > 0:10:45'and at one stage they were thinking of committing her
0:10:45 > 0:10:49'into an asylum or something like that. The doctor
0:10:49 > 0:10:52'said "Right, we will give your wife pills, if it doesn't work,
0:10:52 > 0:10:54'we will have her committed,"
0:10:54 > 0:10:56- 'and Father said, "Over my dead body."- '
0:10:56 > 0:10:59That was really, an overwhelming response,
0:10:59 > 0:11:02I have to say, and it was very immediate
0:11:02 > 0:11:04which is interesting.
0:11:04 > 0:11:05As soon as you were on,
0:11:07 > 0:11:10somebody is saying to me, really busy on this, really busy on this,
0:11:10 > 0:11:13and actually we quickly took a decision to dump what we had planned
0:11:13 > 0:11:16for the last half-hour of the show.
0:11:16 > 0:11:19You kind of know that you have touched a nerve when that happens.
0:11:25 > 0:11:28Sharing experiences honestly and bravely
0:11:28 > 0:11:31is a very powerful thing to do.
0:11:31 > 0:11:34And it can help others to know that they are not alone.
0:11:34 > 0:11:38Especially if they feel they are having to battle to be heard,
0:11:38 > 0:11:40even by their GP.
0:11:40 > 0:11:45I was 46 when I started to see my periods have got less.
0:11:45 > 0:11:50And I feel that I am going through the early stages of the menopause
0:11:50 > 0:11:53and his words were, "You're far too young."
0:11:53 > 0:11:56The menopause does not happen until you're 52.
0:11:56 > 0:12:00Just like that. 52, on maybe the 3rd of January.
0:12:00 > 0:12:06- Great.- A few months down the line I noticed other things like low mood,
0:12:06 > 0:12:09feeling very depressed at times.
0:12:09 > 0:12:13Tearful, emotional for no reason at all.
0:12:13 > 0:12:17So I went back to him again and I sat with him and I said to him,
0:12:17 > 0:12:22"Look, I know I'm going through something. Something is happening to me."
0:12:22 > 0:12:24"Maybe it's just a bit of depression, you're having."
0:12:24 > 0:12:28I said, "No, I know fine it's not a bit of depression I'm having.
0:12:28 > 0:12:33"That's not causing hot sweats," and I said, "If you do a blood test
0:12:33 > 0:12:35"and if it comes back, we'll take it from there."
0:12:35 > 0:12:38He said, "I'll do the blood test but I still think that...
0:12:40 > 0:12:43"..you're not going to be, it's not going to show anything."
0:12:43 > 0:12:44What happened?
0:12:44 > 0:12:48So I went back and he said, "There it is written down in black and white,
0:12:48 > 0:12:52"likely to be perimenopausal," and I breathed a sigh of relief.
0:12:55 > 0:12:58I think lots of people identify with Caroline's story.
0:12:59 > 0:13:04I think lots of women will feel I have just got to manage it,
0:13:04 > 0:13:07because their GPs have been unsympathetic.
0:13:07 > 0:13:10I think there are lots of GPs that are sympathetic, but I think for many
0:13:10 > 0:13:15women, they don't get the answer they want first time and don't feel
0:13:15 > 0:13:18confident about getting an answer the second time.
0:13:18 > 0:13:20So it is a kind of suffer in silence.
0:13:25 > 0:13:31We are all aware of the many pressures GPs and the wider NHS face these days.
0:13:31 > 0:13:36In 2015, the National Institute for Health and Care Excellence, or NICE,
0:13:36 > 0:13:39published its guidelines designed to clarify the confusion
0:13:39 > 0:13:43about both diagnosis and management of the menopause.
0:13:45 > 0:13:49Professor Mary Ann Lumsden is an internationally renowned expert on
0:13:49 > 0:13:53the menopause. She chaired the specialist group which developed the guideline
0:13:53 > 0:13:57by re-evaluating all the existing evidence.
0:13:57 > 0:14:04What we wanted to get across is that menopause can cause problems for a
0:14:04 > 0:14:10lot of women. That help is readily available for them,
0:14:10 > 0:14:17should they want it and that every woman needs to be treated as an
0:14:17 > 0:14:20individual, because everybody's circumstances are different.
0:14:23 > 0:14:26There are lesser known and surprising symptoms.
0:14:26 > 0:14:28It is not just hot flushes and mood swings.
0:14:30 > 0:14:33Zarina has been dealing with joint pain for more than a year.
0:14:35 > 0:14:38I didn't think it was anything to do with menopause.
0:14:38 > 0:14:41I thought it was because I was hitting 50,
0:14:41 > 0:14:45and I'm just getting old, so I'm getting these aches and pains in my joints.
0:14:45 > 0:14:47I need to get more fitter.
0:14:48 > 0:14:50There were other things that were going on as well.
0:14:50 > 0:14:52I was having really bad dizzy spells.
0:14:53 > 0:14:57I was getting really bad headaches, very bad severe headaches.
0:14:57 > 0:15:00What do the pains actually feel like?
0:15:00 > 0:15:03It was like shooting pains, in my ankle or my knees,
0:15:03 > 0:15:05either get a pain that would shoot down my leg
0:15:05 > 0:15:09and then you would have an ache that would last for days.
0:15:09 > 0:15:11So, you've had all these different things,
0:15:11 > 0:15:14you've had joint pains, and night sweats.
0:15:14 > 0:15:17- Yes.- And you go up to the loo in the night?
0:15:17 > 0:15:22Yes. And then you get thirsty because you're sweating in the night and you
0:15:22 > 0:15:26drink water and then you drink water and you need to get up to go to the
0:15:26 > 0:15:30toilet, but most of the time now, after every two hours, I get up.
0:15:30 > 0:15:33You've got two options, you put up with the night sweats, the dizziness,
0:15:33 > 0:15:35the joint pain,
0:15:35 > 0:15:38going to the loo in the middle of the night or you maybe seek some help
0:15:38 > 0:15:41for it, and it might alleviate some of your symptoms.
0:15:41 > 0:15:44- What are you likely to do? - What I would want to do,
0:15:44 > 0:15:49is make my life better and have a better quality of life.
0:15:51 > 0:15:56But, the way I am, I would probably just ignore it and just think,
0:15:56 > 0:15:58it's going to get better and I think part of me thinks,
0:15:58 > 0:16:03it is a passing phase that the menopause is something that will be here
0:16:03 > 0:16:06for a little while and then you go back to normal.
0:16:06 > 0:16:09I know that's not the case, but in my head,
0:16:09 > 0:16:10I'm probably still in denial.
0:16:13 > 0:16:16The most common treatment for menopausal symptoms
0:16:16 > 0:16:19is hormone replacement therapy, HRT,
0:16:19 > 0:16:22which helps replace the oestrogen lost
0:16:22 > 0:16:24when our ovaries stop producing eggs.
0:16:24 > 0:16:28It can be taken via patches or as a gel or tablets.
0:16:29 > 0:16:33But it's been hard to work out if it's wise to take HRT.
0:16:33 > 0:16:37This is due to the confusion ignited by the publication of the
0:16:37 > 0:16:42women's health initiative study in America back in 2002.
0:16:42 > 0:16:46The study cast serious doubts on the safety of HRT.
