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A quick chat about the menopause

Posted 4 August 2015 12:00 AM by Sarah Rayner
Sarah Rayner

Sarah Rayner is the author of five novels including the international bestseller, One Moment, One Morning. As a novelist, Sarah is known for tackling difficult subjects such as bereavement, infertility and mental illness with empathy and insight, but her latest books are non-fiction. Here she talks to us about her latest publication: 'Making Friends with the Menopause: A clear, comforting guide to support you as your body changes’.

How did you come about the idea for this book and why did you pick the menopause as a topic?

It might seem unusual to write fiction and non-fiction but for me there’s a connection – my novels all deal with women’s issues. In terms of specific inspiration, Making Friends with the Menopause is closely related to my first non-fiction book, Making Friends with Anxiety, in which I draw on my own experience of anxiety disorder and recovery to provide help on managing worry and panic. Writing that led me to wonder if there might be a link between my own feelings of panic and my age – I was going through the menopause. Yet when I asked my GP, I was told it was ‘unlikely’ the two were connected. I got the same response from a psychiatrist. I decided to investigate further, and Making Friends with the Menopause was born. In it I explore a whole raft of symptoms – not just anxiety – which can be linked to our changing hormones.

Do you think women get enough support through the menopause? Do you think you knew enough about it?

No and no! Until I researched the book, I could have summed up my knowledge of ‘the change’ on the back of a rather small envelope and I'm sure I'm not alone in my ignorance. Talking about the menopause remains almost taboo, and the result is that this transition from one stage of our lives to another frequently remains shrouded in mystery until we find ourselves in the middle of it, floundering and unsure. It’s a contradiction: on one hand the menopause is one of the only experiences common to all women; on the other, it’s one of the least talked about! I hope that by helping others to understand the changes we go through, it will make the process less daunting and scary.

Do you feel that skin and hair ageing is a concern for women during and after the menopause or is this overshadowed by the more ‘serious’ symptoms and health implications?

Whilst I fully appreciate that symptoms such as hot flushes, night sweats and insomnia can have a significant impact on women’s health and cause great distress, I don’t think we should brush the other changes under the carpet. I know that for me and many of the women I've spoken to, looking good is closely bound up with self-esteem. If we feel our skin and hair appear unattractive, our confidence suffers and that can impact our relationships, our sex lives, our work and our mental health. It’s important to understand all the effects of the menopause and post menopause so we can deal with them in ways we find appropriate. Whether we’re talking about thinning hair, lines and wrinkles or mood swings, Knowledge is Power,’  as Angelina Jolie said!

“Whether we’re talking about thinning hair, lines and wrinkles or mood swings, ‘Knowledge is Power,’  as Angelina Jolie said!”

— Sarah Rayner

Your online community is very popular, why do you think this is?

It’s my experience that many women glean comfort and insight from discussing emotional and physical issues with one another. When my periods began, for instance, I recall telling my female school friends in an excited whisper that I’d ‘come on’ in the cloakroom, and discussions about boyfriends and losing our virginity were had with equal verve. The menopause is another of these life changes, and whilst it may not be talked about as freely as other subjects, I don’t believe this is because women don’t want to – it’s because we’re aware that others may react negatively and are self-conscious about ageing. In a way, the Facebook group replicates that school cloakroom: it is a ‘closed’ group so members have to be admitted by an Administrator, and once they’re ‘in’, only other members can see posts. This frees up members to ask about anything and everything that is worrying them. Unlike a doctor, who’s time-pressured, those who answer do so in their own time, and tend to draw from their own experience. This enables those with concerns to get the perspectives of women at different stages in the menopause and, because with menopausal symptoms there’s no ‘one size fits all’ in terms of treatment, this can be really useful. Say you’re experiencing horrible night sweats, for example, but you’re not able to take HRT because there’s a history of breast cancer in your family. The Making Friends with the Menopause Facebook Group is a great place to ask about alternatives and hear how other women have found them. And whilst all online groups have their drawbacks, so far we haven’t had any trolling or dodgy applicants, and if we did would block them.

What are the most common topics discussed or questions asked of you?

