Can you self-test for perimenopause?

Plus: a misogynistic term we need to retire, and good news on patches!

There’s good news in the local menoverse!

We’ve had confirmation from Pharmac that it has reconsidered its previous decision – made without consultation with actual women who would be affected by it – to fund only one brand of patch (Mylan) from December this year. The funding agency has reversed that decision, and happily has decided to continue to also fund Estradot patches as well as Mylan. This is good news for those women who have trouble with Mylan. I’ve talked to women who struggle with everything from the Mylan patch not sticking or being irritating, to the Mylan patch seeming like it does not work at all, compared to Estradot.

In acknowledging this, Pharmac has heard the voices of thousands of women and wisely decided to listen. It’s proof that we have power, ladies – and we can achieve good things with it.

You can read more about this decision here. (Note: this does not mean Estradot will be easier to get hold of! It’s still unfortunately in global short supply. Its maker can’t, apparently, get it together and make enough to meet demand).

Getting political

I am feeling energized, after our recent event at Parliament. I think it is time for some action on menopause at a higher level; time to get menopause factored into policy on – well - almost everything. Because it affects everything.

I’ve been invited by my fellow advocate Bronda Smith – who has had a couple of very successful meetings with politicians to make this happen – to join her in front of the Health Select Committee to talk about menopause next month. We have a whole 15 minutes to explain the impact of this transition and what we think should be done at legislative level. Easy, right?!

I got some inspiration last week from the UK Member of Parliament and all-around powerhouse, Carolyn Harris. Carolyn is the UK Trade envoy to NZ, and she also happens to be the MP who’s been instrumental in getting menopause front and centre in the UK parliament. She was responsible for our UK sisters getting their hormone therapy prescriptions funded annually; she has been at the forefront of the menopause at work conversation and she’s given speeches on the debating floor raising a ton of awareness. I think it’s fair to say she’s helped get the meno-party started in the UK, making it imho the world leaders in terms of awareness.

Carolyn talked over breakfast with a group of us working in the menopause space about her own experience, which was pretty rough in terms of the toll it took on mental health. Like many women she had no idea that her symptoms were hormone related; she had no awareness of menopause even when she was right in the middle of it.

One anecdote stood out to me. It’s emblematic of why I do what I do, and why I reckon we owe our daughters better when they get to their midlife transitions. Carolyn recalled her mother and aunties having a conversation about menopause once, in her earshot. But when they realized she was in the room, they promptly sent her out of the room – “This is not for you to hear”, they said. She was 36 at the time! What a shame she didn’t get to hear that conversation. And how important for us to talk about menopause, with everyone, every chance we get.

Can you self-test for perimenopause?

I noticed on my recent monthly trip to Chemist Warehouse to pick up my patches that there’s a whole section of DIY health tests. And look what’s lurking there amongst them: a Menopause test!

This falls firmly into the category of: marketing bullshit we do not need.

Why? A few reasons.

1. There are no tests for perimenopause. Not a blood test, not a saliva test and not a urine test like this one. No test is recommended by any of the global organisations specialising in the study of and treatment guidelines for menopause. You can’t test for perimenopause, because hormones in perimenopause do what they’re programmed to do: they fluctuate, and any test you take is only going to take a snapshot of a moment in time. This may or may not correlate with your symptoms, or with what is actually happening with your hormones overall.

2. These tests measure FSH. That’s Follicle Stimulating Hormone – which does what it says on the tin: stimulates the ovary so it releases an egg. In perimenopause FSH can shoot up, because it’s really trying to kick the ovaries into action. But it can also fluctuate wildly, as the cycles go haywire in perimenopause – something that’s perfectly normal and to be expected. An FSH level is not a reliable marker of perimenopause or menopause on its own.

3. The test can be misinterpreted – and that might be harmful. Using a test instead of keeping track of your symptoms and seeking proper medical advice could put you on the wrong track with your health. If you’re having symptoms you think relate to perimenopause, you need to get checked out. Your symptoms might be hormone-related – but they also might be due to something else. And the something else might be serious, and need addressing.

Bottom line: save that money, and put it into useful things like GP fees.

HRT, MHT… what’s the difference?

You might have heard of HRT being called in recent years by a different acronym: MHT. It seems like a subtle difference, and who cares, right? But the terminology has power, as Dr Jen Gunter explains in her excellent Substack post here. It’s well worth a read. It really resonated with me.

Menopause Hormone Therapy (MHT) and Hormone Therapy (HT) are the Terms Women Deserve

Dr Gunter explains that when we say ‘replacement’, we’re implying that the goal is to get the hormones to pre-menopausal levels, which is not the case. By extension, the implication is that this is somehow ideal; and by further extension, that the ideal state for a woman to be is pre-menopausal. Again, not the case, and playing into that dated, sexist idea that menopause is a deficiency or disease. To which I say: no way.

I know we all are used to saying HRT – but I’ve been changing what I say over the past year or so. I now say ‘hormone therapy’ instead of HRT, because this is a more accurate description of what the hormones we use to help our symptoms are actually doing. I encourage you to do the same, and let’s be the generation to retire the old, misogynistic term, HRT.

Until next time

NB