Rhonda - Interview 32

Age at interview: 46

Brief Outline: For Rhonda, the onset of menopause followed a mastectomy for breast cancer and removal of both ovaries. Treated with tamoxifen, she is now taking Arimidex. Night sweats impact on her sleep but she is unable to take HRT.

Background: Rhonda is a training and development manager. She is married with no children. She had a premature menopause at age 37 following treatment for cancer. Ethnic background/nationality' White British.

More about me...

For Rhonda, the onset of menopause followed a mastectomy for breast cancer and removal of both ovaries. Treated with tamoxifen, she is now taking Arimidex. Night sweats impact on her sleep but she is unable to take HRT.
 
My story'
Diagnosed with breast cancer at age 37, Rhonda underwent a mastectomy followed by radiotherapy. Given the oestrogen-sensitive nature of her tumour, she had both ovaries removed, precipitating the onset of a premature menopause. Two months after her operation Rhonda started to experience hot flushes and sweats at night which disrupted her sleep, leaving her feeling tired and unable to concentrate clearly during the day.

Other symptoms have included vaginal dryness. Despite an understanding husband who is ‘very gentle’, she has found sexual intercourse, even with lubricants, painful. Smear tests have also been ‘absolutely uncomfortable’. An oestrogen cream prescribed by her doctor and applied internally for a month before the smear test has eased the discomfort. Despite her willingness to share this aspect of her experience, she feels that vaginal dryness and its effect on libido is a symptom of the menopause which ‘people don’t tend to want to talk about’ because it is ‘a very private thing’.

Unable to take HRT or to use some herbal remedies because of their oestrogen content, Rhonda has developed a range of strategies for managing her symptoms. Identifying hot spicy food, wine and tea as triggers which bring on hot flushes, she now avoids these where possible. In bed at night she uses cooling devices such as a Chillow Pillow and Koolers, as well as adopting visualization techniques where she imagines herself ‘in a lovely beautiful blue sea’. Taking a low dose of calcium and magnesium as well as eating a ‘very healthy diet’ and exercising help offset the increased risk of osteoporosis associated with early menopause.  

Rhonda describes the impact of going through the menopause in her late 30s as ‘life changing’. Hot flushes, which she refers to as ‘hotties’, have meant that fashion-wise she has had to make adjustments, wearing thin tops rather than ‘beautiful jumpers’. She is very conscious that she has put weight on around her stomach and wonders if she would have the ‘lines on my face’ if she were not going through the menopause. Although her husband, mother and her ‘brilliant’ GP have provided support, she has been unable to share her experiences with friends her own age who are yet to reach the menopause

Rhonda acknowledges that the tamoxifen, prescribed to ‘strip oestrogen’ from her body for five years after her operation, may have exacerbated her menopausal symptoms. Now on Arimidex, she has noticed a decrease in the severity of her hot flushes and sweats, although these continue to impact on her sleep at night and her energy levels during the day. Despite the frustration she sometimes feels, she is adamant that she can come through the menopause. Her one consolation is that having had an early menopause, she hopes to be through it by the age of 50.

Rhonda was interviewed for Healthtalkonline in April 2009.

Rhonda had her ovaries removed after surgery for breast cancer. She can't have any treatment that...

So anyway I went back for my results and that’s where I was told that my tumour was oestrogen positive. So at that time I did a lot of research on the internet because I need to know everything and because of that they said they’d need to really get the oestrogen from my body and the way they were going to do that was to also remove my ovaries.

And the first effects I actually felt were the hot flushes and I think the first time I really experienced it was, actually thought I wasn’t feeling very well, I felt sick in my stomach and then realised that I suddenly had this wave of nausea coming up over me. It felt it was travelling up my back, it was up my stomach, and coming over my face. And I’d just sit there feeling quite light headed, feeling quite nauseous and not too sure if I, “Have I got something wrong with me? Am I going down with a chill?” and then realising I was actually very hot and clammy to my skin. So I thought “Ah, this sounds like, not sounds like, feels like this could be like the start of the hot flushes”.

But then when I was first going through it there was information but it wasn’t a lot of information, well there’s a lot more now.

Did you look at any particular websites?

I think I just put in menopause, just Googled menopause and just started reading information on it. I had a book which my Mum bought me.

What was that?

I forget what it was called now but meno H I think it was called ‘HRT and The Menopause’. Now I couldn’t take HRT because it’s got oestrogen in.

Rhonda was prescribed an oestrogen cream to use before her cervical smear because of vaginal dryness

And again it’s something you don’t always feel comfortable talking about and I have a female doctor who’s absolutely fantastic. From a sexual intercourse point of view over the years that has become very painful for me but I have gone back to the doctor and there are things you can have. But one of the issues I have is because I still have my cervix, so when I have to have my smears every three years, and what happened after the first three years after my diagnosis and going through the menopausal symptoms, I found my smear was absolutely uncomfortable, it was very very uncomfortable indeed. But what I had to do before that was that I was given an oestrogen cream to use internally because otherwise they couldn’t get a correct reading from the cervix.

So when did you apply that, was that just before you had the smear?

A month before.

You had to use it for a month?

Yeah, every day for two weeks and then for two weeks every other day. And then that was it and then I had the smear, then not use it again.

Rhonda's exercise routine helps minimise the risk of osteoporosis

I still keep to a low dose of calcium, magnesium and a very healthy diet, lots of veggies and things. I am scanned, I have a scan for osteoporosis every three years and I’ve actually had two so far and I am due another one. And there was a slight decrease on my last scan. From the hospital’s point of view they would have wanted to have treated it but from my doctor’s point of view, she said “You’re border line and keep to load bearing exercise”. Which I do, hence the belly dancing. And also I’ve got a cross trainer and a bike at home which I’m not very good at, every now and then I think I need to do this and I will really kick myself into action and do it. But I do a lot of load bearing exercise before I go to bed at night, just for ten minutes just swinging my legs and my arms and moving my shoulders and moving my hips. Hopefully it’s doing a little bit of good. I do try and walk and we do try and go out on bike rides and keep healthy from that point view as well.

