Denise - Interview 38
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Denise describes herself as ‘blessed’ in terms of not experiencing any particularly bad menopause symptoms such as hot flushes and night sweats. Yet when she started to notice her periods getting lighter, mood swings, itchy skin, and hair loss around age 50 she consulted her GP who confirmed via a blood test that her hormones were ‘obviously lessening and decreasing’. On her doctor’s recommendation she first tried herbal remedies such as black cohosh, but ‘didn’t notice much difference at all’.
Although not initially keen to take HRT because of the risk of breast cancer, she finally agreed to a very low (one milligram) dose of Elleste Duet. However, although she felt fine for some time, the itchy skin and hair loss returned. Now on two milligrams, her symptoms have settled down. She is unsure how long she will take HRT but plans to discuss this with her doctor ‘in the next year or so’.
Denise suffers from the chronic inflammatory condition, ulcerative colitis. Over the past five years this has flared up several times requiring treatment with quite a high dose of steroids. She acknowledges that it is often difficult to determine whether symptoms such as hair loss, tiredness and joint pain are related to this or to the menopause. Moreover, she believes that the menopause often coincides with children ‘flying the nest’, caring for elderly parents, and a desire for change which can impact on feelings of well-being.
Since beginning the menopause, Denise has noticed a decrease in interest in sex. Recently she has been prescribed Vagifem, a hormone pessary to help alleviate symptoms of vaginal dryness. The pessaries, which she uses seven times a week initially, then twice a week, have also been successful in decreasing her frequent visits to the toilet.
For Denise, the menopause is the ‘beginning of another era’, with opportunities to explore new directions in life and work. As a menopausal women, she also joins what she describes as a ‘sisterhood of togetherness’ where women have the chance to be together and share their experiences.
Denise was interviewed for Healthtalkonline in June 2009.
Denise has never had a hot flush or night sweat. She feels blessed.
Denise has never had a hot flush or night sweat. She feels blessed.
Some women I speak to tell me about hot flushes and night sweats. You mentioned you hadn’t really had that.
Not a one, not a hot flush, not a night sweat. Yes, because I know some friends who are drenched etcetera. I have missed that out for whatever reason and as I say to be honest I don’t think the symptoms I’ve had have been particularly bad. They’re fairly general what probably a lot of the population has experienced and maybe some have experienced a lot more or more of the symptoms but I don’t honestly think mine have been too bad. But again, I can’t bench mark. Because I’ve nothing really to refer to but certainly no hot flushes to my great relief because I would normally have a high colour anyway and no night sweats at all.
Denise wakes at 3am and cannot get back to sleep, partly because she worries about her teenage sons.
Denise wakes at 3am and cannot get back to sleep, partly because she worries about her teenage sons.
No, I mean people say, “Oh having children ruins your sleep pattern.” I’m not sure if it’s true or not but I mean I can look with envy at my elder sons sleeping from whenever they go to bed to solidly through to whatever time they may choose to be woken up really. And I can remember sleeping right through to eight, nine, ten, eleven in the morning and I just wouldn’t know what that is now. And I would love to experience it again but don’t. I would tend to go to bed quite early because I’m very tired in the evenings probably because I’m awake then at three in the morning, and will lie there until four or five and then I would sleep a couple of hours quite happily, unfortunately have to get up for work about half six. But I can’t get out of that sleep pattern so whether it’s a case of getting older, whether it’s something to do with the menopause, I’m not sure of that but my sleep patterns certainly have been disrupted. And haven’t returned to what I would consider normal. And I would be a light sleeper as well, not helped of course by teenage boys coming in a little bit later than normal now and out on their own and driving.
Denise believes the vague nature of menopause symptoms can often make it difficult for doctors to know how to help.
Denise believes the vague nature of menopause symptoms can often make it difficult for doctors to know how to help.
No, he’s not too bad actually. He’s a very approachable person but there are some doctors in the practice that I would not have been so comfortable with. They’re perfectly able doctors, I have no doubt. I suppose you probably think, “Older ones are more sympathetic.” And that doesn’t really follow but it’s just a perception if you like, likewise as I say with a female doctor. As I say my own doctor was fine. But again he would rely on you telling him to a degree. I mean he’s seen it all I’m quite sure and he’s good enough to prompt in some circumstances but again it just depends I suspect on the person who’s trying to explain their symptoms especially when they’re so vague very often. And that’s part of the problem. It’s fine if you have a rash or something specific, “This has happened since last week, why?” But it’s much more difficult when it’s sort of very general you don’t feel right or something very, very vague. Which is part of my problem because to be honest I couldn’t give a specific date, time or indeed really specific symptoms. They were all, fairly general.
How comfortable were you when you went to him about the vaginal dryness?
Oh, okay about it in the end. It was factual, it’s something that happens so no, that was just factual. You just have to bite the bullet. I mean, okay, you don’t really relish it but it has to be done, it was not particularly comfortable so.
Denise outlines the pros and cons of a menopause clinic.
Denise outlines the pros and cons of a menopause clinic.