People don’t just ask me – they ask the whole group. That’s the joy of it. Rather than one woman’s inevitably subjective view, one gets several. Obviously that can be confusing, but on the whole I feel it’s a good thing, as it enables us to make informed decisions about our bodies. Let me give you an example that will hopefully make it clear to those women who aren't yet at that stage of life. Supposing, when you started menstruating, you had only asked one other young woman about her experience and she’d said she’d started her periods aged 12 and had them every 28 days, regular as clockwork. If you hadn't started yourself by then, or had but weren't regular, that conversation might well cause alarm. But if you were to ask a few young women and find out some began menstruating much later, and some had cycles that were longer or shorter, it would be very reassuring, wouldn't it? It’s for similar reasons that I feel it’s really important to talk about the menopause. Going through it alone it’s hard, if not impossible, to know what’s happening to us. Going through it with the support of others can make the journey much less fraught.

As for the most common subjects? There are a lot of midlife crisis cartoons posted, for a start. There is also chat about the weather – most members are British after all! But looking back over the last couple of days, I can see we have one member asking about bladder problems, another who’s expressing anxiety about a forthcoming hysteroscopy (a procedure to examine inside the uterus) and someone else asking what a hot flush feels like because she’s not sure if she’s having them or not. From these it’s easy to see why you might not want to share this on your normal Facebook page, and how helpful having the input of others can be.

What is the one piece of advice you would give to anyone who is struggling with symptoms and not sure where to turn?

Start with your GP. Here are a few tips to make sure you get the best from your appointment.

  1. Make sure you see the right doctor at your surgery. Do you want a male or female? Do you not want a specific doctor because of previous problems? Tell the receptionist. It may mean you have to wait a little longer to see the doctor of your choice, but usually menopausal symptoms are not emergencies and the symptoms have been there for some time.
  2. Make a list. You’re going to chat about your menopausal symptoms and worries. So write them down – all of them, but stick to the subject. If you start asking about a second issue you’re going to flummox the GP who has 10 minutes to try to support you with a highly complex problem and you’re not going to get the focus you need. Make another appointment if you have a second, unrelated problem.
  3. Tell the GP what you think may be going on. It helps establish your concerns around your symptoms and you can also be reassured if you are worried about something unnecessarily. However, if you think you may have something more serious then tell the doctor too. e.g. family histories of diseases – these vital clues help to build a picture.
  4. Make sure you allow the GP to ask you questions, even if they seem irrelevant. They are sifting through information to make sure nothing untoward is going on.
  5. Ask your GP what the options are. It may be doing nothing. It may be taking blood tests. It may be medication. It may be counselling. What do you expect to happen? Tell them what you are expecting. If your GP doesn't know what you’re hoping for then they may assume other ways forward.
  6. Make a follow up appointment, if needs be, to see how the changes have gone.

Remember, your doctor is there to support you. They can’t fix your life, but most GPs do aim to listen to your worries and try to provide guidance to the best of their abilities.

You have written both fiction and non-fiction. Which do you find most rewarding and what do you think is next for you as an author?

I find both rewarding in different ways. Fiction is harder to write as it comes from the gut, so takes much more out of me emotionally. On the other hand, stories involving characters allows readers to put themselves into another person’s shoes and experience events vicariously in a way non-fiction rarely allows. I've had letters saying my novels have helped readers going through IVF, depression, bereavement, all sorts, and making that connection means a great deal to me.

I also like writing non-fiction, however, and because both the books I've written – Making Friends with Anxiety and Making Friends with the Menopause - dovetail with social networking groups, I've found they've put me in direct contact with hundreds and hundreds of readers on a daily basis. My next book is another non-fiction one: Making Friends with Anxiety: A calming colouring book, which is illustrated by Jules Miller. So that’s another avenue – putting words and pictures together.

I suppose I’d have to conclude with a cliché – variety is the spice of life, and keeping my writing life varied keeps me inspired and interested. I hope my readers feel likewise, whichever of my books they choose – or don’t choose! – to read.

Making Friends with the Menopause: A clear, comforting guide to support you as your body changes‘Making Friends with the Menopause: A clear and comforting little book to guide you as your body changes’ is available from priced £1.99 (ebook) £6.99 (paperback).

For more information on Sarah, visit her website:

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