LAST UPDATE | 18 Oct 2022
THAT FEELING OF fire. It’s like some kind of comet travelling at a great pace throughout your body, which is burning hot.
It can be just a sudden feeling, and I imagine a bit like a man with an erection – you never know when it’s going to happen, there is no rhyme or reason to it, then suddenly you are on fire.
The most embarrassing things about it are: number one, the colour that it makes you go; and number two, that you just start sweating.
Some people get the ‘tache sweat, some people get the tit sweat – I mean, some people even get the crotch sweat. The crotch sweat is terrible. Why do we sweat in these places? This also stops women from wearing clothes that they want to wear for fear of sweat marks.
‘It’s not funny’
But I think the terrible, terrible thing about a hot flush is that when you’re having one, it just isn’t funny, and yet sometimes we kind of try to make an excuse about it and try to minimise it – ‘Ooo I’m just having a hot flush!’ – and people kind of joke about it.
They think they’re joking along with you but actually, it genuinely isn’t funny, because when it’s happening, all you can think about is what is happening in your body. You’re not thinking about the meeting, you’re not thinking about the thing you’ve just said (you can’t even remember the thing you just said because your face is on fire), you’re not thinking about the date that you’re on – you’re not thinking about anything except just trying to get through this immensely uncomfortable moment.
I have to say that starting HRT was an absolute game-changer in terms of night sweats, and I would like to think that most women if they’re taking HRT, would be able to get their hot flushes completely under control.
There is a new medicine that is coming out that can really help with hot flushes. This too will be a game-changer for so many women, especially for those for whom HRT is not an option because hot flushes really are debilitating.
And now for the science bit: why do hot flushes happen?
It’s thought that lack of oestrogen affects the hypothalamus, the part of the brain that helps regulate body temperature.
When this is disrupted, the brain can think the body is overheating which causes blood vessels close to the surface of our skin to dilate to try to cool us down. This gives us the hot flush.
In addition, our bodies try to cool us down by making us sweat. Food and drink can also trigger hot flushes, or make them worse, such as alcohol, spicy food and even smoking.
Cold flushes
Nope, believe me, you haven’t left the freezer door open.
The opposite of a hot flush is very possible. A cold flush is a sudden onset of shivering, chills and an icy cold feeling through the body.
A cold flush can immediately follow a hot flush or can occur in isolation.
Menopause rage: It’s scary, and mostly for the women it’s happening to
I am really not a shouty person, and as I’ve said before, there were moments in my perimenopause when I really behaved in a way that upset me, and my kids.
I think that for many of us – if we’re usually quite passive and aren’t shouty people and don’t normally blow a gasket – it’s very frightening when we suddenly Go.
These outbursts of rage for me, personally, often would just come out of nowhere and I’d go from nought to 60; something that normally wouldn’t bother me at all would just make me so angry. I would have to practise walking away and then coming back. It was scary.
It didn’t happen all the time; it would come and go. But sometimes it would break out, often while I was trying to get the kids into the car on the school run, and I would feel so bad and I would look at their little faces because they’d be thinking, Who is this? I hated myself, and I didn’t understand what was happening to me.
We have lives that are so crazy and so busy and look, there are plenty of reasons why we might seem stressed out. But moods aren’t always down to whatever job you do, or a tricky relationship, or trying to get the kids to school, or whatever you’ve got on your plate. Sometimes it is actually down to chemicals.
‘What’s happening to my periods?’
My cycle was literally 28 days, regular as clockwork. Then there were quite subtle changes, my periods would maybe last a day longer. So normally I’d be maybe three days, four days of bleeding, but then it became maybe four days and potentially a bit heavier.
I was a bit unsure of what was happening as I’d always been so absolutely on the button, the same thing every month. I didn’t really know why that was happening, but obviously, these changes are completely normal with perimenopause, because of all the hormone shifts.
‘Dry vag’ and other symptoms to do with our vaginas
This is a BIGGY, but it is so rarely talked about and it is SO ABSOLUTELY VITAL for us to talk about because it is a really, really common symptom of perimenopause and the menopause.
It is one that we do not talk about to each other because there is an embarrassment, there is an idea of, oh is that what’s causing it? or there’s probably nothing we can do about it, or maybe now that I can’t have babies my vagina’s just shut forever. But it’s NOT. And there’s NO reason why we can’t have lovely supple vulvas and vaginas for the rest of our lives. We just need to talk about the problem, because there is this really, really easy fix.
I didn’t have the crippling issues that many women have with dry vaginas – UTIs, problems with incontinence and things like that – but I absolutely had a problem with dry vagina when it came to wiping myself after going to the loo.
I just wasn’t lubricated enough and I would wipe myself and it would start slightly catching, because there was no natural lubricant for the loo paper to swipe over. So I began to get really sore and every time I went to the loo it would sting.
It was obviously the same for all areas of pleasure – self-pleasure and pleasure with my partner – that would also become painful. HRT completely sorted that out for me but I am not ruling out the fact that if something does change and I do need a little bit of extra help, I can get that sorted very easily.
So oestrogen, basically, keeps the tissues of our vulva and vagina nice and supple. But oestrogen decline can cause these tissues to become thinner, lose their lubrication and become more painful. So, as I just said, the result – going to the loo, sex, sitting down – can really HURT.