0:16:47 > 0:16:53So, 2002, HRT study cancelled over cancer and stroke fears, The Guardian,
0:16:53 > 0:16:56HRT risk to breast cancer in the Mail,
0:16:56 > 0:16:59HRT does more harm than good, 2002.
0:16:59 > 0:17:052008, new cancer fear for women taking HRT and then HRT is safe for
0:17:05 > 0:17:06millions of women.
0:17:06 > 0:17:09Again the Express, two Express stories.
0:17:10 > 0:17:16New menopause guide says one million women can benefit from HRT.
0:17:16 > 0:17:19This is why it is all so confusing.
0:17:21 > 0:17:25I was using HRT tablets for three years after my hysterectomy
0:17:25 > 0:17:30but stopped suddenly, like so many women, because of this scare.
0:17:31 > 0:17:35In 2002 the result of the women's health initiative study came out and
0:17:35 > 0:17:40those suggested that being on HRT hugely increased your risk of breast
0:17:40 > 0:17:44cancer and at the time it seemed like being on HRT even for a short period.
0:17:44 > 0:17:48So at that time people just stopped taking their HRT because of this
0:17:48 > 0:17:52risk. Lots of them without any discussion with a medical professional,
0:17:52 > 0:17:55they literally stopped, cold turkey and after that people stopped coming
0:17:55 > 0:17:57to ask for HRT from the doctors
0:17:57 > 0:18:00and GPs became less and less familiar with
0:18:00 > 0:18:04prescribing it and also got caught up in the safety issues around it so
0:18:04 > 0:18:06were probably less likely to suggest it to their patients.
0:18:06 > 0:18:09- So it's a kind of vicious circle. - Yes.
0:18:09 > 0:18:13Subsequent research suggested that the analysis of the data was
0:18:13 > 0:18:16flawed and that the findings were overstated.
0:18:16 > 0:18:20But these more positive reappraisals received nothing like the same
0:18:20 > 0:18:22publicity as the original scare.
0:18:23 > 0:18:28More up-to-date research has attempted to offer clarification of the risks involved.
0:18:28 > 0:18:33The current understanding is that if women take oestrogen only,
0:18:33 > 0:18:36which is taken if a woman has had the womb removed,
0:18:36 > 0:18:38had a hysterectomy,
0:18:38 > 0:18:42there seems to be very little increased risk of being diagnosed
0:18:42 > 0:18:43with breast cancer.
0:18:43 > 0:18:47If women take HRT which is oestrogen and progestogen,
0:18:47 > 0:18:52the other hormone, progestogen, is added in to protect the lining of the womb for more
0:18:52 > 0:18:54than five years after the age of 50,
0:18:54 > 0:18:58there is a possibility that there is an increased risk of being diagnosed
0:18:58 > 0:19:01with breast cancer. The other thing we have to clearly remember,
0:19:01 > 0:19:03which is a really important fact,
0:19:03 > 0:19:07is that there is no evidence that HRT causes breast cells to turn into
0:19:07 > 0:19:11cancer. It may be that it is promoting something that is already there and
0:19:11 > 0:19:15the other really important fact is that being overweight or drinking two
0:19:15 > 0:19:19or more units of alcohol a day are actually really important risk factors
0:19:19 > 0:19:20for breast cancer,
0:19:20 > 0:19:26and particularly being overweight is a far greater risk factor than taking HRT.
0:19:26 > 0:19:29The feeling now is that for women who are having menopausal symptoms,
0:19:29 > 0:19:33for most women the benefits of HRT outweigh the risks.
0:19:33 > 0:19:37And it is the most effective treatment that we have for controlling symptoms.
0:19:42 > 0:19:46Janice has been taking HRT for almost ten years.
0:19:46 > 0:19:51She began to experience menopausal symptoms when she was just 39.
0:19:53 > 0:19:57I had this flush and I could feel it and my sister turned round and said
0:19:57 > 0:20:00to me, "Are you OK? You've gone awfully red."
0:20:00 > 0:20:01And I thought, thank God!
0:20:01 > 0:20:04It is actually noticeable.
0:20:04 > 0:20:05I didn't just imagine this.
0:20:05 > 0:20:08So, I went back to my GP just after,
0:20:08 > 0:20:11well, it was actually my nurse and I said to her,
0:20:11 > 0:20:15"Could you do the test for me, just to put my mind at rest?"
0:20:15 > 0:20:18And she put it through and she said she'd get back to me in a couple of
0:20:18 > 0:20:21weeks' time. She phoned me two days later and said,
0:20:21 > 0:20:23"You were absolutely right."
0:20:23 > 0:20:26She says, "Your hormone balances are all over the place."
0:20:26 > 0:20:30So, after that I started dealing with a female GP.
0:20:30 > 0:20:35She offered me the chance to go on HRT but then, you know,
0:20:35 > 0:20:37talked about the risks that were involved,
0:20:37 > 0:20:40like the breast cancer risks and suchlike.
0:20:40 > 0:20:44But also about the risk at my age of osteoporosis.
0:20:44 > 0:20:48And we didn't really have much of a history in our house,
0:20:48 > 0:20:51in our family for breast cancer.
0:20:51 > 0:20:56So for me the osteoporosis thing was more of a sort of...
0:20:56 > 0:21:01because my mum has arthritis and I have known people with osteoporosis
0:21:01 > 0:21:03and thought, "Oh, that's horrible."
0:21:03 > 0:21:08So, talking about that made me more inclined to go with the HRT option
0:21:08 > 0:21:09and they put me on patches.
0:21:09 > 0:21:12And so I started on them and it was great.
0:21:12 > 0:21:15How quickly did things change once you got a patch on?
0:21:15 > 0:21:19I noticed a difference in my symptoms almost within a week.
0:21:19 > 0:21:24The sweat, the night hot flushes weren't nearly as bad.
0:21:24 > 0:21:26They still came,
0:21:26 > 0:21:30but they were so much more bearable, sometimes you barely even noticed them.
0:21:32 > 0:21:37Janice's concerns about osteoporosis are certainly well founded.
0:21:37 > 0:21:39It's a condition that weakens bones,
0:21:39 > 0:21:42making them fragile and more likely to break.
0:21:42 > 0:21:46Reaching menopause at a younger age means your body is losing the oestrogen
0:21:46 > 0:21:49vital for bone health even sooner than usual.
0:21:50 > 0:21:57Many of us are a generation who've watched our mothers experience the
0:21:57 > 0:22:01effects of osteoporosis with multiple fractures often,
0:22:01 > 0:22:05and decreased mobility, loss of confidence.
0:22:05 > 0:22:10It's an awful disease and it is extremely common,
0:22:10 > 0:22:13particularly in women.
0:22:13 > 0:22:18And so some people would like to prevent osteoporosis.
0:22:18 > 0:22:21It doesn't totally prevent fractures,
0:22:21 > 0:22:25but it certainly can go some way in doing so.
0:22:25 > 0:22:28HRT decreases the likelihood of a fracture.
0:22:37 > 0:22:43It's a beautiful sunny morning and I'm on my way to have a bone density scan. A Dexa scan.
0:22:44 > 0:22:50And the reason I'm having it is that it's definitely the case
0:22:50 > 0:22:54that bone density is a pretty critical issue for a lot of women
0:22:54 > 0:22:56going through the menopause,
0:22:56 > 0:22:59and osteoporosis is a pretty horrible disease.
