Anita Powell, 50 “I discovered what perimenopause was when I was probably going through it,” laughs Anita Powell. At 45, she had joint pain and insomnia; people told her she had become “extremely snappy” and at work she found it harder to empathise. “I’m a community worker, I’m supposed to like people!” Among her friends and colleagues, too, she noticed, “conversations were changing. I realised everything was changing: health, relationships, mental health …” A “nosy soul” who loves listening to people’s stories, Powell decided to investigate. She started a meet-up in her home town, Bedford. It became apparent, she says, that women she met had had dramatically different menopause experiences both in terms of treatment, but also attitudes. Many women of colour, she says, thought HRT wouldn’t be prescribed or work for them, and were exploring alternatives. There was also an expectation that they should be strong and uncomplaining. “People have less empathy, I feel, if a black woman is struggling.” That was Powell’s own experience: “People expect you to be more contained emotionally. When you open up and share your vulnerability, people ignore it and dismiss it. So then you don’t open up.” Powell’s GP refused her HRT because of hereditary high blood pressure, and her weight. Alternative strategies she could pursue were limited: “I’m a single mum, I’ve got two kids; I can’t afford to spend £40 on vitamin tablets. I can’t even afford a gym membership at the moment.” Managing her symptoms at home with diet and exercise is “a learning process”. She’s now self-employed, which gives her more flexibility to recover after bad nights, and take steps to limit stress and eat healthily. It’s crucial, she says, for women going through menopause to talk about it. Her group has expanded into the Menopause Alliance, which runs peer-led support groups, and she has started a podcast, Black Menopause and Beyond. “Find a sister, a friend, a work colleague – that’s where you find most of the information, and it can help with the mental health side: if we keep it all in, that enhances frustration and anxiety.” Jess Rad, 41 “I had this sense I was battling my own physiology. I didn’t understand what was happening in my own body,” says Jess Rad. She was only 37 when her menstrual cycle lengthened dramatically; other, debilitating symptoms followed. “I was having 10 hot flushes a day, I couldn’t remember how to spell the word ‘sock’, so much rage and irritability, I was having panic attacks …” Rad didn’t suspect perimenopause. She was still young and the symptoms and treatment of menopause were rarely discussed. Initial blood testing by her GP was inconclusive, before Covid halted everything. “I thought menopause was for older, white-haired women,” she says. Plus, life was overwhelming: she was home schooling two young children through the pandemic, her marriage was ending and she was building a new business. Rad’s own research made her push for further tests. Finally, a year after her first symptoms, her GP called, explaining she had premature ovarian insufficiency. Rad was due to chair an online discussion on hormones two hours later. She felt, she says, an almost “physical” shame at the thought of discussing her diagnosis with strangers, but her new project, The Womenhood, centred on exploring unspoken challenges. “How can I possibly not talk about it?” She did, kicking off conversations that are ongoing: “Something wonderful has come out of that catalyst.” Getting a premature menopause diagnosis was hugely positive for Rad, bringing much-needed answers and opening up treatment strategies. She started HRT. “It felt like a big decision, but I thought, I literally don’t know how I’m going to survive.” It helped, but so does cold-water swimming – “it restores your patience and tolerance”– and finding time in a packed, people-filled life for quiet introspection. Rad still sleeps poorly; she has night sweats and struggles with focus. She was recently diagnosed with ADHD, which has been illuminating: she thinks declining oestrogen exacerbated her concentration difficulties. Even so, these challenges can be potential “gifts in disguise”. Menopause, whenever it comes, can be an opportunity for women to focus on their own health and needs, she says. “We deserve to understand what’s happening in our bodies, in our minds.” Helen Juffs, 56 Helen Juffs didn’t think she was menopausal; she was expecting hot flushes, so when she started feeling confused and struggling at work, she feared it was early onset dementia. A surveyor and self-confessed “Excel queen”, Juffs says: “I’d look at a spreadsheet and think, I don’t know what that means.” Gradually more symptoms piled in, from acid reflux to weight loss and anxiety. Multiple trips to the GP left her feeling frustrated: “Nobody was putting two and two together.” Work was frustrating, too. Juffs’ patience wore thin; she found she was feeling furious. “I realise I was grieving on a very biological level,” she says. She was signed off work, then her research led her to an online menopause forum. It was helpful but, as a queer person, her confidence eroded by menopause, she didn’t feel fully at ease. “Everyone was talking about their husbands … I found I had to hide a bit.” Then one woman reached out privately: “She didn’t make a big deal of it … just ‘Ooh, we don’t really seem to fit in here, do we?’ That was amazing.” They’re still in touch. The group did help Juffs return to her GP armed with information and an HRT request. With some adjustments, they found a regime that worked. Her symptoms improved for a year, but then she suffered repeated urinary infections. That earlier research helped her identify them as a genitourinary syndrome of menopause (GSM) symptom, treatable with vaginal oestrogen. Juffs suspects the idea of menopause as a “one and done” time-limited event is unhelpful in understanding the myriad ways it can present long term. “Menopause is basically your body ageing, your hormones changing. You’re going to get all these symptoms over time.” Apart from HRT, yoga, a good diet, green tea and a career change have helped (Juffs now works as a reflexologist, end-of-life doula and health equity consultant). It was probably a mercy that her wife had an easier menopause: “She literally sailed through it,” Juffs laughs. But perhaps the most important thing, she thinks, is simply being heard. She sees this with her reflexology clients in menopause, too; when she listens as they describe their symptoms, “their whole bodies relax”. QueerMenopause.com