Lisa Smith

my answer to menopause

I was diagnosed with perimenopause at 46. I'm 55 now. Turns out perimenopause was just the surface. Let me explain. Eight years of HRT patches that settled the flushes and did nothing for the belly. Eight years of being told to eat less and move more, the same advice, appointment after appointment. Eight years of a stomach that arrived seemingly overnight and never once moved, no matter what I did to it. I did everything they suggested. Five months of Slimming World, tracked every syn, lost two pounds the whole time. Stopped going the week the group leader asked if I was "being completely honest with myself." I hadn't gone over a single syn. I just couldn't face another Tuesday being weighed in front of a room for two pounds that weren't moving anyway. MyFitnessPal after that, under 1,300 calories most days for six months, half a stone off and straight back on over one bank holiday weekend. Gave it up when I realised I could account for every calorie going in and still have no idea what was actually happening to my body. I booked the jabs consultation that spring, told myself it was the last thing left to try. It worked, is the maddening part. Hunger went quiet within a fortnight. Lost the best part of a stone in six weeks, my face, my arms, barely anything off my middle. But it kept creeping up in price, and I remember standing in the kitchen doing the maths on what I was actually paying for it each month and thinking I genuinely couldn't justify it for the rest of eternity. I stopped that autumn. Within a month everything I'd lost was back, straight to the same place it had always sat. I went back to my GP. Bloods done. Thyroid, normal. Cortisol, one morning blood draw, normal. "Everything looks fine," she said. "This is just perimenopause. Keep at the diet and exercise, it'll come off eventually." She handed me a leaflet and told me to come back in three months. I believed her, mostly, because what else was there to believe. The tests were normal. Nobody was worried. So I told myself I just needed to try harder. I stood in front of the mirror most mornings doing the thing I hated, pulling my trousers up and holding my stomach in to get the button through. Some days I'd catch myself doing the calculation for the whole week, what I could and couldn't wear depending on how the waistband was sitting that morning. I turned down my sister's fiftieth because I couldn't face a restaurant table not knowing what my stomach would be doing by the main course. I looked fine in a loose jumper. Underneath it I felt like I was failing at something everyone else seemed to manage. I started to believe this was just what perimenopause was going to be for me, for good. Then my neighbour, a practice nurse, said something no GP ever had. We were talking over the fence one evening, and I mentioned the trousers thing, mostly just making conversation. "Have they actually looked at what your cortisol's doing through the day, or just the one morning reading?" I said just the one. Came back normal. "That tells you almost nothing," she said. "Cortisol's meant to rise in the morning to get you going, then fall through the day, properly low by evening. A single reading doesn't show you whether it's falling the way it should. It just shows you it exists." "So what's stopping mine falling?" "Oestrogen's part of what keeps that rhythm working. When it drops in perimenopause, cortisol can stop falling the way it should. It doesn't spike. It just stays a bit too high, most of the day, without you ever feeling it as anything dramatic. And cortisol that doesn't come down properly sends one instruction to the fat around your middle. Hold on. Don't let go." I stared at her. Eight years. Every test normal. HRT that fixed everything except this. Nobody had ever explained it that plainly. I went home and looked it up properly, not just skimming. Oestrogen's role in cortisol regulation is genuinely well established. It just isn't something that comes up in a ten minute appointment built around a normal blood test and a leaflet about portion sizes. I asked her the next day what I was actually meant to do about it, since it wasn't as if I could just go and get more oestrogen. She said there's a specific point on the finger connected to the parasympathetic nervous system, the part responsible for telling cortisol the day's actually over. Continuous pressure on it, she said, seemed to help bring that rhythm back down properly. She wore a small ring on that exact point herself, and mentioned it to a few patients when it felt relevant, off the record, since it isn't on the formulary. A ring, though. Everything else had been a prescription, an appointment, a blood test, something with a doctor's name on it. This was jewellery. I couldn't square how something that small was meant to do what patches and diets and months of jabs hadn't, when all three had genuinely worked at what they were actually meant to do. But she'd explained the actual problem first, properly, in a way that matched everything I'd been living with for eight years down to the letter, the mornings, the trousers, the tests that kept coming back normal. She wasn't trying to sell me anything either, just talking to a neighbour over a fence, mentioning what she wore herself. If she'd got the problem that exactly right, it seemed daft to assume she'd got the mechanism wrong. I went looking for it that evening. MenviaRing. Compared to eight years and however many hundred pounds, £28 felt like nothing to lose finding out. Worst case, I'd have my money back and a decent ring to show for it, the kind of thing you'd wear regardless. I ordered one that night. First couple of weeks, nothing I could point to. Woke up most mornings still doing the same trouser routine, still pulling everything in to get the button through. Told myself I'd wasted the money same as everything else, and nearly took it off more than once. By about week three, I noticed I'd gone a whole afternoon at my desk without once thinking about food. Didn't clock it happening. Just realised, looking back, that it had. Week five, I did my trousers up one morning and they went first try. No holding my breath. No pulling anything in. I stood there and did them up again just to check I hadn't imagined it. By week eight, I caught sight of myself properly in the mirror while getting dressed, not the quick glance I normally allowed myself, and just stood there for a second. The stomach that had sat there hard and round for two years wasn't just softer. It was down. Actually down. David noticed before I said a word. Came up behind me while I was doing the school run bags and put his hand flat on my stomach the way he used to, years ago, and said, "what's happened here then." I didn't tell him. Just said I didn't know, must be all the walking. I still have perimenopause. I always will, until I don't. But I didn't have the version of it I thought I did. I had eight years of a signal that had stopped arriving properly, and nobody had thought to mention that the test they'd run only ever checked whether cortisol existed, not whether it was doing its job. If you've been told this is just perimenopause. If you've had the one blood test that came back normal and been sent away with a leaflet. If you're doing the trouser calculation I used to do every single morning. There's a 30 day guarantee, so trying it never really felt like the risk everything else had been. It just looks like a ring. Nobody needs to know any different. It's below if you're curious.