0:23:01 > 0:23:05I am not expecting to find problems with my bone density
0:23:05 > 0:23:09because it's not in the family. I'm reasonably fit and healthy, but you never know!
0:23:21 > 0:23:22Dr Adamson, nice to see you.
0:23:28 > 0:23:31We're going to use this calculation tool just to calculate your
0:23:31 > 0:23:34probability of a fracture and then that will help us to guide us as to
0:23:34 > 0:23:36whether you need a Dexa scan or not.
0:23:36 > 0:23:39You can see the first thing that we need to just pop in is your age.
0:23:39 > 0:23:41- 61.- OK.
0:23:41 > 0:23:42And then you're female.
0:23:42 > 0:23:45No previous fractures.
0:23:45 > 0:23:46- Parent fractured a hip?- No.
0:23:46 > 0:23:47- You don't smoke?- No.
0:23:47 > 0:23:48And alcohol.
0:23:48 > 0:23:51So the question here is three or more units a day?
0:23:51 > 0:23:53So that would be 21 units a week.
0:23:53 > 0:23:56Pretty sure most times I'm under that,
0:23:56 > 0:23:59but there could be the odd party time where I'm over that.
0:23:59 > 0:24:02Of course. So we calculate it both ways because I think it's quite
0:24:02 > 0:24:05interesting to see the difference that that makes.
0:24:05 > 0:24:08So if we do it without and then we calculate,
0:24:09 > 0:24:14you can see that your fracture risk there is 6.7% over ten years.
0:24:14 > 0:24:17And just to see that visually, you can see there.
0:24:17 > 0:24:19So, I'm in green, just.
0:24:19 > 0:24:21Just in the green.
0:24:21 > 0:24:25And then if we change that and say, yes on the alcohol,
0:24:25 > 0:24:29that takes us up to a risk of 8.3% over ten years,
0:24:30 > 0:24:31and you can see that that's
0:24:31 > 0:24:34just enough to push you into the category where
0:24:34 > 0:24:36we would measure your bone mineral density.
0:24:36 > 0:24:39- So, actually, lifestyle is really important.- Really, really important.
0:24:39 > 0:24:41Yes. Alcohol intake is very important.
0:24:41 > 0:24:46- And if you were a smoker then that would have pushed you even further into that category.- OK.
0:24:47 > 0:24:50OK, so we'll just get you to come over and lie up on your back on the table.
0:24:54 > 0:24:58Just shuffle down the bed an inch there. That's lovely. And just rest back.
0:25:00 > 0:25:03So, we're going to start off by taking a picture of your left hip.
0:25:03 > 0:25:06We use this as an average across the population.
0:25:06 > 0:25:09So we do the left hip on every one and the lumber spine.
0:25:09 > 0:25:12OK, so that's just ready for the first scan.
0:25:12 > 0:25:15I'll just pop this hand just on to your tummy.
0:25:15 > 0:25:16Just nice and still there.
0:25:18 > 0:25:22It has recently been estimated that by the age of 70,
0:25:22 > 0:25:27half of all women will have had a fracture related to osteoporosis.
0:25:27 > 0:25:32So, what we're going to do now is position your knees on top of this pad.
0:25:32 > 0:25:33Just there. How is that for you?
0:25:33 > 0:25:35- Fine.- OK.
0:25:35 > 0:25:38No instructions for you, just to lie nice and still.
0:25:38 > 0:25:39Not even pressing my back into the table?
0:25:39 > 0:25:41No. Just relaxing normally.
0:25:44 > 0:25:49Osteoporosis can be treated and bone strength increased in a variety of
0:25:49 > 0:25:53ways. But because it can lead to such devastating consequences,
0:25:53 > 0:25:55it should always be addressed.
0:25:59 > 0:26:01Fantastic! That's us all finished.
0:26:03 > 0:26:04- Hi.- Hi, Kirsty.
0:26:04 > 0:26:07- How was that?- Straightforward.
0:26:07 > 0:26:09Good! Good! Are you a bit anxious to see the results?
0:26:09 > 0:26:11I'm keen. I really am keen.
0:26:11 > 0:26:12OK, so we'll start with the spine.
0:26:12 > 0:26:15- Yes.- OK.
0:26:15 > 0:26:20Bottom line here, total T-score is minus 0.7.
0:26:20 > 0:26:23That's normal. A T-score down to minus 1 is normal.
0:26:23 > 0:26:26A little bit of a different story at the hip though.
0:26:27 > 0:26:30- OK.- Nothing to worry about desperately,
0:26:30 > 0:26:33but just below minus one.
0:26:33 > 0:26:34So minus 1.1.
0:26:34 > 0:26:38So, classification of that would be osteopenia.
0:26:38 > 0:26:40Right, so it's pre-osteoporosis.
0:26:40 > 0:26:42- Wow!- Just a little bit thin at the hip.
0:26:42 > 0:26:45Minus one down to 2.5 is osteopenia.
0:26:45 > 0:26:48And below minus 2.5 is osteoporosis.
0:26:48 > 0:26:55So, what does that mean in terms of what I have to do about it?
0:26:55 > 0:26:57So, we would just recommend lifestyle management.
0:26:57 > 0:26:58Lifestyle changes.
0:26:58 > 0:27:00So the kind of things we talked about earlier,
0:27:00 > 0:27:02keeping your alcohol intake down.
0:27:02 > 0:27:03You don't smoke.
0:27:04 > 0:27:06Sensible, healthy diet.
0:27:06 > 0:27:08Making sure you get a decent amount of calcium in your diet.
0:27:08 > 0:27:14- Yeah.- Yeah.- And in terms of alcohol, it should be south of 14 units.
0:27:14 > 0:27:15South of 14 units, where possible.
0:27:15 > 0:27:17Yeah.
0:27:17 > 0:27:20Good. Well, I better get a grip on that.
0:27:20 > 0:27:21OK.
0:27:25 > 0:27:27Well, that was a bit of a surprise.
0:27:27 > 0:27:31I was quite shocked, actually.
0:27:31 > 0:27:33But, you know, it could be a lot worse
0:27:33 > 0:27:35and I can do something about it.
0:27:38 > 0:27:44I'm now beginning to wonder if coming off HRT so suddenly all these years ago was a mistake.
0:27:44 > 0:27:47If I had kept taking it would my bone density have been better?
0:27:48 > 0:27:51So is it too late for me to start taking it again?
0:27:52 > 0:27:56It's not ideal to have that gap, but we can't turn the clock back,
0:27:56 > 0:28:01so what we have to do is look at the safest way of taking HRT and
0:28:01 > 0:28:05certainly start with a low dose and you'd give consideration as to the
0:28:05 > 0:28:07root, whether it was tablet or a patch.
0:28:07 > 0:28:11But, yes, I feel sorry for a lot of women who,
0:28:11 > 0:28:15you know, this has been often described as ten years wasted,
0:28:15 > 0:28:17but HRT is definitely still an option.
0:28:22 > 0:28:25There's obviously been an impact on my bone health and I'm going to have
0:28:25 > 0:28:27to be extra vigilant for the rest of my life.
0:28:29 > 0:28:33It certainly wasn't something I was thinking about in my 30s.
0:28:33 > 0:28:34So, let's look at this.