I suppose well, it’s a bit unfair because probably if there was a menopause clinic, that sounds terrible, and probably there is because if I went in and asked the practice nurse in one of these the information is probably there. But you tend not to until you’re called because it’s your smear test is due or you’re due an MOT if you like. I’m not sure if it would be worthwhile having one that’s actually entitled that, I mean it might put people off I’m not entirely sure. It’s like all these things I think if you want to ask or you’re desperate to know something and you ask the information will be there. It’s just for those who perhaps don’t want to put themselves out or feel awkward in asking that it’s not flagged specifically. It’s, and again a two edged sword, whether it’s entitled a menopause clinic or something would, “Oh, I’m not going in that door.” So there’s pros and cons for having it sort of specially.
Why do you think women wouldn’t go if you had a menopause clinic?
Well, some people wouldn’t. It wouldn’t worry me but some I would imagine wouldn’t like to sort of flout that they’re of that age. I mean I don’t know as I say it wouldn’t worry me in the least but that depends what door you’re going through I suppose from the big central area where everybody waits. I’m not sure what else you could call it though.
Why do you think they have that attitude towards it?
Well, I suppose some people don’t want to twig or to let on they’re of that age perhaps. I mean I’ve no idea. As I say, it wouldn’t fuss me in the slightest but I mean I presume some people also feel it’s the end of an era if you like, biologically. That’s it and maybe they don’t want to give off that signal. I don’t know.
Denise thought herbal remedies would be 'better than going on chemicals' but wonders what trials have been done.
Denise thought herbal remedies would be 'better than going on chemicals' but wonders what trials have been done.
Have you ever tried any of the over-the-counter remedies, herbal remedies for your symptoms?
My doctor actually did mention a couple, black cohosh I think and another couple which names I can’t remember which of course you try because you think, “Well, that’s great. That would be much better than going onto chemicals if you like or medication in that form”. I didn’t notice much difference at all perhaps because you need to take them a long time and again the symptoms being so general the easing of the symptoms is also so general you suddenly realise you’re maybe not being quite so tired, or it’s not like flicking a switch. So for those homeopathic remedies I really didn’t notice anything in particular.
It would be nice to know if there was maybe more homeopathic remedies that are successful if you like. Because I mean you read on the internet, I mean I know that they say that such and such is great and all the rest but I don’t know what trials have been done or not done. And maybe some of it’s in your mind as well but it would be quite nice to know. It was suggested to me to use them as a first resort which I thought was quite good. Sometimes the very fact of taking something is good in itself. But perhaps more work on that would be useful.
Denise's 'internal midlife crisis' coincided with the menopause.
Denise's 'internal midlife crisis' coincided with the menopause.
Also of course it coincides with the age when your children are very often late teens flying the nest or going to university and going through the money quite happily and various other things like that. It coincides very often with, if you’ve been in a job a long time, changes. All sorts of things perhaps, indeed you sort of have your internal midlife crisis and what is going on, am I here for the rest of my life or should I make a break and try something new? So there’s an awful lot always going on about these years.
As well as that elderly parents very often are on the scene, either looking after them or indeed dealing with the bereavements etcetera. So it’s an age where quite a lot can go on but you don’t realise it because of course everyone has to face it so you don’t think you’re any way different or whatever. But it takes its toll I guess and more so on some.
So are you looking after your elderly parents at the moment?
I myself just went through quite a few, well, a couple of quite bad years when my mother was very poorly with a form of dementia and then broke her hip. So was hospitalised and she eventually passed away a few years ago. At the same time my Godmother by marriage I suppose broke her hip so she has very few relatives so we were visiting her. And of course then my mother-in-law became poorly and became bedridden and just a few years one after the other. It happens I think about this age. They are all of an age. My own father is still alive but getting poorly and so it just goes on but as I say, many others are in the same boat.
Have you had caring responsibilities then? Did your mum live with you?
No, other than visiting or looking after her, taking meals or just trying to look after my father who really was the primary carer but holding down a job, looking after the kids who were doing exams at that time, visiting, it as I say, just takes time. Travelling about, even though they lived fairly close to us just worrying about them I suppose. And dealing with the doctors and the hospitals and trying to help my father but as I say, quite a lot are in the same boat.
Denise, whose lessened interest in sex coincided with her partner's midlife crisis, stresses the importance of good communication.
Denise, whose lessened interest in sex coincided with her partner's midlife crisis, stresses the importance of good communication.
So have you noticed any change in your interest in sex?
Well, definitely a decreased interest, yes. I would be quite happy, as they say, with hugs and cuddles but that’s about it, but no, definitely decreased. And again it’s one of those things you think, oh, dear. Do you go to the doctor for, what do you do? So it’s a difficult area because not everyone’s content or happy with talking about it.
And have you spoken to your husband about it at all?
We tend to laugh about it, yes. Yes, again it coincides very often with the partner’s midlife crisis as well regarding perhaps their work and things so I think as long as you talk, they perhaps look for different things so it’s something you just have to keep open the channels of communication, I presume it could be difficult.
So was your loss of interest related to the vaginal dryness?
No, I think that was just general yes, yes. That didn’t help, I have to say but no, that would be fairly general probably in the last couple of years, yes.