My Story

My menopause story starts at the age of 22 during childbirth when I suffered a third-degree perineal tear which left me with faecal incontinence. Two years later I had surgery to repair my anal sphincter muscle to improve my continence. I remember the distress I felt when the surgeon told me if this operation wasn’t successful the next step would be for me to have a colostomy or stoma. This surgery would involve me having an opening in my abdomen, where my colon would come through so I could poop into a bag to stop me from being incontinent. Thankfully my surgery worked and I had no more incontinence for 23 years.

Around the age of 44, I started to notice slight changes in my periods. A year later, my faecal incontinence came back. This started off being occasional but within six months I was being incontinent constantly. I initially tried to manage this by using anti-diarrhoea medication that I was buying from the pharmacy but this too quickly stopped working. I had no idea why these symptoms had returned and I was also struggling with the shame of it which stopped me from reaching out to my GP for help. At this time I was also feeling unwell but could not figure out what was going on for me.

As a charge nurse in mental health services, I was experienced in the treatment of depression and anxiety. Yet I was at a complete loss with the mood swings, anger rages and overwhelming anxiety I was having as these symptoms were not there all the time. I found myself using depression and anxiety rating assessments on myself desperate to find an answer for what was happening to me although I did not feel depressed and had never been an anxious person before. I had no energy and I stopped doing things like seeing friends and travelling which had always been important to me. I was not sleeping well and my concentration and memory were at times awful which was impacting me at work. I was putting this down to me being both stressed about my incontinence and having a demanding job but each day felt like a huge struggle. The vibe, energy, and joy I had for life was gone and I felt like I would never get it back again. 

There were times when I had thoughts about menopause but I dismissed these as I was only 46, was still having periods and was not having hot flushes. I eventually spoke with a friend in the UK about my struggles and she discussed that she had recently been watching a daytime TV programme where they had been discussing perimenopause. She encouraged me to start reading about this as she thought what was happening to me sounded similar to what had been discussed on this show. I had never heard of perimenopause before but as soon as I started reading about it I realised this was what was happening to me. At that time I wanted to be able to access treatment quickly so I put my name onto the wait list for a menopause clinic but it was 8 months before I could be seen.

Meanwhile, I was still battling my incontinence and eventually I reached a point where I accepted that I could not go on like this. I reached out to my GP, and she immediately referred me to a surgeon to discuss having a colostomy or stoma. Whilst waiting for this appointment I was doing lots of reading about menopause. I stumbled upon a research article about women who suffer third or fourth-degree childbirth perineal tears who have a recurrence of faecal incontinence in menopause due to declining hormone levels. For the first time, I had an answer about why my incontinence had returned and it was linked with menopause. The research showed that some women’s incontinence could be improved by using a specific combination of Hormone Replacement Therapy (HRT).  Armed with this article I go and speak with both the menopause specialist and my surgeon. I can honestly say that I feel so lucky that both were open-minded and willing to read the research article and to explore that what was happening to me was hormonal related to menopause. The result was that I was treated with HRT, outside of normal prescribing guidelines, and within 2 months I was fully continent again. 

I like to think of my menopause journey and path to wellness as being my own, unique jigsaw puzzle, with many different pieces. Each of my symptoms were different jigsaw pieces and in addition to these, I needed multiple, different treatments to support my completed puzzle of menopause wellness. I wish I could say that HRT sorted out all my menopause symptoms and made me feel fully well again, but it didn’t. It made me continent again and for that I will always be grateful. It also helped with some of my other symptoms, the mood swings, anxiety, itchy skin and because of my incontinence it is an essential part of my menopause treatment, and so it's an important piece in my menopause jigsaw puzzle. However, my journey to wellness has needed multiple other jigsaw pieces that are each of equal importance. This has included non-hormonal Menopause Cognitive Behaviour Therapy (CBT) combined with lifestyle and behavioural changes to both optimise my physical and mental health and well-being now and to support me to age well in the future. Today, I can honestly say that I feel well and enjoy life again. 

My journey has made me question how we as women access treatment and are supported in menopause. If with all my expertise as a senior nurse, I struggled to recognise menopause when it happened to me how much harder is it for other women? I realise now how lucky I was. Lucky I spoke with a friend in the UK who had watched a TV programme about perimenopause. Lucky that I delayed accessing help for my incontinence which would have seen me have a colostomy had I asked for help sooner. Lucky that I found that research article by chance during a web search and could read medical research papers. Lucky that I had open minded healthcare clinicians who were willing to try treatment that was out of the norm. Lucky that I have been able to implement behaviour and lifestyle changes to mitigate the high blood pressure and cholesterol levels that occurred within menopause which could have supported me to die early from a heart attack or stroke in the future. But luck is not something that any woman in menopause should need to rely upon.  

This is my story and here is Menopause and Wellness.

Monica