0:28:34 > 0:28:36Back when she was in her 30s,
0:28:36 > 0:28:40Jennifer Saunders was writing about the funny side of the menopause.
0:28:40 > 0:28:42- Did you go to the hospital?- Yes.
0:28:42 > 0:28:44And to the gynaecologist.
0:28:44 > 0:28:45I hate gynaecologists,
0:28:45 > 0:28:47a man who can look you in the vagina but never in the eye!
0:28:50 > 0:28:52Used that line about four times!
0:28:54 > 0:28:56Patsy's got osteoporosis.
0:28:59 > 0:29:01She has the lowest bone density on record.
0:29:01 > 0:29:03Cheers! Well done, darling!
0:29:05 > 0:29:09She is just gristle clinging on to bone powder.
0:29:09 > 0:29:11This is what happens when you have the menopause.
0:29:11 > 0:29:17- No!- No!- You will learn about this and you will take control because
0:29:17 > 0:29:20frankly, if you don't...
0:29:20 > 0:29:21See you learn about this and take control.
0:29:21 > 0:29:23Certainly was a precedent.
0:29:25 > 0:29:26Oh! This is bad!
0:29:30 > 0:29:31BONES CRACK
0:29:31 > 0:29:32Oh!
0:29:34 > 0:29:38- Is that my leg?- It's my leg.
0:29:38 > 0:29:39Split!
0:29:44 > 0:29:46Oh, God!
0:29:46 > 0:29:47When you look at that now!
0:29:47 > 0:29:48I know!
0:29:50 > 0:29:53Oh, my God! Little did I know it was all going to happen.
0:29:54 > 0:29:57When you were writing this episode,
0:29:57 > 0:29:59this was specifically about the menopause.
0:29:59 > 0:30:01Yes. I wonder why I did that?
0:30:01 > 0:30:06I think I did it because I thought it would be funny if Patsy had osteoporosis.
0:30:06 > 0:30:07We liked it when she had a breast check,
0:30:07 > 0:30:10so I thought anything gynaecological with Patsy is really funny.
0:30:10 > 0:30:11And we don't know how old she is,
0:30:11 > 0:30:16so I thought she won't have any bones in it, so it's a funny thing.
0:30:16 > 0:30:19Yours was a particular kind of menopause.
0:30:19 > 0:30:26- What happened?- I was, I got breast cancer and so I wasn't menopausal,
0:30:26 > 0:30:29I was still having periods,
0:30:29 > 0:30:34but the second year of chemotherapy all your periods stop
0:30:34 > 0:30:39and so you're sort of plunged into it, but because you're so full of
0:30:39 > 0:30:41chemicals, you really have no idea.
0:30:41 > 0:30:43It's like the tiniest thing.
0:30:43 > 0:30:46Compared to everything else that's happening.
0:30:46 > 0:30:50By the time you've got over the chemicals and you're on Tamoxifen,
0:30:50 > 0:30:55which gets rid of all your oestrogen, you can't tell the difference.
0:30:55 > 0:30:59You don't know what's coming out of chemo and what's menopause and it
0:30:59 > 0:31:03wasn't until, I think about a year after,
0:31:03 > 0:31:06that I started to feel like, oh, this doesn't feel right.
0:31:06 > 0:31:08This feels different and it changes everything.
0:31:08 > 0:31:14It changes your metabolism, your energy levels, your skin, your hair.
0:31:14 > 0:31:17Everything. I mean it was quite astonishing.
0:31:17 > 0:31:19- So, how did you deal with it? - I don't know.
0:31:20 > 0:31:21I drank. No!
0:31:22 > 0:31:24I had a large glass of champagne!
0:31:26 > 0:31:29And got on with it. I think you just get on with it.
0:31:29 > 0:31:30What are your symptoms now?
0:31:30 > 0:31:36I mean I still have, my main symptoms are night sweats and bad sleep pattern.
0:31:36 > 0:31:38I've always had a very good sleep, I'm very good at sleeping.
0:31:38 > 0:31:42- Lucky you!- Yes, I'm very good at sleeping, but the
0:31:42 > 0:31:46first time I had a hot sweat it did take me by surprise.
0:31:46 > 0:31:48I kept going, "What's that?
0:31:48 > 0:31:51"What am I sitting on? What am I sitting on?"
0:31:51 > 0:31:54I kept thinking... It felt like I was sitting on a radiator.
0:31:54 > 0:31:56Sitting on a radiator.
0:31:56 > 0:31:58I was looking around the room going, "Is everyone else?
0:31:58 > 0:32:00"No, they are not hot like me."
0:32:00 > 0:32:04Do you actually feel different post menopausal as to who you were before?
0:32:04 > 0:32:06Is that tied up in the breast cancer as well?
0:32:07 > 0:32:09No, I don't really think about the breast cancer.
0:32:11 > 0:32:13But I think, yeah,
0:32:13 > 0:32:19I think it happens and all the things I used to make jokes about are so true.
0:32:19 > 0:32:23You know, just your place in the world and how you feel about yourself.
0:32:24 > 0:32:30Your general feeling of sexiness and libido and, and,
0:32:30 > 0:32:34it's an indefinable something that you don't have any more.
0:32:36 > 0:32:40But for me, I feel completely able to do what I want to do.
0:32:44 > 0:32:47Some of the physical changes of the menopause can massively affect a
0:32:47 > 0:32:50woman's self-esteem. Like Jennifer,
0:32:50 > 0:32:54Isabel experienced what is termed medical menopause,
0:32:54 > 0:32:58'that is when a woman is catapulted putted into menopause unnaturally
0:32:58 > 0:33:01'because of surgery, like a hysterectomy,
0:33:01 > 0:33:03'or as a result of cancer treatment.
0:33:03 > 0:33:09'Isabel experienced symptoms almost overnight after she had her ovaries removed.'
0:33:09 > 0:33:11Because I didn't feel like me.
0:33:11 > 0:33:12I didn't really feel like me.
0:33:12 > 0:33:15When I was looking in the mirror I had changed so, so much.
0:33:15 > 0:33:19My face had changed, it blew up, everything.
0:33:19 > 0:33:20My skin was really...
0:33:20 > 0:33:23My mum always had amazing skin,
0:33:23 > 0:33:26she always looked younger than what she was and I prided myself in that.
0:33:26 > 0:33:31I then developed a beard as well
0:33:31 > 0:33:34and my husband... That became a joke as well because my husband has got a
0:33:34 > 0:33:40goatee and these hairs stop growing on your legs but they just travel up
0:33:40 > 0:33:43to your chin, so tweezers became my best friend.
0:33:43 > 0:33:45Do you think there is a problem talking about the menopause?
0:33:45 > 0:33:47Yes, I think so.
0:33:47 > 0:33:53I think in one way it's you're facing the fact that you are no longer
0:33:53 > 0:34:01a young woman. As we say. So you've got that to get over as well, that this is now...
0:34:01 > 0:34:04You're not going back the way,
0:34:04 > 0:34:07there's no change, as much as I didn't want to have any more children,
0:34:07 > 0:34:11it's gone. All that's gone, you're into a new phase of your life but...
0:34:11 > 0:34:15- And I think...- But the point is you're not old.
0:34:15 > 0:34:17You're young, middle-aged.
0:34:17 > 0:34:21But it made me feel old.
