Lorna - Interview 08

Age at interview: 56

Brief Outline: Erratic periods at age 51 marked the start of the menopause for Lorna. Prescribed HRT 6 months later for severe hot flushes and night sweats accompanied by mood swings. A strong advocate of its benefits, Lorna plans to stay on HRT indefinitely.

Background: Lorna is a research manager. She is married with an adult son and stepdaughter. She started the menopause at age 51. Ethnic background/nationality' White British.

More about me...

Lorna first noticed menopausal changes at age 51, with her periods becoming less regular and lighter over 6 months. Then, suddenly, she was hit by hot flushes and severe night sweats which disrupted her sleep, and by increased premenstrual-type mood swings. In a senior position at work, and feeling tired, emotional and unworthy, Lorna felt ill-equipped to cope.

After just two weeks of symptoms and at her wits end, Lorna went to her GP and ‘demanded’ HRT. Her GP also did a FSH test which showed a decline in oestrogen levels and confirmed that she had started the menopause. Prescribed HRT in tablet form, Lorna noticed an immediate improvement in her symptoms and has now been on HRT for 4.5 years. She is a strong advocate of HRT, and plans to be on it until her retirement, fearing the return of symptoms if she comes off it earlier. She has some minor concerns about the health risks but believes that quality of life is paramount. She is concerned about the pressure on women to discontinue use of HRT after a number of years despite its benefits. She believes that many women miss out on the benefits of taking HRT because of adverse publicity associated with risks which, she believes, are quite slight. She says she would ‘kill’ anyone who tried to take her off HRT because it makes her feel so good, though anticipates that her long term use may become an issue with her GP in the future.

As a scientist working in the field of ageing, Lorna is well informed about the menopause and has consulted numerous academic studies. She has had strong support from her partner/husband, with whom she discussed aspects of the menopause and her decision to take HRT. The menopause is not, however, something which she has discussed with friends. She wonders why women do not talk to each other about it and suggests that the menopause is a taboo subject. Yet by masking their symptoms in public life, she believes women stop others being aware of the realities of the menopause.

For Lorna, the menopause is a complex physical and emotional transition. She feels it is not just about symptoms but about being a woman and about being older. While feeling more confident and in control, she senses a loss of femininity, characterised by an illogical ‘female womanly broody desire’ for children. 

Lorna was interviewed for Healthtalkonline in December 2008.

Lorna could 'set the clock' by her periods. When her periods became irregular she knew the menopause had started.

Menopause. I think the first time I was aware was about when I was about 51, 52. 51 probably. When my periods started to not be as regular as they were. Now you could set a clock by my periods. Okay. Twenty eight days more or less to the hour, almost to the minute I mean it was amazing, and just as regular as clockwork. And they started to not be the regular twenty eight. And there were delays, the period extended. So I knew that this was the start of the menopause because I’d been so incredibly regular for so many years.

Lorna describes her 'female womanly broody desire' to have children with her new partner. She felt she was losing 'part of being female'.

How do I feel about menopause? I think when it first started I thought about my femininity and I also thought about not being able to have kids. But I knew I couldn’t. When you get to our sort of age you’re not going to get pregnant anyway and your fertility goes down. But it felt very final and I think for me it was harder because I was in a new relationship and I’d been on my own for quite a while and I’d found this wonderful man who I loved to death and still do and I think always there’s that feeling with a new relationship that you want, that wouldn’t it have been nice if we could have had kids. Even though obviously we’re both in our fifties and the reality is that we don’t, of course we don’t, we’ve done that, been there, looking forward to the grandchildren. But there’s that sense of wanting to have that even though it’s unrealistic and the menopause for me was a feeling that part of being female was being taken away. Now that’s quite illogical because I’m still female and not being able to have children, does that mean that you’re not female? Of course it doesn’t. So there’s a sense of being quite illogical about all of this.

It’s not just symptoms, it’s not just PMT, it’s just not all of that, it’s about being a woman. It’s about being female, it’s about being older. And what does that mean. And there is a sense of loss, there is a sense of bereavement almost and perhaps that’s too strong, a sense of loss, perhaps I’ll leave it at that. Bereavement’s too much.

In what way is it a loss?

No children, no chance. Not that I want them logically but it’s an emotional want. It’s a broody want. Logic tells you something completely different, I’ve been there, done that, don’t want to do it again, look forward to the grandchildren but there’s a femininity, there’s a female womanly broody desire that I think is always there. Well certainly it’s always there in me. What is there a loss of? I think I’ve had moments of feeling a loss of being female, being feminine and it’s not logical but then emotions, feelings don’t have to be logical. It’s just that sense of not being as feminine, yes feminine I think is the right word.

In what way?

That perhaps associating the inner workings of the womb with being female is linked somehow in my mind. Logically well that’s not true but somehow or other on an emotional level, that all going and not working, disappearing feels like there’s part of my femininity has disappeared as well.

Lorna's experience of taking HRT has been 'incredibly positive'. It has transformed her life.

