Menopause: Glasgow woman says GP training must improve

Holly Ritchie, a fit and healthy running enthusiast,  spent New Years Day in A&E after her heart started racing uncontrollably.

The then 38-year-old was unaware that she was perimenopausal, which can begin years before the menopause and palpitations are a common symptom.

She says she was dismissed as "too young" to be going through the menopause by her GP but it transpired her mother had also experienced it prematurely under the age of 45.

The Scottish Government this week published a new Women's Health Plan, which pledges to ensure women have equitable access to specialist menopause services.

It comes after a survey by the Scottish Women's Convention found that almost two thirds of women felt there was not enough information available at the beginning of their menopause and almost a quarter reported a poor experience when they went to their GP for help with symptoms including hot flushes and low mood.

"Menopause comes in so insidiously," said Ms Ritchie, now 41. "Symptoms come and go depending on your hormone levels and it's easy to put it down to something else.

"I started going through it but didn't know, so I was having all these symptoms like kidney infections and heart palpitations and anxiety.

"My mother was early but didn't tell me because no one spoke about it really then.

"I had spent New Year's Day 2020 in A&E because I thought I was taking a heart attack.

"They did an ECG and took blood tests and said I was fine and I later found out that heart issues are a symptom of low oestrogen. All it would have taken is for one person to ask 'how are your periods?'"

She returned to her GP who told her she was "a bit young" to be menopausal but the former BBC employee insisted on blood tests, which confirmed she was in the transition phase.

Ms Ritchie, who is married with an eight-year-old daughter and lives in Glasgow's Southside said she is now at a place where her symptoms are well controlled, after being prescribed hormone replacement therapy.

She says she had "no concerns" about using HRT after doing her own research and advises women to watch the recent Channel Four documentary by TV presenter Davina McColl if they are worried.

"There is more chance of me getting cancer from drinking a glass of wine and I've been on the pill my whole life," said Ms Ritchie, who works for Disney. "It's a bit of a disgrace how women have been treated."

A study by the Universities of Nottingham and Oxford, published last year, suggests there is a lower increased risk of breast cancer associated with longer term HRT use, and more pronounced declines in risk once it has stopped.

Among those who use combined oestrogen-progesterone HRT between nine and 36 extra cases per 10,000 women years would be expected. 

The treatment helps protect bones and some studies have suggested it could offer a protective role for heart disease.

She says she was initially prescribed synthetic progesterone, which must be taken alongside oestrogen if women are still having periods to reduce cancer risks. The body identical form is considered safer but some women have reported being told they would have to pay for a prescription.

Ms Richie said she then "had to fight" to get the hormone testosterone, which can improve libido, mood, energy and concentration and can be especially beneficial in young women and those women who have had a surgical menopause

She said: "Women have more testosterone than oestrogen in our bodies which nobody tells you, so when your oestrogen drops, your testosterone drops too and that's what affects libido and energy.

"GPs won't prescribe it, so I had to wait for a referral to the Glasgow Menopause Clinic. 

"I used to run eight miles before work and when the menopause struck, I wasn't able to do it. I'm now back running again."

She says she is also, now sleeping better than she has for years after starting to take CBD drops at bedtime.

She uses a product by Nutrivie, one of a number of firms which have reported positive testimonials from women who are using the substance to help manage symptoms including anxiety and sleep disruption.

Ms Richie said she has written to Nicola Sturgeon and the Health Secretary, Humza Yousaf to address what she describes as shortcomings in the new Women's Health Plan.

She said: "There is a menopause section that says women should be largely supported by their GPs but my point to them was that GPs don't have the knowledge so the foundations of this plan are shaky because you do not have the training in place. My GP knew very little."

Deputy Chief Medical Officer Nicola Steedman said: “Menopause is an important period of transition in women’s lives, but one that many of us know little about. 

"Improving the information available can bust the myths around menopause, helping women to be more confident about the options available to them

"Women who contributed to the Women’s Health Plan said what they wanted most from employers was flexibility to manage their own symptoms – such as being able to work from home, or change their hours if needed.

"The Plan absolutely recognises the importance of this."