0:34:21 > 0:34:23For some women like Isabel,
0:34:23 > 0:34:27the menopause can really shake their confidence but it doesn't need to
0:34:27 > 0:34:29feel like the beginning of the end.
0:34:30 > 0:34:32No matter what we look like on the outside,
0:34:32 > 0:34:36inside our bodies are inevitably ageing
0:34:36 > 0:34:39but there are many ways to deal with that.
0:34:40 > 0:34:43We know that being low on oestrogen also affects our bone health and our
0:34:43 > 0:34:49heart health and for these reasons, so HRT is part of the option,
0:34:49 > 0:34:52one of the options, if we need to take treatment for
0:34:52 > 0:34:54menopausal effects but
0:34:54 > 0:34:57also diet and lifestyle changes are really important as well.
0:34:57 > 0:35:00So not only are the symptoms important,
0:35:00 > 0:35:03but that should also lead to a discussion
0:35:03 > 0:35:06around what can I do to improve my health later on?
0:35:09 > 0:35:15Now, some people turn their noses up at herbal remedies or
0:35:15 > 0:35:18different kind of, almost talismanic things.
0:35:20 > 0:35:22But I'm going to meet Karen.
0:35:22 > 0:35:30The thing about Karen is that she swears by her lady magnet and
0:35:30 > 0:35:33what we're going to do is we're going to see how that works for her,
0:35:33 > 0:35:35what difference it's made to her life.
0:35:38 > 0:35:42For Karen, and women like her who have a family history of ovarian or
0:35:42 > 0:35:47breast cancer, taking HRT does have slightly increased risks of
0:35:47 > 0:35:50breast cancer, so Karen felt it was not a safe option
0:35:50 > 0:35:53and she had to consider alternatives.
0:35:55 > 0:35:57So I looked at my diet,
0:35:57 > 0:35:58I looked at my exercise regime,
0:35:58 > 0:36:01which was kind of non-existent at that time,
0:36:01 > 0:36:04and I thought I've been a runner before, I can do this again.
0:36:04 > 0:36:07That's been a big part of your, as it were, rejuvenation.
0:36:07 > 0:36:11It has been an absolute huge part of my rejuvenation.
0:36:11 > 0:36:14And then I thought, right OK, the exercise thing is there,
0:36:14 > 0:36:16now I need to adjust my eating.
0:36:16 > 0:36:19My eating habits were just a bit appalling, really.
0:36:19 > 0:36:21Then the hot flushes started.
0:36:21 > 0:36:24I thought, what's this? I was like, what?
0:36:24 > 0:36:27People had told me about this and you just have to whip all your
0:36:27 > 0:36:30clothes off and then it doesn't matter where you are,
0:36:30 > 0:36:32Marks & Spencer's or anywhere, you'd be like...
0:36:32 > 0:36:36And people will be looking and you going, "Oh, dear."
0:36:36 > 0:36:39Well, I was having up to about 85 hot flushes a day and night
0:36:39 > 0:36:42in a 24-hour period. I've ignored this a wee bit.
0:36:42 > 0:36:43No, I'll do it, it's my job.
0:36:44 > 0:36:49And so I heard about this magnet and I thought, right, OK.
0:36:49 > 0:36:53People wear magnets for arthritis and rheumatism,
0:36:53 > 0:36:56and it works on the same principle as that.
0:36:56 > 0:36:58I think it's a balancing thing.
0:36:58 > 0:36:59So how long did it take to stop the hot flushes?
0:36:59 > 0:37:01It took me about eight weeks.
0:37:01 > 0:37:07- But you persevered?- For me to notice a difference and the difference
0:37:07 > 0:37:11that it's made to my life, I probably have maybe four,
0:37:11 > 0:37:13five hot flushes a day now.
0:37:13 > 0:37:17I'd still say four or five is quite a lot actually, but obviously compared to 80.
0:37:17 > 0:37:18Compared to 80 it's not.
0:37:18 > 0:37:23And you think it's definitely the magnet and not a progression of your
0:37:23 > 0:37:26- menopause?- It could be a progression of my menopause.
0:37:26 > 0:37:29- It doesn't matter because it works for you.- It doesn't matter because it works for me.
0:37:29 > 0:37:34So it could all be psychosomatic but it works for me.
0:37:34 > 0:37:35- Can I just see the magnet? - Yes, of course.
0:37:38 > 0:37:42That's the magnet now. How does it...?
0:37:42 > 0:37:44It's two bits. Two pieces to it.
0:37:46 > 0:37:49- Right.- And that it goes inside, up against...- Yes.
0:37:49 > 0:37:54- Your pubic bone there.- And the other bit goes on the front of your knickers and keeps it firm.
0:37:54 > 0:37:57- And that's 24 hours a day? - 24 hours a day.
0:38:01 > 0:38:04Magnet therapy is just one option for dealing with the menopause.
0:38:06 > 0:38:09Although there is no comprehensive medical research to back up the
0:38:09 > 0:38:12effectiveness of alternative therapies,
0:38:12 > 0:38:18the idea of a placebo which works on the mind rather than the body has been proven.
0:38:19 > 0:38:21Placebo work brilliantly for everything.
0:38:21 > 0:38:25And you need quite an effective treatment to be better than
0:38:25 > 0:38:29placebos, so I never say to a woman something won't work.
0:38:29 > 0:38:34- Never say that because you know that in a certain proportion of cases it will.- Why?
0:38:35 > 0:38:41I suspect it's because of neuronal pathways.
0:38:41 > 0:38:44The control of hot flushing is in the brain
0:38:44 > 0:38:48and it's an alteration in the perception of temperature,
0:38:48 > 0:38:50heat and cold.
0:38:50 > 0:38:54So you react very quickly to changes in temperature postmenopausally in a
0:38:54 > 0:38:59way you don't premenopausally, due to the absence of oestrogen,
0:38:59 > 0:39:05and I wonder if somehow the placebo, if you like,
0:39:05 > 0:39:07relaxes somebody.
0:39:07 > 0:39:11They feel differently and this impacts on the way the brain is working.
0:39:11 > 0:39:13It's quite possible.
0:39:14 > 0:39:19This connection between mind and body can have a massive impact on our lives.
0:39:19 > 0:39:24One of the effects of the menopause is the mood swing or indeed low
0:39:24 > 0:39:26mood, as I've heard it described.
0:39:26 > 0:39:31And that can be incredibly upsetting and debilitating for women
0:39:31 > 0:39:34experiencing that, but just as upsetting and debilitating for
0:39:34 > 0:39:39relationships, be it with your partner or indeed with your family when,
0:39:39 > 0:39:41all of a sudden, out of nowhere
0:39:41 > 0:39:42a rage comes on.
0:39:45 > 0:39:49Women are, historically and traditionally,
0:39:49 > 0:39:55have been thought of as unstable, volatile, uncontrollable.
0:39:55 > 0:40:00What happens is that they are supposed to, post-menopause, do good deeds,
0:40:00 > 0:40:07do charity, to become serene, to get by on just the love of their families
0:40:07 > 0:40:09and the love of society.
0:40:09 > 0:40:12Generally keep quiet, not rock the boat,
0:40:12 > 0:40:15vanish. Just disappear and if you don't do that
0:40:15 > 0:40:17then you're troublesome and
0:40:17 > 0:40:20then you can be diagnosed with a immoral insanity or hysteria.
