DDN February 2022 February 2022 | Page 12








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It really reminded me of when I was using , and I really hated it ...’ This quote is from a 2020 TV interview with Davina McCall , who has been open about her history of addiction and has more recently put menopause in the public eye by sharing her experience of the symptoms associated with her own menopause . As we consider the impact of menopause on our colleagues , we can also improve our understanding of the possible impact of the menopause on our service users . According to the Office for Health Improvement and Disparities ( OHID ), across our sector 32 per cent of service users are women , and at WDP the largest segment of our women service users is the 35-54 age group , the period where someone is most likely to go through the menopause . How they experience the menopause and how they are supported during it could affect their recovery and mental health .

Perimenopausal women are twice as likely to have depressive symptoms or depression than premenopausal women and suicide rates in women of menopausal age have increased by 6 per cent in the last 20 years despite rates for older women ( 55 +) falling by 28 per cent across the same period . A difficult menopause can affect relationships and often occurs alongside other difficult life events or transitions such as an ‘ empty nest ’, divorce , or
In the second of a two-part article , Helen O ’ Connor talks about the importance of understanding the potential impact of the menopause on service users and how it can affect their recovery .
being a carer for elderly relatives . If a person ’ s GP does not identify the symptoms they are describing ( depression , anxiety , sleep issues , ‘ brain fog ’) as being related to the perimenopause , or offer appropriate treatment , that can also be confusing , frustrating , and upsetting .
The largest segment of our women service users is the 35-54 age group ... where someone is most likely to go through the menopause .
All of this indicates that the menopause is another factor to consider when assessing risk and developing care plans . This could include looking at how symptoms of the menopause , combined with active substance misuse , might lead to an increase in use as a way of managing moods , increase the risk of suicide or self-harm for some service users , or how menopause symptoms and concurrent life events might introduce an increased risk of relapse for service users who are abstinent .
Hannah Lidsell , an experienced coach and addiction specialist , also feels passionately about these issues . ‘ Using substances to try and manage debilitating menopausal symptoms , such as anxiety , heart palpitations and hot flushes , can actually exacerbate them ,’ she says . ‘ Once you throw in health inequalities , stigma , and unequal access to services , you have the perfect storm for increased use / lapse / relapse .’
In Merton , our service users can access a specialist menopause service . Esha Saha , consultant gynaecologist and lead for this service at St George ’ s NHS Trust , believes that ‘ asking for help or taking HRT ( hormone replacement therapy ) whilst undergoing the menopause transition should not be considered as a last resort ’. She recommends that women are encouraged to use tools such as the Menopause Quality of Life Scale ( MENQOL ) to prepare for a discussion with their GP about how their symptoms are affecting their quality of life . It allows them to both validate and score the severity of their symptoms which should be the springboard for a discussion with their GP about the best way to manage their menopause transition . If clinicians , keyworkers , and other professionals are more informed and confident about discussing the relationship between drug and alcohol use and menopause , they can educate service users and signpost them to this tool and other support available .
Fortunately , more information and resources that can improve our understanding of , and empathy for , how symptoms of the menopause transition might affect the individuals we work with are available than ever before . WDP has created a handout of these resources and is combining them with staff lunch and learn sessions to increase confidence about having discussions with service users . The Menopause Charity also offers training for healthcare professionals , some of which is free of charge .
Considering the impact and effects of the menopause should sit within a person-centred and holistic view of the individual . Experiences of menopause can vary – some will have a difficult time with lifechanging symptoms whilst others report menopause as being a time of personal growth , or simply a relief and freedom from painful periods .
As we commit to engaging more women into treatment at any age , WDP welcomes the creation of the cross-party Menopause Taskforce , alongside the development of the first ever Women ’ s Health Strategy for England , given our role in supporting people to improve their physical and mental wellbeing , through achieving recovery from problematic substance use .
Helen O ’ Connor is service manager at WDP Merton