Els (71): “If I had received better guidance back then, I might have suffered less”

For Els, her painful joints have been the most challenging. “My upper arms and shoulders have been hurting for thirty years. Of course, I don’t know if it’s solely due to menopause, but at the time, that possibility wasn’t even discussed. Doctors quickly attributed it to osteoarthritis. Now I think: if only someone had explained the role hormones can play in this.”

That realisation came much later. “When I talked about it with my daughter, I was shocked. I really thought: if I had known all this earlier, I probably would have made different choices.”

Els underwent a blood test and a bone scan, which led to the conclusion that she was in menopause and that her bone density appeared “good.” “And that was it,” she says. General practitioners mainly noted that she was ‘sturdily built,’ which might protect against cartilage loss.

With what we know now, Els sees several moments where additional investigation or referral could have been helpful:

• advice on nutrition, supplements (such as vitamin D, possibly calcium, collagen),
• guided exercise/physiotherapy focused on stability and strength,
• sleep optimisation (sleep hygiene, circadian rhythm) to promote recovery,
• more insight into her hormonal profile – although such extensive testing is usually only done when an abnormality is suspected,
• a more thorough assessment of her joint symptoms in relation to hormonal changes – something that typically only happens if there is a specific indication.

At the time, these options were often missing from standard care; there was little attention given to hormone therapy beyond the common “hot flushes triangle.” Often, the advice boiled down to: “Just grit your teeth.”

To this day, Els experiences joint pain, poor sleep, and occasional mental exhaustion. But she believes that with better care during her forties and fifties:

• her symptoms could have been addressed earlier and more effectively,
• the pain might have become less chronic,
• she could have learned coping strategies (such as targeted exercise, relaxation techniques, sleep optimisation),
• hormone therapy (if appropriate and well-supervised) might have played a role in alleviating some symptoms.

“You have more options than you think,” Els says now. She encourages women to take themselves seriously, even when symptoms initially seem ‘mild.’ Ask questions to your general practitioner or gynaecologist and keep asking: what can you do now, which treatments or therapies suit your situation? Also, make sure to get well-informed about hormone therapy and discuss the pros and cons with an expert, so you can make a choice that truly fits you.

Lifestyle can also make a big difference. Think about sufficient exercise, healthy nutrition, good sleep, and – if necessary – supplements. And if you experience persistent symptoms or feel that you’re not being taken seriously, seek help from a specialist. According to Els, this might be the most important message: stay curious, don’t be afraid to ask questions, and realise that good care can make a difference.

What if…

• Doctors at the time recognised that joint pain, sleep problems, and fatigue could occur in connection with menopause;
• Informing women about hormonal changes and their impact on body and mind was a standard part of conversations with women around forty;
• Early support through lifestyle interventions, physiotherapy, and sleep advice had been offered;
• Hormone therapy, if safely applicable, had been discussed as an option for those with bothersome symptoms;
• Better education for women: what you can do yourself, what your doctor can offer, where you can find help.

According to Els, good guidance at the time couldn’t have prevented everything, but it might have made a difference.

Els’ story shows how significant the difference can be between then and now. Although even today, things don’t always go well. By being better informed, asking questions, and standing up for yourself, you can contribute to better care for yourself and for the generation of women after you.

You might wonder: what should I pay attention to now, and what care is available? In this article, you’ll find more targeted information and practical tips: Menopause then and now.