Christina - Interview 36

Age at interview: 52
Brief Outline: Christina's periods stopped at age 42 but she still suffers from hot flushes, sweats, poor memory, and mood swings. Unable to take HRT, she feels embarrassed and misunderstood at work. Weight gain and stress incontinence have eroded her confidence.
Background: Christina is an administrative assistant. She is single with an adult son. She started the menopause at age 40 and had her last period at 42. Ethnic background/nationality' White British.

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Christina first noticed menopausal changes at age 40 when her periods became irregular, finally stopping altogether at 42. Menopausal symptoms, however, including hot flushes, sweats, mood swings and poor memory, have continued to have an adverse effect on her work and quality of life.

Experiencing up to 20 hot flushes a day have not only caused Christina embarrassment at work with her ‘beetroot red’ appearance but have led to tensions with colleagues who fail to understand her need to open the window for fresh air. Poor memory has made it difficult to juggle the different aspects of Christina’s job and the demands of her [male] boss who ‘will want three things urgently in the same moment’. Trying to explain to him about the menopause has led to responses such as ‘too much information’ rather than understanding. Mood swings have also made life difficult both at work and at home' ‘I can be a screaming banshee one minute, in tears the next’. She describes the difficulty of trying to control her moods while ‘silently seething inside’.

Christina’s menopause experience has been complicated by other health factors, including thyroid, pernicious anaemia, and a genetic protein S deficiency which has led to an embolism on the lung. Despite her desire to go on HRT to relieve her symptoms, Christina accepts her GP’s refusal to prescribe because of the high risk of further blood clots. This condition also precludes her taking herbal remedies.

Weight gain has undermined Christina’s self-esteem in recent years and she has become a more insular person as a result. She describes her despair when trying on shorts for a holiday' ‘I burst into tears because none of them fit. And even a size sixteen didn’t fit’. She feels that the two stone she has put on could be attributed to a ‘mixture of thyroid and menopause’. Added to this, stress incontinence has also been a problem. Now, instead of worrying about sanitary towels, ‘it’s a life of worrying whether you’re needing Tena-lady supplies and things’. On the advice of her doctor, she has tried pelvic floor exercises without success. After ten years of menopausal symptoms, Christina just wants ‘her life back’ and to feel good about herself.

 

Christina didn’t seek help for her ongoing symptoms which have made her life miserable. If like Christina, you’re feeling low and your symptoms are getting you down, there are sources of help available. Please go and talk to your GP.

Christina was interviewed for Healthtalkonline in June 2009.

Christina went to her GP when she missed a period and had hot flushes at age 40. She had her last period at 42.

Christina went to her GP when she missed a period and had hot flushes at age 40. She had her last period at 42.

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I went after I’d missed my second month. I mean I wasn’t in a relationship or anything so I knew there was no way that there was going to be a pregnancy or anything like that and I went and said, “I’m just worried, I just want to make sure that everything’s okay.” And he said, “Well, you probably are going through the menopause. So we’ll leave it but if you have a period then come back.” But it wasn’t until I went back six months later because I was feeling really grotty and I’d had the sweats and everything else and I saw a female GP in our practice, and she said, “I’ll take your hormone test and find out what your hormone levels are and then we’ll confirm one way or another what’s happening before we look at your thyroid again.” And all this that and the other and the results came back that I was going through. And she said, “Unfortunately, there’s nothing we can do for you because of the problems, medical history you’ve got.” So she said, “You’ve got to grin and bear it.”

So you said you had a blood clotting problem. What was that?

Yeah, I have protein S deficiency. My mum had previously had several deep vein thromboses and embolisms on the lung so I had an embolism on my lung.

On a bad night Christina wakes up drenched, and has to get up and wash before trying to get back to sleep.

On a bad night Christina wakes up drenched, and has to get up and wash before trying to get back to sleep.

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The night sweats are terrible. It doesn’t matter whether I go to bed with nothing on and I sleep on my own, and I will still wake up absolutely drenched. And I can have a sheet over me and that will be wringing wet in the morning as well so it’s like having to go to sleep with towels. And I don’t have a plastic cover on my mattress because that tends to aggravate the situation so it’s just me having towels underneath me so you wake up with marks all over your back and everything else. But, even just going with no sheet you still have the sweats.

