Hormonal hotspots in the Guardian

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Having discussed it recently with my sister I came across this article on the Guardian about HRT and whether it really is the cure-all that has been so often claimed. It makes me cringe that the arguments seem to centre on the idea that the menopause is a disease that can be cured (or at least treated), and it reminds me so much of the medicalisation of childbirth (and how pissed off that made me), the way that pregnancy is also treated as an illness rather than a natural process that the human body has been going through since the dawn of time. Doctors just seemed to jump on the bandwagon with the pharmaceutical companies and there seems to be a distinct lack of decent studies into the long term health effects of taking hormone replacements. It is not about being all 'natural' and not wanting chemicals in my body, because plainly they have relieved the symptoms of millions of women, it's just about women being able to make properly informed consent to the treatment.

The lives and concerns of women-of-a-certain-age seem to be quite a hot topic these days, with all these celebrities/film stars reaching their middle years and 'proving' that women over 50 can still be sexy and attractive. The briefest follow-up perusal of the Guardian's website gave me a handful of other articles that expanded on this most vital of issues. Mariella Frostrup complains about the invisibility of women in our age group, while pointing out that we are healthier and wealthier than other age groups and our predecessors; I did love her comment, "the demographic we share our closest links to aren’t retirees but teenagers. Our hormones are raging, we’re interested in pleasing ourselves and the rest of the world be damned." Old age isn't what it used to be, the problem is that employers attitudes to ageing have not changed leaving us potentially facing mid-life redundancy. She claims dishearteningly that women struggle alone through menopause, too embarrassed to complain or discuss it with friends; not strictly true in my experience, though I did agree with her final quip, "Having our worth totted up in childbearing and rearing for millennia has caused us to view the close of that chapter as a mini death."

Jeanette Winterson takes an entirely different tack and goes on the offensive against HRT, with a lengthy exposé about her search for a more natural response to her menopausal symptoms. Thanks to private health care her doctor looks in closer detail at the other things that are going on in a menopausal body and she goes down the route of bio-identical hormones. Don't take her advice and google 'Premarin' if you are currently taking HRT, though she gives you a brief run-down of the worst of the gory details of its production. Thought provoking quote of the article, "Hormone treatment is not a miracle cure for misogyny. Society does not value older women, and often, older women do not value themselves."

Helen Walmsley-Johnson's article was more annoying (she writes a blog for the Guardian called Invisible Woman, about 'clothing, body image and getting older'). She lost me pretty much completely with her opening paragraph: 
"At the end of the Women Starting Over conference in London recently, delegates were handed a little bag of treats containing two magazines (one of which was Countryfile), a card from a meditation coach, two lots of 50+ multivitamins, two sorts of anti-wrinkle moisturiser, a pack of artificial sweetener and two condoms (one male and one female), plus one anonymous envelope containing "natural intimate moisturiser". Not a bad insight into what women entering, or emerging from, the menopause are expected to be interested in."
Well, no. I would not be interested in any of those things. While I did like her annoyance on the idea that women still need to feel that they have to be given 'permission', be it to love their bodies, to eat what they like or to engage in middle age sex, she lost me again with the assertion that we all grew up with 'a good deal of baggage' around sex. Having said that I agree we could all do with a little mojo reclamation. 

Lumps and Bumps

The anxieties of growing old really are multiple. Sometimes it feels as if every week you find a new bit of your body failing you. Most of them you manage to keep in proportion and even smile ruefully, but there are certain things that strike fear deep in your belly. Finding lumps is one of those things.
I followed a link on Facebook to this fabulous video aimed at raising awareness of the importance of checking your breasts regularly:

So I did. I found a lump. It was late on a Friday night and my first reaction was 'oh shit, the doctors will not be open for two whole days!' and I had a pretty sleepless night. The next day I calmed down and did some research and found some helpful advice that reassured me. It was very smooth and rounded so I rationalised that in all probability it was a cyst. However telling yourself that things will be fine only works up to a point. So deciding that I was going to continue to feel anxious without some medical reassurance I called the surgery on Tuesday morning and made an appointment. On the Friday after a week of sleepless nights, I saw a lovely doctor who was very calm and relaxed, and she agreed there was a lump (the other anxiety is thinking you are just being paranoid, since breasts are very lumpy things at the best of times.) However she said that because of my age, and because it can be difficult to tell just from the feel of the thing, she was going to refer me to the breast clinic down at Wythenshaw hospital. It should take less than a fortnight to get an appointment she said, and if I had not heard by then I should chase it up with the surgery.