I was at my wits end. And when I went to see the GP I think I sort of went in there and said something along the lines of “I’m menopausal, and this, and this, and this, and this is happening to me. Do something about it, do something about it now. I’m not leaving this room until you do something about it”. So it was really quite that surprised me that the symptoms didn’t come on gradually. It was as though I’d hit a threshold of hormone level and suddenly all these things appeared. So the GP I think I must have come across as a little bonkers but I’m sure the GP was used to that. And he looked at me very kindly and said, “Well it certainly sounds like you’re perimenopausal”. And I went, “It does doesn’t it”, and he said, “Look, here, I’m going to put you on HRT if that’s what you want me to”. Sorry we actually discussed that because I said, “Get me HRT now”. And he said, “I’ll find you a low dose but I’ll take some blood and get your hormone levels done so you can, don’t start taking your pills until I’ve spoken with you”. So a few days later he spoke to me, “Guess what? Your hormone levels are coming down and you’re definitely perimenopausal and start taking your pills and come back and see me”. My experience, and I’ve been on HRT for the last four and a half years.

My experience of HRT has been incredibly positive. If you threatened to take my HRT away, I’d probably kill you. It’s that positive. It has transformed, I mean I feel great. I think that’s all I can really say. I feel like the woman I was and what’s great about it is that I don’t get premenstrual, so my life is much more evened out but it’s a great even out. Not a bad even out. I don’t feel any of the symptoms that you hear about with the menopause.

Lorna recommends that people should look for the original academic papers on menopause as well as general information.

I looked at the papers and I looked at the academic papers so I looked on PubMed on the on the internet. I looked up that, there’s a lot of information on the internet and that’s where I went but that’s where I go for my information anyway.

Any other websites that you particularly looked at or?

Oh, I can’t remember now. I’d warn people there are only a few decent places to get information. Medical information is appalling I think on the website because anybody can put any old rubbish up and it’s very very hard. Now there are a number of websites that are worth probably looking at but they’re academic papers and I would always recommend that people actually go to the sources of information, not somebody’s interpretation of that information. And I’m sorry but if you were a reasonably intelligent person you can read those academic papers. there’s nothing, it’s not rocket science for goodness sake, it’s all very straight forward. And that's actually possibly the most important thing is to go to the sources of the big studies. And then from the basic information not somebody’s interpretation of what it is. It’s all there.

Lorna advises women to think carefully about the latest research before going on HRT.

Now I don’t know who’s going to be listening to this, who will take any notice of this, but I’ve got friends who have been very scared by the stories in the press about HRT and actually suffering pretty horribly. And of course everybody needs to make up their own minds what they want to do and what risks they want to take, but do look carefully at the data. Not just what the press headlines say. Just look carefully at actually what the risks are and the increased risks and remember that as we age, we’re going to be more at risk to these sorts of cancers and conditions anyway. And life is about deciding what sort of risks you want to take but life is for living. Life is all about quality of life. It’s about enjoying life. It’s about living life to the full. I don’t know how long I’m going to live, hopefully I’m going to live a nice long life but I don’t know how long I’m going to live. But it’s about making sure that your quality of life is great.

We’re all in there together. You’re not alone. My advice would be to read up, get your facts known, decide whether you want to go on to HRT or not, quite clearly, quite early on, because if you’re going to go on then you need to be clear and you need to talk to your GP and you need to be clear that’s what you want to do and the only way you can be clear about that is by getting the facts and figures. Go and look up the studies. Make your own mind up. If you’re not going to go on HRT then you need all sorts of strategies to deal with it. So you need to get as much information again as you possibly can and talk to people.

Lorna has had much support from her husband. She wonders why women only mention the menopause and other consequences of ageing in 'hushed voices'.

And he [my partner] was absolutely superb. I cannot imagine what it must be like to have a partner that doesn’t do that or doesn’t relate to a woman who’s going through the menopause. And particularly if a woman has made a decision not to take HRT. You need so much support. I’m sure there are women out there who don’t have symptoms but I’d like to meet them to be honest with you, as I suspect they are few and far between. Now, you need support because you need somebody to tell you’re not going doolally apart from anything else.

Do you think women generally talk about these sorts of things?

No I don’t think so. I don’t think we do it as much as we should.

Why do you think we don’t?

It’s a very interesting question. Why don’t we women, we all know it’s coming, we all know round about what time it’s going to come and yet we mention it to one another almost in hushed voices. Why do we do that? A denial, it’s ageing, it’s, I think there’s a lot of conspiracy of silence around things that are uncomfortable anyway. I mean it’s like the conspiracy of silence around child birth, nobody actually tells you what it’s going to be like. Maybe we wouldn’t do it if we knew what it was really going to be like. But nobody bothers to tell you. We talk about everything else under the sun but they don’t actually tell you what it’s like in graphic terms to have a baby. And maybe there is this thing about we don’t like to give bad news or we don’t like to talk about things that are difficult, that we’re quite good at talking about how we feel about things I think these days women to women. But we don’t actually like to talk about the facts in that sort of way. I don’t know, I’m posturing, I have no evidence whatsoever for it, this is just my feeling. I don’t know why we don’t. We should, we really should. We should prepare ourselves and think about it and maybe you wouldn’t feel that you were going a bit doolally if we talked about it more with one another. If it was more openly talked about but there are so many taboo subjects in society. We don’t talk about that, we don’t talk about all sorts of things, we don’t talk about mental illness, we don’t talk about incontinence, we don’t talk about you name it. So many taboos.