At 44 years old, Davina McCall started experiencing night sweats. She needed to get up for the loo two or three times every night and felt so sleep-deprived during the day, she couldn’t read the autocue at work.
She had no idea what was happening to her.
“I got such a bad hot flush in a makeup chair one day that I asked if the chair was heated,” she says. “They looked at me like I was really weird. I thought: ‘I’m 44, I’m too young, I can’t be going through the menopause, that happens to women in their 50s.’”
She “battled on” with fatigue, memory fog, low mood and anxiety for a year. At one point, she even wondered if she had early onset dementia. Eventually, her periods became very light and very, very long and the penny dropped: she’d entered the perimenopause.
Perimenopause is the name given to the transition women experience before the menopause. Technically, a woman has only entered the “menopause” when she’s had one year without periods. “Perimenopause” is run-up to that, when oestrogen in the body starts to decline. You start experiencing symptoms, but often still have periods – even if your monthly cycle has gone a bit awol.
The presenter, now 53, knew very little about perimenopause back then, and soon realised friends were equally uninformed. Now, to help other women, she’s sharing her experience and busting myths in a new documentary: Davina McCall: Sex, Myths and The Menopause.
Perimenopause was a “tough experience” before she sought help, she says during a press conference ahead of of the show, and the scariest bit was the night sweats. “What was really horrible for me about getting night sweats, was that I’m a recovering addict,” she says. “So it took me back to being sick and trying to recover from addiction.”
“It took me back to being sick and trying to recover from addiction.”
McCall hasn’t drank alcohol for 30 years and is even hesitant about taking over-the-counter painkillers after overcoming heroin addiction in her early 20s, so she was reluctant about menopause medication. But she eventually sought medical support when her symptoms threatened to end her career.
“I couldn’t work anymore and I was the breadwinner, I needed to make money and put food on the table, so I had to find a way of working,” she says. She visited a private gynaecologist, who prescribed hormone replacement therapy, or HRT. Within a week, she started to feel more like herself.
There are 13 million women in the UK who are either peri- or post-menopausal, but McCall’s story is actually quite unusual. Just one in 10 of these women take HRT, despite the fact HRT is the recommended treatment for dealing with symptoms. Most perimenopausal women don’t take HRT, sometimes out of choice, but also due to fear, or lack of support from their GP.
In the documentary, we meet Dr Nighat Arif, a family GP specialising in women’s health, and Dr Louise Newson, who runs the world’s largest private menopause clinic. Both say there’s a distinct lack of up-to-date menopause training for GPs, which results in a reluctance to prescribe HRT. Doctors also frequently misdiagnose menopause or prescribe antidepressants, they say, which won’t help depression if it’s linked to low oestrogen. Dr Newson sees at least two women each week who are suicidal without access to the correct medication.
A study from the 90s fuelled misconceptions about the safety of HRT among the medical community and public alike. The Women’s Health Initiative (WHI) was a US study of nearly 162,000 women launched in 1991. It identified a link between HRT, breast cancer and heart disease, which made newspaper headlines around the world. Overnight, one million British women stopped taking HRT.
But Dr Nick Paney, a gynaecologist and menopause specialist, says “the design of the study was far from ideal”. Women in it had an average age of 63, and they were as old as 79 when they were recruited. “We don’t routinely prescribe hormone therapy to women in that age group,” Dr Paney says in the show.
Re-analysis of the data showed it was only women in the 70-79 age group that had heart attack and breast cancer cases and even then, the increased risk wasn’t considered “statistically significant”.
More recent research indicates the breast cancer risk associated with HRT is far smaller than most people realise – it’s there, but drinking alcohol and being overweight both pose much higher risks. Studies also indicate HRT actually decreases the risk of osteoporosis, diabetes, dementia and bowel cancer.
It’s “a pandemic of injustice” that women aren’t given access to this information, says McCall, who’d like to see more NHS-funded menopause clinics throughout the country and better support for women in the workplace.
“These are our bodies and I get very, very angry when we can’t make a decision about our bodies,” she says. “If you choose not to do it, that’s absolutely fine, but if you choose not to go on HRT, at least make an informed decision.”
As well as demystifying HRT, the documentary aims to shatter misconceptions about sex after menopause – yes, you can still have an orgasm at 90 – plus remove the stigma surrounding some of the more taboo symptoms.
“These are our bodies and I get very, very angry when we can’t make a decision about our bodies.”
McCall meets a woman who suffered vaginal atrophy – a thinning, drying and inflammation of the vaginal wall that can occur when your body has less oestrogen. She describes sitting on a block of ice for hours, to cool the fire-like pain. The presenter recalls her own experience of the condition. “I had severe dryness – so severe, that when I tried to wipe myself after going to the loo it felt sore, so I had to dab,” she says. “I didn’t know what that was and I had no idea that it was part of being perimenopausal.”
It’s not easy to talk about this stuff, says McCall, and she was actually advised to keep schtum, in case it was seen as “ageing and a bit unsavoury”. But she thinks we have a responsibility to talk about perimenopause and menopause. Because if we don’t, who will?
“As women, and as parents of young girls, or sisters, or grandmothers, we owe it to our children and our children’s children and all of our friends to learn about HRT and menopause, because it’s going to hit all of us,” she says.
“I’m back to normal now, and in fact, I’m feeling better than I have done in years. I’m working hard, I’m at the top of my game, I feel like I’ve been reborn.”
Davina McCall: Sex, Myths and The Menopause is on Channel 4, Wednesday, May 12 at 9pm.