The appointment letter arrived promptly and two weeks later I found myself waiting at the tram stop to travel down the new airport line, which very conveniently goes right past the hospital. I waited for a while and then I waited for a while more. Two trams to Didsbury went past but the tram to the airport still showed 9 minutes. Then it showed 20 minutes. We (myself and an old bloke also heading to the hospital) waited another half an hour and the time on the display seemed to go up and down somewhat randomly. After a 50 minute wait it finally arrived, by which time I was extremely stressed about being late for my appointment. But everyone at the Nightingale Centre could not have been more lovely. It is a what they call a one-stop-shop for breast care. First I saw a doctor who checked out the lump, and also agreed that it was probably a cyst. Then I went for a mammogram. I've seen pictures of women having it done but I had no idea. "The breast is placed on the X-ray machine and gently, but firmly, compressed with a clear plate. Two X-rays are taken of each breast at different angles. Most women find the procedure uncomfortable and can occasionally be painful." Breasts really are not designed to be crushed like that; uncomfortable has to be the understatement of the year. Then I went for an ultrasound and had the cyst drained with a needle. That made me nervous, but it did not hurt a bit. A tiny amount of dark greenish fluid was all that came out of it. The doctor said she was satisfied that there was nothing there to be worried about. The whole thing took only about an hour and a half. I came away very reassured.

Afraid of getting old

Random things pop up in life ... and on Facebook. Today on Bored Panda (a source of much procrastination) an entry appeared with the title 'Illustrator turns people's deepest and darkest fears into comics'. It is drawn by a guy called Fran Krause and available for perusal on his Tumblr. The one that really struck me as poignant amongst the silliness was this one. It says something quite existential about how we as humans feel about getting and being old. Old age is something unknown and unknowable by the young, and they fear it, seeing it as something terrible. It is somehow reassuring to find that as you approach, it doesn't seem half so bad as you feared.

Menopause Cake

I have several very wholesome friends who tend towards the herbal tea/soya milk/vegetarian/I-might-have-some-sugar-at-the-back-of-the-cupboard-somewhere school of thinking about the way they eat. While I do occasionally cook with lentils and last year we ate veggie for a month, I tend to avoid obsessiveness where my food is concerned. My sensible home cooked diet is well supplemented with jelly babies and chocolate (though I do buy Green and Blacks when I can afford it). But my generally level of feeling run down and lack of appetite made me perk up my ears when Jill (she of the lego fan) mentioned her 'Menopause Cake'. It started life as a 'Birth Cake' given by a friend after her first baby but really it is a substance designed to nourish the body at any demanding stage of life. I have adapted a little based on what I had in the cupboard.

Menopause Cake

4oz soya flour

4oz oats

4oz wheat flour

(Basically 12oz of dry ingredients, I used oatmeal for one part. I used porridge but you could use coarser oats to give more texture. Substitute others types of flour if you want gluten free.) (Edited 24th February: Also tried rye flakes for variation.)

4oz linseeds

2oz pumpkin seeds

2oz sesame seeds

2oz sunflower seeds

(Grind the seeds in a processor or coffee grinder. Again use any combination depending on your preference. You can leave them whole but they do digest better if ground.)

2oz flaked almonds (I missed these out as I did not have any, or add any kind of nuts you like)

8oz dried fruit (chop up bigger stuff like apricots, kitchen scissors work much better for this than a knife) (Edit 24th February: I have upped the fruit content to 1lb in subsequent bakings)

(Edit 6th September 2017 - I have recently discovered dried cranberries and crystallised ginger makes a wonderful combination)

Finely chopped stem ginger - optional but tasty

1/2 tsp ginger

1/2 tsp cinnamon

1/2 tsp nutmeg

(again go with personal taste on your flavourings)

15 fluid oz soya milk (I used about a pint of ordinary cows milk)

2-3 tablespoons of molasses

I also added 3 big tablespoons of honey as I felt there was not enough sweetness in it.