0:40:20 > 0:40:24Hysteria was a very big thing, only dying out in the early 20th century.
0:40:25 > 0:40:29The cliche of the older woman as mad, bad and dangerous to know
0:40:29 > 0:40:33is the comedy gift that just keeps on giving.
0:40:39 > 0:40:41- Dougal!- Hello.
0:40:43 > 0:40:47But uncontrollable rage is no joke.
0:40:47 > 0:40:50For Jackie, it's been horrendous.
0:40:50 > 0:40:53She was prescribed antidepressants for six months
0:40:53 > 0:40:54to try to help her cope
0:40:54 > 0:40:57but she didn't feel that was the best way for her.
0:40:57 > 0:41:01She's been trying to manage the effects of her menopause without
0:41:01 > 0:41:03medication for more than a year.
0:41:04 > 0:41:10It's like having an out of body experience where I'm watching and
0:41:10 > 0:41:13listening to myself ranting like a lunatic.
0:41:14 > 0:41:18Completely nuts and what I'm saying is irrational
0:41:18 > 0:41:24and the logical side of my brain is saying, "Shut up, you are being stupid," and I can't.
0:41:25 > 0:41:29So did you direct the attack at anybody in particular?
0:41:29 > 0:41:30My husband got it every time.
0:41:32 > 0:41:38And sometimes he'll poke fun at me a wee bit just to make me laugh
0:41:38 > 0:41:42and he actually said to me, he says, "It's not the menopause,
0:41:42 > 0:41:44"I've got another phrase for it," and I said, "What is it?"
0:41:45 > 0:41:50Me - No - Pause. He says, because see when you start,
0:41:50 > 0:41:53you don't know when to shut up.
0:41:55 > 0:41:57Full-on. You know,
0:41:57 > 0:42:01all those years ago women were locked up in lunatic asylums for it
0:42:01 > 0:42:05and I'm thinking, "Yep, that would probably be me."
0:42:05 > 0:42:07If that was a century ago, that would have probably been me.
0:42:07 > 0:42:11What, losing the temper, losing the rag, going into a rage?
0:42:11 > 0:42:12Absolute rage.
0:42:14 > 0:42:17And I've been making sandwiches with a knife in my hand and I've had to
0:42:17 > 0:42:19put the knife down and just walk away.
0:42:21 > 0:42:24How do you calm yourself down?
0:42:25 > 0:42:29Well, I was taught some breathing techniques.
0:42:29 > 0:42:34So I close my eyes, imagine this light round me,
0:42:34 > 0:42:38slow down my breathing and imagine either running water...
0:42:38 > 0:42:42I'm either at the side of a river or on the shore
0:42:42 > 0:42:45and then as my breathing slows down,
0:42:45 > 0:42:51I then lie down on the bed and carry that through for the next 10-15 minutes.
0:42:51 > 0:42:55Just concentrating on breathing slowly,
0:42:55 > 0:42:57deeply, in and out.
0:42:59 > 0:43:03Finding practical ways to cope with the symptoms of the menopause can be
0:43:03 > 0:43:04an uphill struggle.
0:43:05 > 0:43:12'Three teas? I invited some of the women I met in the course of making this film for afternoon tea.
0:43:13 > 0:43:17'And the chance to get a bit more information and support from Ruth Devlin,
0:43:17 > 0:43:21'who runs workshops for small groups of women.
0:43:21 > 0:43:25'She's also the Scottish ambassador for the British Menopause Society.'
0:43:25 > 0:43:27So do you take us through,
0:43:27 > 0:43:29do you now take us through different treatments for what happens?
0:43:29 > 0:43:31Yes, I will go through different treatments.
0:43:31 > 0:43:34- Great.- You'll have heard of vaginal atrophy being bandied around.
0:43:34 > 0:43:38Well, that just means that basically everything is thinning and wasting
0:43:38 > 0:43:42away down below. I've never talked about vaginas so much in all my life
0:43:42 > 0:43:44since taking this on.
0:43:44 > 0:43:46Very easily treatable.
0:43:46 > 0:43:51You can have the moisturising lubricants or you can have vaginal
0:43:51 > 0:43:55oestrogen. That is the safest way to take HRT.
0:43:55 > 0:43:58It is a tiny, tiny, tiny amount of oestrogen.
0:43:58 > 0:44:02It's extremely safe and it's also not systemic because it's localised,
0:44:02 > 0:44:04so it's not being processed through your liver,
0:44:04 > 0:44:08so it's the safest way that you can have it.
0:44:08 > 0:44:11You get something like this tiny little tablet in the end there which you
0:44:11 > 0:44:14insert. You can start off, if you've got bad symptoms,
0:44:14 > 0:44:17you can start off having it daily and then reduce it down
0:44:17 > 0:44:19to twice a week and then you might find
0:44:19 > 0:44:21that you just need it once a week.
0:44:21 > 0:44:22If you take oestrogen like that,
0:44:22 > 0:44:24that is a general good or is it too small a dose?
0:44:24 > 0:44:29The vaginal oestrogen is only treating your vaginal atrophy.
0:44:29 > 0:44:31- That isn't treating any of the other symptoms.- OK.
0:44:31 > 0:44:34- If you want to go...- This poor woman's having a hot flush.
0:44:34 > 0:44:38It always happens at the most inopportune times. Sorry.
0:44:38 > 0:44:41- Would you like some water? - I've got some here, it's OK.
0:44:43 > 0:44:48That one came from your head down. Explain to me what's happening.
0:44:48 > 0:44:50Right, it starts here.
0:44:51 > 0:44:53And as much as you try and put it off,
0:44:53 > 0:44:56you can't and I was getting hotter and hotter and hotter and I thought,
0:44:56 > 0:45:00typical. This always happens to me at the most inopportune times.
0:45:00 > 0:45:04- Can happen anywhere, can't it?- Yes. - It doesn't matter, you just proved it.
0:45:04 > 0:45:09CBT, cognitive behavioural therapy has definitely been proven
0:45:09 > 0:45:11to help with all your psychological symptoms,
0:45:11 > 0:45:16but also now you can train yourself to help manage your hot flushes
0:45:16 > 0:45:18and your night sweats as well.
0:45:18 > 0:45:22I don't get many hot flushes but sometimes they come on if I'm stressed
0:45:22 > 0:45:26with something or a train journey being late or about to miss a flight
0:45:26 > 0:45:28or something. That tends to bring them on.
0:45:28 > 0:45:32Sometimes they'll come on in the middle of a meeting at work
0:45:32 > 0:45:35and it's usually a meeting where you're predominantly surrounded by men.
0:45:35 > 0:45:38You should just be able to take a little fan.
0:45:38 > 0:45:40A rather lovely fan and fan yourself.
0:45:40 > 0:45:41That would be wonderful.
0:45:50 > 0:45:54It's one thing for women to talk to each other but symptoms that can
0:45:54 > 0:46:00affect a couple's physical relationship are often really tricky to tackle.
0:46:00 > 0:46:04Artists Minty and Nick have been together for almost 30 years.
0:46:07 > 0:46:09We don't have children and that's through choice.
0:46:09 > 0:46:11So for me, in a way,
0:46:11 > 0:46:14going through menopause isn't tied up with reproduction.
0:46:15 > 0:46:20When you were going through the menopause, what symptoms did you have?
