Brenda - Interview 25

Age at interview: 47

Brief Outline: Irregular and heavy periods marked the start of the menopause for Brenda. Loss of libido and the inability to carry out the Orthodox Jewish cultural practice 'mikvah' have led to tensions in her relationship. She has taken HRT to regulate her periods.

Background: Brenda is a part-time teacher. She is married with five children. She started the menopause at age 46. Ethnic background/nationality' White Orthodox Jewish.

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Brenda feels that she is only at the very beginning of her menopause story. Having always had a regular menstrual cycle, she first noticed her periods becoming irregular about a year ago as well as experiencing hot flushes at night which affected her sleep. Concerned at her extremely heavy ‘flooding the bed type periods’, Brenda consulted her GP who dismissed her problems with ‘if you’re over 40 anything can happen’. Unimpressed, Brenda saw a gynaecologist privately, had a small fibroid removed and a Mirena coil fitted, which has to some extent controlled the heavy bleeding.

Central to Brenda’s menopause story is the Orthodox Jewish cultural practice of ‘mikvah’. Couples do not sleep together for five days while a woman is having her period and for the following seven days. At the end of this time, the woman undergoes a ritual bath, known as ‘mikvah’, at which stage she is able to resume sexual relations with her husband. For a menopausal woman, however, irregular periods can interfere with the timing of this practice and consequently with her availability to her partner. In Brenda’s case, her inability to ‘make mikvah’ every month, combined with a loss of libido ‘I don’t want anything to do with sex’, has created friction in her marriage. Initially Brenda blamed herself for this, feeling that she had ‘failed the test’. Reading books on the menopause, however, has helped her understand that loss of interest in sex may be one of the changes associated with the menopausal transition. HRT (norethisterone) has helped regulate her cycle, although she is planning to come off this because of associated weight gain.

With five teenage children and ageing parents to care for, Brenda’s life is very busy. Yet while this has added to the stress of the menopause, she has never discussed it with girlfriends, nor heard anyone else in her community talk about it. Indeed she is unsure whether there is even a term for ‘menopause’ in Hebrew. Recently, however, she has begun to talk to her husband about the changes she is going through to help him understand more about the menopause.

Brenda believes that the menopause represents a transitional phase in her life. No longer enjoying the status associated with having children, she is yet to reach the stage of being ‘mother of the bride’ or grandmother. She feels that women her age are ‘a very invisible group of people’ with ‘very little voice’ in the community. Nevertheless, she looks forward to being postmenopausal when, freed from the need to ‘make mikvah’, she can enjoy a more relaxed relationship with her husband and assume new roles in the community.

Brenda was interviewed for Healthtalkonline in March 2009.

Brenda is taking on new responsibilities in the Orthodox Jewish community now that she's older

I think I’m in a very between time. In a few years time I’ll be marrying off kids and I’ll become like the mother of the bride and then the grandmother. At a certain stage I was having babies, everybody was coming to congratulate me on having babies. I’m doing none of that now, I’m just living with the teenagers, my goodness. I think it’s a very middle time, yes.

I think it’s, I don’t know I think you have to be happy at every stage you come to and I’ve learnt that in life. At a certain stage I had lots and lots of very small children and I thought I could go mad or I could really enjoy now and go down to their level and just be a mum right now. And now I feel that I’m able to take on stuff that is not only to do with the children and that’s making me, I suppose that’s making me feel quite, yeah, quite grown up.

And I’ve also joined the Hevra Kadisha which is the group that looks after bodies after people die, because I thought now I’m a grown up and I can deal with this. And so I’ve only gone once, I’ve only been called once but I could, I mean I’m not somebody who’s frightened of sickness or whatever. So I went and did that. And I think that’s something. And I discovered that it’s the only time I’ve ever sat in a room with a group of women for years and been the youngest one present.

Coming from an Orthodox Jewish background, Brenda had never heard anyone discuss the menopause...

And I am very pleased that I’ve read books now about the menopause and I see that it’s quite a normal thing because it’s very strange to have these feelings of I don’t want anything to do with sex and you think why, is it something to do with emotional changes. But I see now it’s not and it’s physical. I see also there are physical things you can do to help which is good news. And that sort of made me feel a bit better. I feel less uptight about it because of that.

So you feel it’s something that’s not discussed in Jewish communities?

Yes, it’s not discussed at all. No I don’t think so.

Why would that be?

I don’t know, it’s not something that I’ve ever heard people talk about openly. Firstly I don’t actually mix, I’m one of the older people working in the kindergarten, I had my children when I was slightly older so a lot of my fellow mothers are a bit younger than me. And so I don’t actually know that many people who are a little bit older than me who are just going through it. And I’m older than my sister so I’m ahead of her there. I don’t think it’s something that I’ve ever heard anybody discuss openly actually.

Brenda talks about the stresses she is under as she goes through the menopause

Can you tell me a little bit about the other things that are going on in life around this menopause transition?

Right, right. First we have major money problems. I began to think I was unable to cope with everything partly because of that. But now I see that that’s just an additional thing. And secondly I have children turning into teenagers who are refusing to continue in the same schools at which they are at present and one of them choosing to do a career which seems to me totally inappropriate. And so these things are very stressful and my parents are getting older and my mother’s just been hospitalised, all these things just are and I see that’s the way life is.

Brenda, an Orthodox Jewish woman, discusses how loss of interest in sex and her inability to...

Well the year is just about over if it’s not over and from being very regular I’ve become extremely irregular and sometimes I think “Oh well, a couple of months have passed and my periods are stopping” and then I suddenly get an incredibly heavy period and then another one a couple of weeks later. So it’s all very disorganised. And where the Orthodox Jewish side of things comes in is that we, the husband and wife, don’t sleep together when the woman’s having a period and then when the period finishes we have five days and then seven days and then the woman goes to the mikvah [a bath for purification of women after menstruation]. And in those five days and seven days we don’t touch and embrace. And therefore if one is having periods every 10 days one never gets to the mikvah and one never gets to touch and embrace. And in addition I’m finding sex is extremely not what I want to do. So in addition to not being able to, I don’t want to and so there’s been a lot of friction in our marriage because of that and actually it was very helpful when I began to read up about the menopause to discover, to start to sort out that some things were physical, not that I was going off my husband, I was going off my husband in one way but I began to realise that that’s quite a normal thing to do. And we’re having to work through that. But I would quite like to be period free and then I could like stop having all this worry about starting and stopping in between.

And I am very pleased that I’ve read books now about the menopause and I see that it’s quite a normal thing because it’s very strange to have these feelings of I don’t want anything to do with sex and you think why, is it something to do with emotional changes. But I see now it’s not and it’s physical. I see also there are physical things you can do to help which is good news. And that made me feel a bit better. I feel less uptight about it because of that.