Put all the dry ingredients in a big bowl.

Heat the soya milk with the molasses just enough to melt it.

Pour the warm milk/molasses into the other ingredients and mix well.

Leave to absorb for 30 minutes to one hour - it will be quite sloppy and looks pretty disgusting but smells like Christmas cake mixture.

Spread the mixture in a deep baking tray lined with greaseproof paper.

Oven - Gas 5 190C or 375F

Jill's recipe said 1 hour+ but I only baked mine for about 50 minutes (I had to take it out as I was making a roast dinner at the same time and the veggies needed to go it.)

And what came out was pretty f***ing wonderful. I was anticipating something rather dry and earthy but it is moist and delicious. It is very dense and you can practically feel it doing you good. I cut it into little fingers but can easily eat two. I have been taking it to work with me.
Edit 19th March 2015
Most recent batch made with ground hazelnuts and glacé cherries.

But for our afternoon cup of tea I confess I still prefer a slice of this:

VVA and HRT

NAMS

While everyone else at knitting club was bemoaning the hot flushes and joking about Jill's piece of lego board that she carries in her bag to use as an emergency fan, I was feeling left out because my symptoms have been much less of a cause for mirth. The dreaded vulvovaginal atrophy is caused by the drop in oestrogen levels that results in a thinning of the tissues of the vagina (as shown in the fun illustration). The ph balance of the vagina is affected causing a reduction in the natural lubrication. The tissues become less stretchy and much more liable to damage and infection. It can also lead to frequent bladder infections and general dryness and discomfort. It was a nasty infection that had me calling the doctor a couple of weeks ago. I had a course of antibiotics prescribed over the phone but by the time I actually saw her the worst was over and she couldn't find anything. However she said that the skin looked very dry and she suggested I try an oestrogen cream that would help to repair any damage and restore the vaginal lining. Although she asked me if I had considered HRT she didn't actually say that the cream she prescribed was HRT; it was only because I read the leaflet in detail that I realised that it is considered a form of HRT. Because it is applied internally it just absorbs into the tissues there and does not have an impact on other menopause symptoms. I am reserving judgement at the moment as it says it can take several weeks for any improvement. As well as this drama my summer had been mostly taken up with two long periods that dragged on for weeks, so I am hoping for an uneventful autumn.

Mid-life Crisis

Life has pottered on through the summer, I've had my own version of a mid-life crisis and dyed my hair for the first time ever ... and no, not to cover up any grey, just for the hell of it. However I am totally in sympathy sometimes with the reaction of Eva in 'The Woman Who Went to Bed for a Year'. When you have spent half your life seeing to the needs of other people you can see the appeal of just retiring to bed and refusing to get up again. While the book was pretty dire it made me laugh quite a bit, including this lovely exchange between her weird genius twins:

" 'No,' said Brianne, 'tell me now.'
Brian Junior said, 'It's nothing much, but Dad rang and said that after we'd gone Mum went to bed wearing all her clothes, even her shoes, and she's still there.'
...
Brianne said, 'That's what happens to women when they get to be fifty. It's called the men-o-pause.'
'So what do they do?' Brian Junior asked.
'Oh, they go mad, shoplift, stab their husbands, go to bed for three days ... that kind of thing.'
Brian Junior said, 'Poor Mum. We'll phone her after the Fresher's Fair.'" (p.38)

Three year anniversary

Three years on from the original post that started this blog the moon is still waxing and waning along with my cycle. It has continued to be gloriously unpredictable; a nasty flood Christmas week was followed by long pauses and stop-start periods that couldn't decide if they were coming or going. The only other symptom appears to be a long term drop in my energy levels; I come home from work exhausted after what should really be just ordinary days. I begin to wonder how long this will go on and if there might be a 'normal' to get back to.

I had the interesting experience of discovering that a friend on Facebook who I went to school with (I mean 'is the same age as me') had her first baby at the beginning of May. Looking at the photo of her holding her tiny premature son was quite moving, it must be incredible to feel that you missed your chance, and then to have such a miracle. Having been broody for so many years I now cannot imagine having a newborn baby. I definitely feel glad not to be back at the beginning of the process of raising a family.

Instead I was being wild and reckless in Costa Rica.

 I think I could enjoy growing old disgracefully.