So this is even in winter you are sleeping with a sheet.

Yeah. Windows open and everything else so just trying to calm that down.

And how many times would you be woken up at night?

On a bad night at least three or four times and then having to go and get washed and try and dry off and everything else and change everything and then try and get back to sleep again.

So you actually change your clothing and your bedding do you?

Yeah, if I’m wearing like a cotton nightie. That all has to come off. The towels that are on top of the sheets have to come off and be changed again. And then I go to the other side of the bed and try and make sure that you’re sleeping on a dry patch. I mean I’m quite lucky because I am on my own and I don’t have to disturb anybody.

Christina's stress incontinence has affected her life.

Christina's stress incontinence has affected her life.

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I mean it is now a life without having to worry about sanitary towels or anything else.

But it’s now a life of worrying whether you’re needing Tena-lady supplies and things like that because of a weak bladder control and your pelvic floor goes.

Have you experienced that?

Yes, yeah especially with coughing. I think they call it stress incontinence. So it’s just another thing of ageing.

And that’s been happening since you’ve been going through the menopause?

Yes, yeah. More particularly the last four years, five years.

And is that during the day that happens?

Yeah. And especially when you’ve been to the toilet and then you get in the car and you’re going home and you’ve got your key in the door and you’re thinking, “I need the toilet quickly.” So it’s like drop everything and dive upstairs.

And are you getting up a lot in the night to go?

Not particularly during the night because I stop an intake of fluid. My last drink is probably about 8 o’clock at night and then I go to the loo. So then of course I’ve got the sweats and it’s horrible. It really is horrible.

Have you talked to your doctor about the stress incontinence?

Yeah, and he [said] do more pelvic floor to try and tighten up a little bit.

And has that helped?

Not really, no. I get some funny looks sometimes if I’m out. Especially in the car and you’re going whooer whooer. Nobody is supposed to know that you’re doing these but my face tells a different story.

Christina felt reassured to find that other women had similar problems with memory. She talks about her coping strategies at work.

Christina felt reassured to find that other women had similar problems with memory. She talks about her coping strategies at work.

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Yeah, I mean you forget, it’s normal to forget some things but if I started feeling, “Oh, hang on a minute.” And then people were saying, “Well, I told you that yesterday.” And I thought, “No, I’ve forgotten that.” And so now as I said, I have to write things down otherwise it goes in there and out there and it’s not maintaining in here. So I don’t know whether, and then you start thinking, “Oh God, I’m going senile.” Or it’s the start of something else and then sitting down and speaking to somebody else regarding their problems with the menopause you think, “Well, hang on a minute. That’s the same.” So I’m not going mad or anything else and then getting the little coping strategies on how to, like writing things down and making sure you’ve got your pad, and you write things. And especially with my boss, you’ll write three pages but then you turn the page and you forget what’s on there so you have to keep on going back and saying, today’s date is, and this is what I’ve got to achieve today.

Christina's health problems mean she can't use HRT to relieve her hot flushes and night sweats.

Christina's health problems mean she can't use HRT to relieve her hot flushes and night sweats.

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I have a problem with my blood which means I can’t take HRT so it was hot flushes, night sweats and not being able to take anything to help relieve this and being told, “Sorry, you’ve got to suffer it on your own.”

Oh, yes. I said, “I want HRT.” And he said, “You can’t have it. You cannot have it whatsoever.” And then I checked with my female GP when I went back for the test and she said, “You can’t.” She said, “We cannot give it to you.” She said, “There’s no low dose one or anything else.” She said, “You’re just going to have to go through it and hopefully it’ll reduce as you come through the other side.” And it hasn’t.

But I was told by my GP that it’s not that she wouldn’t prescribe HRT. I could have HRT as long as I knew what the risks were and she said that the risks overcome your need for HRT. She said, “It’s extremely serious.”

And you agreed with that.

I agreed with that because I want to be around for a few more years.

Christina didn't want her partner near her when she was having a hot sweat.

Christina didn't want her partner near her when she was having a hot sweat.

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Have you been in a relationship at all during this time?

I have and it’s been embarrassing and its like, “Will you go away please?”, “You’re making me too hot.” And in the end the relationship split up so I don’t know whether it was because he couldn’t handle me pushing him away and he’s feeling rejected about it, but I just couldn’t have anybody that close to me.