The wee question
The lack of oestrogen is also very tricky with our waterworks, leading to problems like stress incontinence, which I definitely have had – so that when you laugh or lift something heavy, wee comes out.
Wanting to wee a lot at night time was another issue, and this was the thing that mainly used to wake me up. So I would have broken sleep, for ages, which was unbelievably debilitating, because broken sleep means that you never get a proper night’s sleep, which is not good for your brain function either. Low oestrogen levels can also make you a lot more prone to urinary tract infections – and you know how horrible those feel.
So look, if this sounds familiar to you, and you need some help and advice right now, skip this bit and go straight to Chapter 8 of the book: The Dry Vagina Monologues. It covers everything you need to know about how to spot, treat and beat vaginal dryness and UTIs. Don’t worry: it really IS all going to be ok.
Sex drive M.I.A?
Oestrogen and testosterone are really important in terms of sexual function. During the perimenopause, when levels fluctuate, you may notice your libido take a nosedive.
You might not be as sensitive to touch or just not feel in the mood as often, and this can particularly be the case if you have surgical or medically-induced menopause (when your body goes into menopause because of medical treatment or surgery), because of the sharp decline in hormones.
And even if your mind’s saying, Yes, let’s do it! your body is saying NO. Vaginal dryness, as we talked about earlier, and symptoms like UTIs, can be a massive barrier to happy sex life. And other things like hot flushes or that tyre that we put on around our waists overnight: all of these things are TERRIBLE for our self-esteem, which in turn is terrible for our libido.
Let’s not forget how absolutely shattered we are, either, because we are up five times a night, weeing and sweating. And we have been on the go all day, with teenagers and kids, or a mad job – or all of it. Often when you’ve got little kids, especially babies, your libido takes a hit. But when you go through perimenopause your libido can wane and you don’t even really notice it – it happens quite slowly.
Before HRT, I felt that I’d changed so much physically, and I was SO tired from not sleeping. I was SO exhausted from waking up all those times during the night, that it really affected how I felt about my body, which in turn affected how I felt about sex.
Recently, I was talking to a mate going through the menopause. She’s been with her husband for years and always had a super-healthy sex life; it had been a huge part of their relationship.
She was so depressed because she felt that her libido had just disappeared, but her husband still had the same sex drive he’d always had, and he couldn’t understand why she didn’t want him anymore. He felt frustrated and rejected, unloved and confused. And she felt guilty because she was shattered and didn’t feel the same way as she used to and that was putting a huge strain on their relationship.
Brain fog, aka ‘did I say that already?’
It’s always quite hard to explain to somebody who isn’t going through perimenopause what brain fog means. We get to our mid-forties, or our early forties, or our late thirties, and we’ve lived quite a life.
Sometimes we’ve got young children, sometimes we’ve got careers, sometimes we’re organised members of society who help with charities. It doesn’t really matter, but by the time you’ve got to that age, generally speaking, you are quite on it. You are a valuable and productive member of society who is reliable, and when you are asked to do something, you turn up on time.
Brain fog, for me, was an absolute HORROR, because I am List Lady. I am super-organised. I am Madam Multi-tasker. And all of a sudden, I am literally just not turning up to a mate’s supper somewhere. Like, not even remembering. I’d forgotten to put it in my diary, I’m not at my friend’s supper, they all call me up and go, ‘Where are you?’ And they might have told me about it that morning, and I would have said to them, ‘Yes, I’ll see you tonight.’ And I would have forgotten after putting the phone down. That is what brain fog is.
If you are a relative or a loved one of somebody who is suffering with brain fog, it’s not their fault. It’s the hormones. You might look at them and go, ‘Really? You forgot that?’ Or, ‘Really? You didn’t remember the thing I told you this morning?’ Honestly: We. Don’t. Remember.
The way I combat that stress is that I try to bring in immense order. Now that I’ve forgotten so many events, my diary is a very complex place where I just literally write down everything. I keep lots of notes on my phone to help me remember things that I think I might forget.
I put in reminders a couple of days before somebody’s birthday, even if it’s normally a birthday that I would remember with ease every year. I try to keep my life relatively in order. Things like: I get up, I make my bed, I tidy my house because I feel like, ‘tidy house tidy mind’. These little things do help me.
One morning, I was sitting on the drive and I looked at some grass, and I was thinking, what is the name of a big patch of green stuff like that? It’s not grasses… I could remember the word grass, and I was thinking, but when there’s a lot of it together…? And I was thinking, wow, there’s nothing there. The page was completely blank. I thought, wow, this is really frightening, I don’t even know what that is. And about six hours later, I thought: lawn! That’s the word!
Anybody who’s reading this who has gone through that, don’t worry – it happens to all of us, and there are lots of things that you can do to help yourself. Brain fog is a kind of umbrella term for all those memory-related symptoms – forgetfulness, finding sentences, trailing off while you try to find the right word, or just feeling that your brain is stuck in first gear.
Davina McCall is a TV presenter, fitness expert, author and mother. She has campaigned for women in menopause in recent years and her new book, co-written with Dr Naomi Potter, ‘Menopausing’ is out now. More information here. Davina can be found on Instagram and Twitter.
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