My top tips on dealing with menopause: What worked for me

I’m Sima Davarian and I experienced the trauma and upset of a bowel cancer diagnosis back in September 2015. I was 34 at the time and was unexpectedly diagnosed with bowel cancer towards the end of my pregnancy. I went to the doctor because I had experienced bleeding from my bottom. Thankfully my GP referred me urgently and I was diagnosed. My daughter was delivered four weeks early by caesarian section to enable me to have further tests and begin treatment. Thankfully my treatment was successful, and I have been cancer free since.

Another pretty hideous factor to deal with at the time was the fact that part of my treatment plan, a short course of radiotherapy to the pelvis, would include early menopause as a side effect. I clearly remember telling my would-be oncologist and colorectal surgeon that I couldn’t go through with a caesarian section, major surgery and be left infertile and menopausal. It was too much! But I made the decision to have the short course of radiotherapy before my surgery (an abdominoperineal resection). It improved my chances of the cancer not returning. With a six-week-old daughter I couldn’t ignore this.

So how did I cope with that early menopause that I had been so horrified by?

My oncologist clearly told me that early menopause would be a side effect. However, he rather glibly said there would be some hot flushes about six weeks after radiotherapy and that my GP would prescribe hormone replacement therapy (HRT). It sounded very simple, but it was not! I wanted to share a few tips in case they are useful to others. This is from my perspective as a patient - I am not a medical professional.

My top tips:

1. Be aware of the whole range of symptoms that could affect you. Although hot flushes are cited as a classic sign of menopause, for me they were not a headline symptom. I felt stiff and about 150 years old. It was hard to distinguish between recovering from surgery and treatment and whether this was menopause.
2. Know that the symptoms could affect both your body and your mind. My emotions were quite heightened: sometimes I felt quite volatile and at other times I felt quite sad. I used meditation and breathing exercises to feel calmer. I also found it helpful to have counselling with a professional psychotherapist through the NHS.
3. Seek medical advice from your GP or your specialist. When I didn’t have classic hot flushes, I asked my GP for advice. She decided to do further blood tests to check my hormone levels. They did indicate I was menopausal. Having that conversation then enabled me to start HRT and discuss why it was beneficial for me because my understanding was limited. My GP was clear that at my age HRT was essential for bone and heart protection, as well as other benefits.
4. If you are prescribed HRT it can take time to get the right one for you and your body. There are lots of ways of administering HRT, like patches, creams, gels, tables, implants, as well as different types. I was initially taking a combined continuous form of oestrogen and progesterone. This didn’t work for me for a number of reasons, including debilitating dizzy spells, and over time and with my trusted healthcare professional I have found a regime that works for me.
5. Ensure you are getting the best advice. I live in an area with no NHS specialist menopause clinic, as it was sadly decommissioned. The only way I can see a GP who specialises in complex menopause is to pay for a private appointment. Unfortunately, this isn’t an option for everyone.
6. Seek out useful material - online, books and social media. For women experiencing early menopause I found the Daisy Network was a really helpful charity. They have a range of materials available online and a closed chat group on Facebook. I have recently enjoyed ‘Menopausing’ by Davina McCall with Dr Naomi Potter because of the range of women’s experiences shared there, along with medical insight. I found it useful to look at books focused on eating well during the menopause and to gain an understanding of how diet can support me. There’s lots of helpful material available.

I think a key point to remember is that there are many women experiencing menopause - whether related to cancer treatment or not, so you aren’t alone! My experience has been a journey where it has taken time to understand my symptoms and to get my HRT right.

• Read our 'Younger people with bowel cancer: a guide for the under 50s' booklet which has a section on fertility for women and men
• Find out more about Sima's experience of bowel cancer in our Real Life Stories