Did you talk about that?

I did but of course, he’s a man. And they don’t understand, it’s their feelings of rejection and, “No, can’t cope with this.” And, “You don’t want to be anywhere near me.” And everything else, so the understanding isn’t there about what we’re going through. What I’m going through.

Christina despairs at her weight gain.

Christina despairs at her weight gain.

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I’m two stone overweight and I mean some say, “Well, it’s a mixture of your thyroid and the menopause as well.” But the joking matter, trying to cope with it in a light-hearted way is everything’s going south. But it doesn’t help when having had an emergency c-section as well I’ve got an overhang of stomach and you just feel absolutely grotty. I’m going on holiday in five weeks time to Benidorm for five days and now I brought out my shorts yesterday to try on, which fitted me last year, and I don’t scoff and I’ve been on diets and I’m on the Wii fit and keeping occupied and get fit, and I burst into tears because none of them fit. And even a size sixteen didn’t fit. So it just seems to have expanded even more and not knowing the reason for and then you just say, “Oh well, it’s your time of life and you expand.” So it’s harder to lose. Put it that way.

Have you talked to the doctor about it?

I have. He said, “You’re within a limit. We’ve taken a cholesterol and the cholesterol’s okay.” But he said it’s just one of the problems that again he, it’s just one of the problems of menopause.

But more often than not they’ll say well, it’s a mixture and we can’t block things off or allocate blame to different things and plus as you get older you do gain weight because your metabolism is slowing down and everything else and I’m thinking, “I just want my life back and I want to feel good about myself.” And I’m going through all these hot flushes and night sweats and everything else. Night sweats, I would think I would lose buckets of weight and it doesn’t happen. You’ve still got your cellulite and your overhang and your lumpy bits and everything else and you call them your wobbly bits but they’re not very nice in a swimming costume. So you’ve gone then from a bikini to swimming costume, to swimming costume with tummy control. And breathe in girls but it’s mad. It really is mad. And it doesn’t help when people say, “Oh, you don’t look overweight.” Or anything else but I know. I said, “You don’t see me first thing in the morning looking in the mirror. I do.”

Christina's unpredictable moods have affected her relationship with her son.

Christina's unpredictable moods have affected her relationship with her son.

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Oh gosh, I can be a screaming banshee one minute, in tears the next and feeling that nobody understands or anything else, and I go very quiet one minute and then something can just trigger it, whether it be driving. Road rage, I’ve never had road rage before and people passing me, overdoing the speed limit, I’m going, “It’s supposed to be thirty miles an hour here.” And I’m thinking, “Nobody is listening to me.”

But my poor son has had to put up with a lot and one minute it’ll be okay and then he’ll just ask something totally different or change a routine or something like that and expect me to drop everything and then go and I’m getting very good because I’m now saying no to him whereas usually I’d have been off like a shot.

I can be extremely short with him and then apologise afterwards because it’s not his fault when he’s in the same room as me when I’m on one of my turns as they say. But friends are coping with it and they know when to leave me alone.

Is there a pattern at all to it or?

No, no it can be anything at all and I can be going quite merrily along my way and then somebody will say something and it will turn, and they’ll say, “Oh, she’s in one of her moods.” But it’s difficult because you can’t really say, “Look, I really am sorry but it’s to do with the menopause, postmenopause and it’s still going on.”

Christina's administrative role involves managing her boss' workload as well as her own. Lack of sleep makes it difficult to concentrate and prioritise tasks.

Christina's administrative role involves managing her boss' workload as well as her own. Lack of sleep makes it difficult to concentrate and prioritise tasks.

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So what impact do you think all that has on your work?

It does because you’re not focused, and you’re going in and your brain can be going all over the place and I’m trying to juggle seven different things i.e. today and I’m thinking, “Which one do I start first?” And it’s trying to put those in an order where I need to do this first, this is urgent and everything else can follow on behind but then I’ve got a boss who will want three things urgently in the same moment and it’s trying to juggle that as well. And all you want to say is, “Give me ten minutes on my own with no phones or anything else so I can focus on what I’m doing.” But the phones are going, you’ve got people in the office and everything else so it’s tiring.