The symptom that doesn't look like menopause

Drawing on a conversation with Claire Hattrick, menopause coach and author.

Ten years. Twelve consultants.

Along the way: fibromyalgia, Lyme disease, arthritis, a referral to a psychiatrist. At the worst of it she could not stand, sit or walk for any length of time, and got out of bed by crawling.

Nobody said the word hormones.

What finally changed it was her physiotherapist. She had crawled into his cubicle left elbow this week, having been the knee and the hip before that and asked him, half joking, whether she was dying and nobody was telling her. He had reached his limit. He walked her back up the road to her GP surgery and said it for her: I am not treating this lady any more, you need to look at hormones.

A physiotherapist got there before twelve consultants did.

Joint pain has a name now

Claire Hattrick is a menopause coach and author, and she went through early menopause at forty. When we spoke, she made a point that should be better known: musculoskeletal symptoms in this transition now have a name. Musculoskeletal Syndrome of Menopause.

More women experience joint and muscle symptoms than experience hot flushes.

Sit with that for a moment, and then consider what most menopause services are built to recognise.

The triage question

If a woman presents to your clinic with hot flushes, night sweats and irregular periods, nothing about her journey is difficult. Everyone involved knows what they are looking at.

The difficulty is the woman who presents with none of those.

Her knee hurts. Then her elbow. Then her hip. She is tired in a way that sleep does not fix, and she is slightly irritable about it, which means the conversation drifts towards mood. She has seen a rheumatologist, a physiotherapist, possibly an orthopaedic surgeon. Each of them has looked carefully at the joint in front of them.

Nobody has looked at the pattern.

What this means for a clinic

Where do your referrals actually come from? Claire's route in was a physiotherapist who ran out of patience. Musculoskeletal clinicians, dentists, ophthalmologists and audiologists see these women early and often, and most have never been given a reason to think hormones. That is a referral network almost nobody is building.

What does your intake ask? A symptom list built around vasomotor symptoms will find vasomotor patients. If joint pain, muscle aches, frozen shoulder and tendon problems are not on your form, the women experiencing them will not recognise themselves on it and will not book.

How does your website describe the problem? Someone searching "why do all my joints hurt at 46" is not searching for menopause care. She does not know that is what this is. If your site only speaks the language of someone who has already worked it out, she will not find you.

What do you do with the ones who arrive late? A woman who has spent years being investigated arrives differently. She is tired of explaining, half expecting not to be believed, and braced for another dead end. The first five minutes of that appointment are doing more work than the clinical content.

The business case, plainly

Every woman in that position is seeing someone. She is spending money, taking time off, attending appointments. The spend is happening.

It is going to the clinicians who are examining her joints one at a time.

The full conversation with Claire Hattrick is on the Wellness & Growth Journeys podcast: https://youtu.be/QXmK2yrF17E

Claire Hattrick is a menopause coach and educator, not a medical doctor. Her episode is general education and shared experience, not medical advice.