When Rebecca*, 46, found a lump in her breast three years ago, she was understandably concerned. “My automatic reaction was to think it was breast cancer,” she says. “No matter how much I tried to convince myself it would be fine, I couldn’t help thinking dark thoughts. I only told my husband and my mum, not my three children, and went for the mammogram by myself as I didn’t want to have them there and potentially get bad news.
“It was a gut-wrenching feeling sitting in the waiting room. After the mammogram they called me in for an ultrasound so I then was convinced they had found something. But thankfully it was ok and they said I have lumpy breast tissue. Since then I’ve had two other lumps and for the last one I had to have a biopsy.”
Around the same time, when Rebecca went to get her smear test, the nurse observed that she’d had several urine infections (UTISs). In fact, she’d had so many that she had taken six courses of antibiotics over one winter for the problem. But what the nurse said surprised her; Rebecca was told that her UTIs were most likely a symptom of menopause, as was the lumpy breast tissue.
Both were unusual manifestations of perimenopause (defined as the time from the start of menopausal symptoms to your last period), which can cause many atypical and little understood physical and mental symptoms.
Research in October, by sleep company Simba, found that even perimenopausal women struggle to name many symptoms, with just four named on average, while a quarter of women are experiencing 20 symptoms. The three best known symptoms were hot flushes (87 per cent) night sweats (85 per cent) and mood swings (75 per cent). While very few had heard of dizziness, dental problems or itchy skin.
Rebecca already thought she was quite clued up about menopause; as both her mother and grandmother experienced early onset, she was on the lookout for symptoms from her late thirties. “I was more attuned to what might happen because of my family history,” she says. “But my symptoms weren’t typical.” It is said there are more than 30 common symptoms of menopause, but these can vary and the NHS doesn’t even list the tender breasts, lumpy breast tissue and UTIs that Rebecca experienced on its symptoms page.
Dr Stella George, chief medical officer at global health service company Cigna Healthcare, says that the lack of wider knowledge about menopause is leading some women to mistake symptoms for better known but much more serious conditions, such as confusing sore breasts for cancer, or thinking that brain fog – a symptom that’s been reported to affect between 40 and 70 per cent of menopausal women – is a sign of early dementia.
“The symptoms of menopause can be vague and can mimic many other diseases,” says Dr George. “You can start blaming everything on other conditions…if there is tenderness in the breasts, you can worry it’s cancer, or you might think you have multiple sclerosis if you suffer from tingling in hands and feet, or even dementia because you are more forgetful.”
So what can we do? Dr George says: “Education and awareness is required to help promote greater understanding of some of the lesser-known symptoms and side effects. These can include dizziness and vertigo, heart issues and dental problems.”
Her advice focuses on workplace education, and says that British businesses stand to lose female talent from the workplace without proper care or support. (This summer the law firm Shakespeare Martineau found that almost half, 48 per cent, of women surveyed said they have lied about taking a sick day for menopausal symptoms).
“Educating women about this issue can help give peace of mind,” she says. “People often don’t want to talk about it themselves or be seen to be complaining, but this is a natural progression in every woman’s life. We need to normalise discussions about the menopause at all levels.”
Rebecca’s brain fog became so serious she worried she’d have to take time off from her work as a senior marketing executive. “I was in a very negative place,” she admits. “The memory loss, emptiness and dizziness left me feeling like I wasn’t in my own body. I was struggling to think straight and it made me upset and stressed. I felt in a vulnerable position and like I was jeopardising my career. ” Luckily, Rebecca was able to confide in her boss who had been through the menopause and was supportive.
As well as talking to those around her, Rebecca found that having the coil helped alleviate her symptoms, working as a sort of hormone replacement therapy (HRT). The NHS says the Mirena coil can be a way of giving progestogen over a period of time (as well as using oestrogen tablets, patches, gel or spray). As Rebecca approaches the end of a five-year coil cycle, she wonders if the symptoms of menopause will rear their head again as the effectiveness of the coil wears off.
For women who experience changes in their breasts, the NHS says it is vital women have them examined by a GP – and are regularly checking themselves for changes. But says breast pain is not usually a symptom of breast cancer.
*some names have been changed
Menopause symptoms you might mistake for something more serious– Numbness and tingling: loss of sensation in fingers and toes has been mixed up with multiple sclerosis
– Brain fog and forgetfulness: women worry they are experiencing early onset dementia
– Sore breasts: hormone level changes can lead to tender breast tissue and even lumps, which is confused with breast cancer
– Oral health: less mucus and fluid is produced during perimenopause, while jaw bone density can also be reduced, leading to dry mouth and loose teeth and increased risk of infection, which may be mistaken for mouth cancers
– Mental health: While increased anxiety and depression for menopausal women is real, it can be helped with treatment, and will not necessarily last past this period of life