Visualisation helped Rhonda to calm her hot flushes so she could get back to sleep

One of my other coping mechanisms was visualisation as well especially at night. I would visualise myself in a lovely beautiful blue sea somewhere on holiday. I’d be laying on the beach, with this, and this hot flush would come over me and I’d run in the water, lots of cold water and that’s what I visualise. And then just try and relax myself and to get through it and I actually found it worked for me. But I actually don’t do that as often now which I think is telling me now they have died down, they’re not as aggressive, unless I’ve had over the Christmas period where I have over indulged in things that perhaps I wouldn’t normally eat, I have drunk more. And then for a week after or so I don’t sleep very well. I’m not a good sleeper, since this I’m not a good sleeper and the hot flushes will wake me up. And I know enough’s enough and I give myself a break for a week or so and then I do start sleeping better and I’m not waking up with hot flushes as bad. So I do know there’s trigger points and hot spicy food, I love curries, hot spicy food is a trigger point as well for me.

Rhonda stopped taking black cohosh when she found it was unsuitable for women who had had breast...

You mentioned you used some alternative remedies, black cohosh and so on. How long did you use them for?

Probably about six months and then, the black cohosh is absolutely disgusting so I just stopped taking that.

Was that in tablet form?

Yeah, you can get it in tablet or liquid, and it was just horrible. Then I found out if you’ve had breast cancer you shouldn’t take it so anyway I stopped that. Then I went on to sage, I had the sage tincture, so I was just dripping dropping that into some water and drinking that. My Mum started taking that as well so we used to compare notes but I don’t think it did anything for me personally. I tried the different menopause tablets you could get but I can’t remember the names of them now; my Mum’s also tried them and I didn’t find that had any affect either. And I just thought, “No, at the end of the day I just need to think about what the trigger points are when I’m eating and really just try and curb it that way”.

Rhonda advises women to talk to their partner as well as their peers and supervisors at work

And I think when you’re going through it, it’s not the end of the world, no, it’s not always very pleasant and people going through the hot flushes, yes you can flush up, but I think as well let your people let your peers know, or let your supervisors know at work as well, if you’re going through it as well because you may need to take regular breaks, lots of drinking water. You may be in a position where you do have to wear a uniform and this is something that the police are looking at with females at the moment because they have to wear their stab vests, they’ve got their utility belts, which are very uncomfortable and it may be that you need to speak to somebody because in a uniform that can be very uncomfortable and can something be done to help. But I think not to be afraid to go and talk about it, get as much information as you can. Think about your diet when you’re eating, are there trigger points that set that hot flush off. Let your partner know when you’re going through it, don’t be afraid to talk about it. I know some people can get quite a bit moody, there are mood swings to consider.

Rhonda helped organise an event on the menopause in her workplace. She hoped it would raise...

Last year here at the [workplace] we ran a Women’s Event which was all around menopause and the health of ladies which I was one of the main organisers of and we had some external speakers come in and talk to us and talk about diet. And we also had a gynaecologist come in and talk about it as well. And it was a very well turned out event and everybody’s got their own story to tell and they’ve all got their own ways of coping with things. So it was a really good way of networking in a funny sort of way. But also we wanted to raise the awareness for our supervisors and managers because I think our male colleagues, unless they have partners themselves that are going through it, I think don’t really understand what it’s always about and making sure that the working environment, do you need a seat by a window, do you need to have a fan on the desk, do you need to take regular breaks to get some fresh air. And it was all about raising the awareness around that as well.

So you had police officers attending as well?

Yes, yes we did yeah. It was mainly turned out by females, we were really encouraging our male colleagues to come along but it was quite difficult, but we did have a few there. But it was mainly well attended by females and what was good to see was it was females of a very young age as well obviously wanting to know.

Rhonda highlights the importance of talking through changes with partners to increase understanding

I think patience as well. I think patience is something but try and understand what it is as well. So rather than perhaps the partner just saying, “Oh, I’m having a hot flush, I’m taking my jacket off” knowing what that hot flush actually is and knowing when you do get the clammy skin, recognising that if you have got an arm round them or they’re feeling hot, they’re not shrugging you off because they don’t want you near them, they’re just, it’s basically they just need that space. Let them cool down, because once you’ve cooled down then you’re okay for another ‘x’ amount of hours or a day even. Just understanding that I think. Understanding perhaps sleep patterns will change and if they are getting up in the night more, it’s because they just need that air. A lot of women have to get up and get a shower in the night to just get themselves cooled down. And I think it’s just making sure, talk to your partner, making sure your partner’s living it with you really. So each time you have an experience or something changes let them know what’s changing and just talk them through it. So they just know. Because I think that’s perhaps what we can all be very guilty of, we try and not hide it but just protect them. So they don’t worry and I think the thing is it isn’t anything to worry about, it’s a natural thing. Hope one day there’ll be a cure for it, one day. But don’t protect them, let them in, talk to them so they do really understand because I found that and we laugh and we joke about it. I can be sat eating my dinner some nights, and I’m sat there and I’ll go “Oh, hang on a minute” and I’ll go out and I’ll come back and I’ll get a clip and put all my hair up and I’ll say, “Oh I’m having a hottie” especially when I’m eating a curry which I love. And think well I’m having it because I enjoy it. So they know why I’ve gone out, [partner] knows why I’ve gone out of the room to put my hair up, and I’ll come back in and I’m having a hottie and carry on. Not “Why have you done that?” and shutting them out. Let them know. Let them know.