Hello 3am

Image by Elf-Moondance from Pixabay

Earlier in the year I was chatting with a much younger work colleague about being awake at 3am. She was horrified that I seemed so casual about it until I assured her that 3am and I were old friends. I told her that a lot of the time it doesn’t bother me but sometimes stuff happens at 3am that keeps me awake for quite a long time and that can be a bit problematic the next day when people are expecting me to be functional. 

My journey to menopause was a little different from some people’s in that a lot of peri menopause symptoms were neatly masked by the contraceptive pill. In addition, I was quite young when I became menopausal (46 years old) so a lot of peri menopause symptoms that I experienced were not recognised as such. I was diagnosed with depression by my General Practitioner in my late thirties. He never even mentioned the possibility that it was probably linked to peri menopause. He probably didn’t even consider it. For several years I took the antidepressant Pristiq which is a desvenlafaxine class of drug and works by balancing the way your body processes serotonin. At the time when my GP diagnosed me an older friend who had experienced menopause told me that the symptoms I was experiencing could be related to pre or peri menopause. I didn’t talk to my GP about this and because he never mentioned it I just accepted his diagnosis. 

Insomnia has been a feature of my life for so long I can’t remember when it started. There seems to be this blur between having a toddler who didn’t sleep all night and dealing with young children who were ill during the night. Once the children were a bit older and sleeping better the snoring started. Mr Jones suffers from sleep apnoea. The snoring wasn’t loud but what was distressing was listening for his breathing to stop so I could jolt him back to breathing again. All in all I have had many reasons not to sleep well for so long that changes in sleep patterns as a result of peri- and post menopause were difficult to identify. 

While I was taking Pristiq I insomnia was an issue. If for whatever reason I was awake at 3am and didn’t go immediately back to sleep I would toss and turn sometimes for two or three hours only to doze for a short while before the alarm went at 5am to start the day. These sessions of wakefulness were made worse because I would worry the whole time because I knew I would feel like rubbish the next day. Sometimes I would make myself get up and do some kind of task, planning a lesson, ironing even writing. Often this would be enough to settle my mind and sleep would be easier. A lot of times I didn’t have the mental power to get myself out of a warm bed, dress and begin the task. These were the times I would toss and turn and ultimately be a mess the next day. Even while all this was happening I was blaming the depression. There was never any consideration that it could be my hormones.

After several years I went back to the same GP (doctor choice in my area is not great) and asked to change medication. Not because of the sleep but that is another story. He changed me to a medication called Valdoxan which works by mimicking the pattern of melatonin. Almost immediately I noticed some changes. I still had my eyes open to say hi to 3am regularly but it didn’t bother me as much as it used to. The small amount of sleep I sometimes got was enough. Around the same time I stopped taking the contraceptive pill and have not had a period since. A hormone screen confirmed that I am post- menopausal. 

Is the change in my sleeping due to the medication or the change in my hormones or a combination of both? Even if I stop taking this medication I will likely never know. My journey to menopause was unconventional and clouded by other issues. I was 46 when the GP confirmed my menopausal status which is quite young. This is probably why my doctor didn’t really discuss menopause as a contributor to my depression or sleep issues. Additionally, as I said earlier the area I live in is not populated well with affordable high quality doctors. Often a woman has to deal with being treated by a male doctor from a very conservative cultural background. This means discussing issues like reproductive health can be awkward. Mentioning unconventional lifestyles like non-monogamy can lead to some prejudice. 

It is unlikely that I will ever really be sure if my relationship with 3am is a result of a mental health condition or if it is related to menopause. I don’t know if my mental health condition is related to menopause. I don’t think I will ever get answers because the time for seeking them has passed. What I do know is that women sharing their stories in an honest open forum is probably the best way for us to learn about this issue and become empowered. By creating the menopause diaries Marie has given women a space to share their experiences and possibly learn from each other. 

The Menopause Diaries