0:46:20 > 0:46:24The big one was vaginal dryness and soreness
0:46:24 > 0:46:29and how that affected having vaginal sex,
0:46:29 > 0:46:30and that was a bit of a shock.
0:46:30 > 0:46:34Yeah, and was that gradual or did you, when you went through menopause,
0:46:34 > 0:46:37- was that quite quick?- It was quite quick actually.
0:46:37 > 0:46:39It was really quite quick.
0:46:39 > 0:46:42It seemed to go from being completely fine
0:46:42 > 0:46:47and everything in the garden was rosy, then, ooh, what's going on?
0:46:47 > 0:46:49This is actually sore, this is not...
0:46:49 > 0:46:51This is not comfortable.
0:46:51 > 0:46:53So what did you do about that?
0:46:55 > 0:46:59- Initially...- Initially, I suppose you kind of, you know,
0:46:59 > 0:47:03take a little bit of advice and suss out things that might help.
0:47:05 > 0:47:11- But that wasn't really...- It didn't really seem to make enough difference
0:47:11 > 0:47:18and the kind of faffing around with tubes of lube and stuff like that.
0:47:18 > 0:47:21Yeah, it was odd to find it not straightforward.
0:47:21 > 0:47:23- Yes.- But, I mean,
0:47:23 > 0:47:29it wasn't that difficult to start going, OK,
0:47:29 > 0:47:34how do we enjoy having sex but in a different way, or whatever?
0:47:34 > 0:47:37So without penetration, that's the key thing?
0:47:37 > 0:47:40- Yeah, without that.- Wasn't going to work.
0:47:40 > 0:47:43I mean, we often sort of talk about it as a bit more like adolescent sex,
0:47:43 > 0:47:45really, which a lot of fun, really.
0:47:45 > 0:47:47- Yeah.- Yep.
0:47:49 > 0:47:53And it's kind of, you know, it's a funny thing.
0:47:53 > 0:47:54Then you go, actually,
0:47:54 > 0:48:00but we think about sex as being just about vaginal penetrative sex and
0:48:00 > 0:48:01actually it's lots of things.
0:48:01 > 0:48:02But clearly,
0:48:02 > 0:48:05I mean it's wonderful because you have a relationship where you can
0:48:05 > 0:48:08talk about this stuff and you can deal with it together.
0:48:08 > 0:48:12Yeah, I think... There was a bit where I felt like...
0:48:12 > 0:48:14I was letting you down, I think.
0:48:14 > 0:48:18We don't always talk about everything immediately, it maybe took a week,
0:48:18 > 0:48:19a month or so, before...
0:48:19 > 0:48:24Or you said, I'm not sure which of us said, actually, you know,
0:48:24 > 0:48:29if this is just painful, let's just stop trying to do this and it's OK.
0:48:29 > 0:48:31I mean, there's other options.
0:48:35 > 0:48:39Nick and Minty were just so honest and giving and reassuring about the
0:48:39 > 0:48:43impact it's had on their relationship and how they've dealt with it.
0:48:43 > 0:48:45And it must be like that for lots of people.
0:48:54 > 0:48:57We tend to think of the menopause as something that usually happens to
0:48:57 > 0:48:59women in their 50s,
0:48:59 > 0:49:05but going through a natural menopause before the age of 45 is not uncommon
0:49:05 > 0:49:09and a tiny proportion of women will experience it at a very young age.
0:49:11 > 0:49:14It's a devastating diagnosis to be told.
0:49:14 > 0:49:17We've had lots of young women who'd been told, it can't be menopause,
0:49:17 > 0:49:19you're too young, but actually we are encouraging
0:49:19 > 0:49:24that investigations are carried out. So there is the fertility aspect,
0:49:24 > 0:49:27which is hugely important and, as I said, absolutely devastating,
0:49:27 > 0:49:31but there are also then these extra number of years of potentially being
0:49:31 > 0:49:32low on hormones.
0:49:35 > 0:49:37'Dealing with the health implications of the menopause
0:49:37 > 0:49:41'when you're extremely young is a lot to bear.
0:49:41 > 0:49:44'When it happened to Heather, she was still at school.'
0:49:45 > 0:49:48I was very young when I went through menopause.
0:49:49 > 0:49:52It was termed as premature ovarian failure.
0:49:52 > 0:49:55I was 14 and it was diagnosed at 16.
0:49:55 > 0:49:58And in those two years do you remember what life was like?
0:49:58 > 0:50:04When I was 13 I started to miss periods, so we went to the GP who had said,
0:50:04 > 0:50:07"You're still young, they're just settling down."
0:50:07 > 0:50:09So we just kind of forgot about it and, actually,
0:50:09 > 0:50:10I was quite pleased that they weren't there
0:50:10 > 0:50:13because they'd been so heavy and painful.
0:50:13 > 0:50:15But actually at school that must have been quite interesting
0:50:15 > 0:50:17because your friends were having periods and you weren't,
0:50:17 > 0:50:20so you are able to say, well, actually, I don't feel so bad.
0:50:20 > 0:50:21I don't feel so bad, exactly.
0:50:21 > 0:50:23I was doing my GCSEs,
0:50:23 > 0:50:26quite glad not to have periods but it was at the end of that,
0:50:26 > 0:50:29when I was 16, that we went back to the GP and said, "Look,
0:50:29 > 0:50:31"I think this needs to be looked into the bit further."
0:50:31 > 0:50:35And that's when I was referred to and an endocrinologist, who said,
0:50:35 > 0:50:38actually, you're no longer ovulating,
0:50:38 > 0:50:40you've had premature ovarian failure.
0:50:40 > 0:50:42But your mum was perimenopausal at that moment, no?
0:50:42 > 0:50:46She was in her early 40s, hadn't gone through the menopause,
0:50:46 > 0:50:50my grandmother had not long gone through the menopause,
0:50:50 > 0:50:54so it wasn't something that I'd ever really thought about.
0:50:54 > 0:50:57How did you and your mum talk about it?
0:50:57 > 0:51:01I think after we left the hospital there was that initial...aah
0:51:01 > 0:51:03..moment and I had a good cry.
0:51:03 > 0:51:05Always knew that I wanted to be a mum,
0:51:05 > 0:51:08and that was the only thing at first that was sort of sticking with me.
0:51:08 > 0:51:11This is going to be quite difficult to be a mum now.
0:51:11 > 0:51:13So when did you meet your husband?
0:51:13 > 0:51:15When I was 22.
0:51:15 > 0:51:18And he would have known from the beginning?
0:51:18 > 0:51:22Yes. About six weeks in, I knew, very early on,
0:51:22 > 0:51:26that he was the man for me, so I had to test at that point.
0:51:27 > 0:51:33It was a big part, I wouldn't want him down the line saying this is a deal-breaker for me,
0:51:33 > 0:51:36- so...- And the implications for you in terms of having a family were,
0:51:36 > 0:51:39obviously, huge. But you have taken steps.
0:51:39 > 0:51:42We have tried egg donation and IVF treatment
0:51:42 > 0:51:45and unfortunately it wasn't successful.
0:51:47 > 0:51:49It was quite a painful time.
0:51:49 > 0:51:51It was five years ago and we haven't tried since.
0:51:51 > 0:51:56And there is a part of me that doesn't want to get hurt again.
