Vivienne O'Shea says she was met with laughter when describing mood swings, that she now knows were related to perimenopause, to a GP.
The 55-year-old from regional Victoria, who was living in Naarm/Melbourne at the time she first sought help, was also told nothing could be done about heavy bleeding that meant she had to change pads and tampons "half-hourly".
For migraines she was experiencing, Vivienne was recommended aspirin.
"Being told these things by doctors made me feel like the problem was with me and not a genuine cause for concern," she says.
While many people don't recognise symptoms like headaches, rage and "brain fog" as being related to perimenopause, frustratingly they're often missed by health professionals too.
We heard from several readers after publishing our story on perimenopause symptoms, who had come up against "gaslighting" and "lacking education" around perimenopause when seeking medical support.
We also heard that finding a doctor able to understand and help with symptoms can be a game changer — but how do you do that?
And just a heads up, the story mentions suicide.
Medical professionals lacking awareness
Professor Jayashri Kulkarni is the director of Monash University's Health Education Research Centre and an advocate for women's mental health during perimenopause.
She says there is a lack of awareness and education around perimenopause — the long transition into menopause — and that's not limited to the general public.
"Somehow we have got it in our heads that menopause is the province of old women — we need to get rid of that myth.
"Healthcare professionals are not looking for perimenopause in younger-aged women, and many are not looking for brain or mental health changes, only body changes.
"We have it stuck in our heads that menopause is hot flushes and the stopping of periods."
And because menopause symptoms are "very diverse"; happening in the brain and different parts of the body, it can be hard to get a broad picture, explains Professor Kulkarni.
"Medicine is still practised in silos," she says.
"If someone has a bit of a knee ache, and they're not sleeping well, and they're feeling tired, it's going to take a very complicated story to be able to connect those dots."
Professor Kulkarni says the fluctuation of symptoms also makes it trickier for women and health professionals to recognise.
"Symptoms can be here for a few weeks, then [you're] fine — and they can fluctuate in severity as well."
'Women's business' and 'hysteria'
When medical researcher Erin Morton noticed that her experience of depression and "massive brain fog" was cyclic, she began researching online.
"The executive dysfunction almost killed me sometimes … [I] couldn't remember anything, couldn't get my words out," she says.
"Every day for six months I dreamt of quitting [my job]. But I'd worked by butt off for 20 years."
Dr Morton was 42 at the time, and took what she'd learnt about the mental health symptoms of perimenopause — a process made easier by having access to medical studies — and presented it to her GP.
"I was incredibly lucky; I went in and said 'I get these symptoms, they seem to be cyclic, can I get on the [birth control] pill or MHT [menopausal hormone therapy]?'
"I got an instant 'sure, here you go' … we are pretty frank when you work in medical research."
But for the average woman, Dr Morton says there are barriers to finding help.
As well as the lacking of education and research in the medical arena, she says stigma around "women's business", symptoms being dismissed as "hysteria", and a study on HRT (now known as MHT) in 2002 that "destroyed" the treatment's reputation (which has since been refuted) are all hurdles.
She says little is known about perimenopause for white, cis, middle-income, metropolitan-based women — and even less for everyone else.
Dr Morton started MHT immediately after that initial appointment with her GP.
She was able to focus at work again, and get outside to exercise.
"Getting the benefits of being outside in nature, it became an upward spiral instead of a downward one."
She began speaking out about her experience, and quickly realised she was one of the lucky ones.
"Some charities have been set up for mothers who have committed suicide in perimenopause because it was never recognised," Dr Morton says.
"There are so many stories of women taking years and thousands of dollars, being sent from specialist to specialist with no-one cluing in on 'oh it could be this'."
After experiencing perimenopause and discovering how little we know about it, Dr Morton set up VITAL — a virtual perimenopause and menopause registry to improve community healthcare outcomes for people experience symptoms.
"I recognise as someone suffering from perimenopause, there is so much we don't know.
"We have so much to catch up on."
Finding the right care for perimenopause symptoms
Going into your GP armed with information can help cut to the chase when it comes to getting the right help, says Dr Morton.
She recommends Australasian Menopause Society, which has a lot of information on its website including a "find a doctor" tool and symptom check card.
Dr Morton says The Greene Scale, which provides a brief measure of menopause symptoms, is helpful when used alongside Meno-D — a scale to detect depression.
"Many people look at physical scale, and go 'I have one or two', then tick every box on Meno-D list."
Professor Kulkarni, who developed Meno-D, says there are dedicated menopause clinics with experts more "attuned" to joining the dots of diverse symptoms.
An online search will find them and many offer telehealth services.
This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.
