Medicating Menopause
Women are often already self-medicating with booze long before seeing their GP about menopause symptoms. Swapping out the bottle of wine for hormone treatment is easier said than done.
A woman came to see me in a menopausal funk. Her mood was down, weight was up, energy absent, relationship tenuous, employment challenged, and the only friend she could count on was the bottle of wine she bought home each night. She came to see me because she didn’t know what to do next - her life felt like it was about to implode.
I listened with my heart as she described the stress and pain she was experiencing. I felt a stab of familiarity when she talked about disappearing into a glass or four of wine every night so that her day couldn’t find her for a while. The problem was that tomorrow found her even more fragile than the day before. She admitted drinking was one of her vices, but it was also one of her solutions in a life that felt short on them. Her husband told her that she would never be able to give up drinking.
It was difficult to pinpoint when it all got so bad. It’s as though the shine on life dulls until one day you look around and there is no sparkle anywhere. Feeling excited about anything becomes a thing of the past, and dragging yourself through each day and home to the bottle becomes a well-worn path. Meanwhile, havoc is wrought. Fat is laid down in uncomfortable places, and everything starts to hurt. Sleep is robbed and fatigue vies with wine for the title of closest companion.
Unfortunately, we formulate a pretty daunting list when she comes back after all of her tests; perimenopause, depression, harmful alcohol intake, obesity, high cholesterol, hypertension(high blood pressure), impaired liver function, and probably early diabetes. Fuck.
It took a decade of accumulation to get to this point, and it will take grit and determination to turn things around, but it is possible to undo the tangle. Alcohol is the first thing we talked about because it negatively impacts nearly every medical and health issue that has just been diagnosed. Significantly reducing or stopping drinking can affect a near-immediate improvement across all parameters, yet it is often the last thing people want to talk about, me and my own drinking included.
Alcohol is an addictive medication that doesn’t need a prescription, and it is EVERYWHERE. It has been harmfully socialized over the past century or two, but I am hopeful that a cultural shift is happening - going alcohol-free seems to be the new cool. I recently read Emma Gannon’s newsletter, The Hyphen, and came across the term sober-curious, which is such a kind and gentle way to examine a potential future without booze. When people tell me that they’re giving no alcohol a try at social events, my first response is, “oh, how cool!” My second is to give them a high-five, and the third is to hide the pang of envy I feel that they’ve arrived somewhere I really want to get to.
Over the following year, I started my patient on blood pressure medicine, hormone treatment, and antidepressants. I encouraged her to exercise regularly and supported her with a weight loss plan. At every appointment, I asked her about her drinking. Everything we implemented helped correct the trajectory but never as much as when she had alcohol-free periods. Energy, mood, sleep, relationships, and work performance improved dramatically when alcohol was absent but deteriorated when booze was back in the fold.
Menopause is tricky enough with the potential to mess with the best part of our lives, but alcohol messes with our whole life if we let it. More women now talk and write about these topics and empower us to meet them head-on. Two excellent books on menopause by NZ writers were published this year and should be essential kit for all of us making or about to make the transition. Lotta Dann is another New Zealander empowering women by helping them to shake the hold that alcohol has on them.
Doctors are only human and try as we might to remain impartial and objective, we are not always successful. If someone comes to see us with a problem that we are also challenged by but aren’t ready to face, there is a risk it won’t get the attention it is due. To talk to my patient about her drinking when I knew full well I would be drinking the edge off my day when it ended wasn’t easy. I even removed ‘liver function’ from the blood test form my GP gave me once so that she wasn’t alerted to a potential alcohol problem, but it showed up in one of the cholesterol tests anyway. I've learned that trying to hide from problems doesn’t serve me.
Us women need to band together to inform, support, empower, and forgive each other. There is much work still to do in dissembling the patriarchy, raising good, good humans, and saving our planet, so the sooner we reclaim our power, the sooner we can do this. Menopause and alcohol are two potential stumbling blocks that can derail us if we aren’t fully informed - there is no time like now to start asking the questions.
I believe we can minimize our pain and struggle by sharing it, so I will leave you with a poem I wrote recently. Please feel free to do the same in the comments section; reflections, questions, or feedback heartfully received. Go well and strong sisters.
The Wrong Apothecary
Shaking the booze is like
trying to remove biddy-bids
from a rag dog’s hair,
always another reason
to douse the tangle
so it doesn’t hurt so much
when dragging it out,
a false economy all the same
the knot is still there tomorrow
even more of an effort
to be bothered to pull
at the offending claw
of nature or nurture,
whatever lined up to be
the problem or the excuse.
I'm doing a read of your back-issues Melissa. I'm alcohol free as I learned through years of hormonal havoc that it seriously messes with me. If you also manage a highly sensitive system and are menopausal, it's a lighter to the bonfire. The other contributing factor is the sense of fear and inadequacy that most women carry deep in their psyche and that, often unknowingly, contribute to the physical symptoms of menopause. Peeling back the layers of these emotions to root out their causes has made a fundamental difference to my experience of life. We're complex beings and I agree that sharing our journey and experiences will make us stronger.
I put the cork in the bottle 18 years ago. Whatever ailments befall me in my life, I feel insured and secure because of my sobriety. That feels better than any booze buzz, and there's zero hangover. I couldn't give two shits about how anyone judges me either, because I'm a grown feminist, and I do whatever I want!