0:51:57 > 0:52:00At the moment, I'm over the weight limit to get treated,
0:52:00 > 0:52:04so I think a little part of me is thinking, well,
0:52:04 > 0:52:07I can't get the treatment, I can't get hurt again.
0:52:07 > 0:52:11So, there's a little bit that I need to work on with myself to do that.
0:52:11 > 0:52:14But it hasn't dulled my want to have children.
0:52:18 > 0:52:23Entering menopause at such a young age is extremely rare,
0:52:23 > 0:52:28but it can happen in your 20s or 30s and this has a massive effect on the
0:52:28 > 0:52:29chances of having children.
0:52:30 > 0:52:35But in the future, this may not always mean the end of a woman's fertility.
0:52:39 > 0:52:43In Edinburgh, Professor Evelyn Telfer and Dr Marie McLaughlin are
0:52:43 > 0:52:47collaborating with US scientists on ground-breaking research to determine
0:52:47 > 0:52:49the potential of our ovaries.
0:52:51 > 0:52:55The prevailing wisdom has been that woman are born with a finite supply
0:52:55 > 0:53:00of eggs. However, a controversial scientific paper was published
0:53:00 > 0:53:02in 2004 which challenged this thinking.
0:53:04 > 0:53:09The view now is that ever since the work of an American scientist at
0:53:09 > 0:53:12Harvard, he discovered a population of cells
0:53:12 > 0:53:18within the ovary that had the potential to form new eggs later in life
0:53:18 > 0:53:20and that was the work of John Tilly.
0:53:20 > 0:53:27And this really met the scientific community with surprise and...
0:53:27 > 0:53:30- Scepticism.- Scepticism, and I was one of the sceptics.
0:53:30 > 0:53:33I was really incredibly sceptical.
0:53:33 > 0:53:34He came to our lab.
0:53:34 > 0:53:39He brought the cells and we then saw what these cells were capable of,
0:53:39 > 0:53:44and we then thought, well, you know, there is something in this.
0:53:44 > 0:53:49The game changer was the cells that had the potential to form eggs.
0:53:49 > 0:53:53Now, that's different from them forming eggs throughout life.
0:53:53 > 0:53:57So, they may well be sitting there, dormant,
0:53:57 > 0:54:02but if they're given the opportunity of the correct environment they may
0:54:02 > 0:54:03well form new eggs.
0:54:04 > 0:54:09So, we then decided we're going to look to see if we can isolate them.
0:54:11 > 0:54:15These are cells that we have taken, we've taken a piece of human tissue,
0:54:15 > 0:54:17cut into very, very tiny pieces.
0:54:17 > 0:54:20We've dissociated using enzymes and filtered that,
0:54:20 > 0:54:24so essentially we have a single cell suspension.
0:54:24 > 0:54:29We've then used an anti-body to try and tease out the cells that have
0:54:29 > 0:54:32- the important molecular markers. - Potential?- Yes, that's right.
0:54:32 > 0:54:37The gem cells and then we've gotten these back and sorted them out and
0:54:37 > 0:54:41then grown them to a point where we think we can see cells that look
0:54:41 > 0:54:43as if they're developing into eggs.
0:54:43 > 0:54:46And to them we would then inject them into small pieces of tissue and
0:54:46 > 0:54:50watch and wait and see what happens.
0:54:50 > 0:54:54At this stage, we see our researchers finding out more about the ovary.
0:54:54 > 0:55:01We see it more in terms of say, alleviating infertility
0:55:01 > 0:55:05for particularly young girls who lose their eggs
0:55:05 > 0:55:09very early and that may well be through a genetic disorder,
0:55:09 > 0:55:10or chemotherapy.
0:55:10 > 0:55:13But I think we really need to get more,
0:55:13 > 0:55:18a greater understanding of how the ovary actually works,
0:55:18 > 0:55:23and then we can, you know, understand the process of menopause
0:55:23 > 0:55:26and how we view the ovary as well.
0:55:28 > 0:55:33The work that Professor Telfer and her team is doing is potentially
0:55:33 > 0:55:37transformative for all women who are, for whatever reason, infertile.
0:55:37 > 0:55:39But it's got something else going for it,
0:55:39 > 0:55:43it also means that the way we view the menopause may well be different
0:55:43 > 0:55:46because it may not be the end of a woman's child-bearing years
0:55:46 > 0:55:50and if that is the case, what is the impact that will have
0:55:50 > 0:55:52on the way we look at ageing?
0:55:54 > 0:55:58In years past, women have often been written off after a certain age,
0:55:58 > 0:56:01when work and child rearing are at an end.
0:56:01 > 0:56:03But in the early 21st century,
0:56:03 > 0:56:07when the average life expectancy for women is now 81,
0:56:07 > 0:56:11how can we best approach this next stage?
0:56:11 > 0:56:15I don't think many people have thought through that women will live
0:56:15 > 0:56:18probably a third of their life post menopausally,
0:56:20 > 0:56:26and so need to be absolutely at their best in terms of feeling well.
0:56:27 > 0:56:30The key thing I think is let's talk.
0:56:30 > 0:56:34Let's just talk menopause, so it is going to happen to all of us, so,
0:56:34 > 0:56:39it's a normal event, but we need to tackle it and be proactive about it.
0:56:43 > 0:56:48So, post menopause, women are still strong and vital,
0:56:48 > 0:56:51creative and capable.
0:56:51 > 0:56:52We are not in retreat.
0:56:54 > 0:56:57Instead of fearing this stage of life,
0:56:57 > 0:57:03the years after the menopause should be a positive, liberating time.
0:57:04 > 0:57:06I don't feel any less intelligent
0:57:06 > 0:57:10and, in fact, I think I'm probably more confident.
0:57:11 > 0:57:18I think I set out more positively about things because I don't,
0:57:18 > 0:57:20I don't know... I don't ever,
0:57:20 > 0:57:22like if I go into a meeting or anything,
0:57:22 > 0:57:28there's not that element of, oh, I wonder if I look all right? I don't have any of that any more.
0:57:28 > 0:57:33I feel much more positive and confident about my own abilities for things.
0:57:35 > 0:57:38In the making of this programme, I have met such lovely women,
0:57:38 > 0:57:42willingly sharing our stories with us and some of these stories are very
0:57:42 > 0:57:45different, all because they don't want other women to feel alone or to
0:57:45 > 0:57:48suffer in silence. Of course,
0:57:48 > 0:57:51some women will sail through the menopause and there'll always be women
0:57:51 > 0:57:54who put up with whatever the menopause throws at them.
0:57:54 > 0:57:56But we don't have to do that.
0:57:56 > 0:57:57Things are changing.
0:57:57 > 0:58:02I had no idea the extent and variety of symptoms, so, of course,
0:58:02 > 0:58:04women should have individualised care.
0:58:04 > 0:58:07And I certainly learned I need to take better care of myself,
0:58:07 > 0:58:10to do even more exercise, watch my alcohol intake,
0:58:10 > 0:58:15take vitamin D and now I may revisit taking HRT.
0:58:15 > 0:58:20The menopause, the 21st century shouldn't be a curse.
0:58:20 > 0:58:23It should be about stepping forward to embrace the next stage in our lives,
0:58:23 > 0:58:26not letting it hold us back, and in order to do that,
0:58:26 > 0:58:29we have to learn to be good to ourselves.