Sandra - Interview 19

Age at interview: 47
Brief Outline: Although Sandra's periods have been regular, she has experienced hot flushes during the day and uncomfortable night sweats. Rather than take HRT, she has pursued alternative approaches, including acupuncture and herbal remedies, with mixed results.
Background: Sandra is a bookkeeper. She is widowed with an adult daughter. She started the menopause at age 45. Ethnic background/nationality' White British.

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Sandra first noticed changes about eighteen months ago when, despite having regular periods, she started to have uncomfortable night sweats. These interfered with her sleep, leaving her feeling tired during the day. The onset of symptoms at age 45 surprised Sandra as her mother had gone through the menopause in her fifties.

Deciding not to go on HRT because of her fear of cancer, Sandra consulted Chinese herbalists who prescribed acupuncture and herbal medication. While the acupuncture was expensive and failed to make ‘any dramatic difference’, the herbal remedies, designed to ‘take the heat of your body’, brought some relief. However, night sweats returned within months of stopping the treatment. Furthermore, the onset of hot flushes during the day made her feel embarrassed in front of clients' ‘surely they must have been able to see that I’d gone red’.

Sandra believes women should be proactive in finding ways of helping themselves through the menopause transition. Alongside alternative treatments, she has found regular exercise and a healthy diet important in managing her symptoms. Spraying her face with rose water has helped her feel fresher after a hot flush. Although she has found the internet useful in researching the menopause, she is concerned at the lack of information available in doctors’ surgeries, where she has found ‘everything else, drugs, sex, abuse, everything but nothing on the menopause’' She recommends weekly meetings where women could share experiences as one way of supporting them through the menopause.

Sandra has recently returned to the Chinese herbalist and is again taking herbal medication along with ‘little bottles of drink’ to help her sleep. Relief from her symptoms, however, has been patchy. Although she is unsure what is in the herbal medication or what it is supposed to do, Sandra plans to continue the treatment for a further two months. Despite mixed results, she finds an alternative approach worthwhile and remains determined not to take HRT. She continues to have regular periods.

Sandra was interviewed for Healthtalkonline in February 2009.

Sandra gets embarrassed when she has a hot flush in front of clients

Sandra gets embarrassed when she has a hot flush in front of clients

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I do feel very embarrassed because I know I can feel when one’s coming on and the first time I experienced that was when I was sitting opposite one of my clients and I knew it was coming and I could feel the sweat on the top of my forehead and it just like down under my eyes as well and I thought if I keep talking I’ll work my way through this but I was thinking surely they must be able to see that I’ve gone red or I’ve got sweat on the top of my forehead and my face and I felt very uncomfortable with that. And I couldn’t start stripping off taking my cardigan or my coat off or anything like that and I found that very difficult.

Sandra's poor sleep affects her daily life

Sandra's poor sleep affects her daily life

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Well I’d go to bed fairly early and it’s probably in the back of my mind am I going to have one tonight, if I do am I going to wake up and all this. So I’d go off to sleep fine but I was fine I was waking up at certain times without even having the hot flushes. I got myself into a routine expecting to have one and of course once you’re in that circle it’s very difficult to break, but then when I do have one and it does wake me up I then lie there thinking am I going to have another one; is it going to come on soon; am I just going to drop off to sleep; then I’ll have another one; then I look at the time; then I’m thinking I’ve got to get up soon and it’s like a circle. You don’t seem to be able to get, well I don’t seem to be able to get back to sleep. And then just as I do drop off it’s time to get up. And of course that’s when I’m really tired. And doing the sort of work that I do I can’t really afford to be tired because it's figure work and then some of the companies that I go to are quite a distance to drive to so there’s that element as well. I haven’t as yet lost my temper with anyone I think or got cross or anything. I’ll probably get a bit cross when I get home but that’s with myself, cross because I haven’t been able to perhaps work as quick as I would like to but then I’m thinking as you get older you slow down anyway.

When Sandra asked her practice nurse about the menopause she suggested she talk to the doctor...

When Sandra asked her practice nurse about the menopause she suggested she talk to the doctor...

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Yeah. The practice nurse says, “Oh well you just have to get on with it, it’s just part of being a woman but if you want to book an appointment to go and see your doctor that’s fine. And then she’ll just go briefly through with what’s available but I haven’t got the time at the moment.”

That’s what she said.

That’s what she said. Because you’ve only come in here for I think I went in for a blood test, you’ve only come in for a blood test, and I’ve got so and so after this.

So you specifically asked her about your symptoms and so on?

Yeah. But she said she couldn’t talk to me about it at the time. So I did turn round and say well if I make another appointment she says, “Well I would suggest you make an appointment with your doctor first”.

How do you feel about that?

I was a bit gobsmacked to be quite honest because I thought well they’re supposed to be there to take the pressure off the doctors to a certain degree and it’s a big practice and there’s probably seven nurses there, perhaps I’d just chosen the wrong one. You don’t know.

Sandra consulted a Chinese herbalist who prescribed tablets. She couldn't understand the...

Sandra consulted a Chinese herbalist who prescribed tablets. She couldn't understand the...

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Tell me about the consultation with the Chinese man.

When I went in, he couldn’t speak a word of English so he had to have an interpreter but he took my pulses first of all and after he took those he looked at my tongue. Then he asked me if I was stressed or depressed in myself. I mean everybody’s stressed to a certain degree so you’re always going to say that. He asked me the type of work I do, the type of lifestyle and he said that my system wasn’t working properly. He more or less was asking me did I suffer with a lot of headaches as well at the time and again everybody has their days. The consultation wasn’t long and it was just a case of him saying, “I think you are [menopausal]”. He didn’t actually turn around and say, “You are. I think you are" that’s what he said and that’s when he started to recommend these different tablets.

What were the tablets?

I’ve got them in my bag. What they were they’re like, it’s a little sachet of twenty very very small tablets you take the two sachets twice a day and then there’s another load of tablets which are supposed to help take the heat out of your body and you take ten three times a day. They are very good because once they’ve got into your system and if you keep taking them on a regular basis they do help. And then the little bottles of drink which I have, you take two of those, one in the morning you’re supposed to take but I take them both of night time to help me sleep and it’s just like they do really relax you and it’s like knock you out sort of thing, they’re very good the drinks. But I’m not sure what these little, the twenty odd little packets are supposed to be doing.

Did the doctor or the herbalist explain to you what was in them?

They did explain to me and they give you a chart because all these tablets, all the instructions on how to take them are all in Chinese and of course I wanted to know what was inside them.

And I do remember going along to another Chinese place in [town] and asking them. Again I took all the packets that I’d got from this previous gentleman and I took them and I asked them to explain again to me what the different ones were but they said, “You don’t want to take any of those”, and again it was you want to come in here and we can offer you this that and the other. They’re all trying to sell their own services but again I couldn’t understand why they wouldn’t tell me when all I was asking was what they were for really and trying to look on the internet and trying to type in certain words, trying to pick off certain words from the boxes you don’t know what the Chinese equivalent is you see.

Sandra suggests that support group meetings run by women would help, where women could learn from...

Sandra suggests that support group meetings run by women would help, where women could learn from...

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You were talking about the idea of having weekly meetings. How would you see them working?

I think people should think about working women and women who haven’t all the time in the world. I like evening meetings because if you work and you’re not going to be able to get there [during the day] I think if you knew it was a meeting in the evening you’re more likely to go. I would be more likely to go to that and just listen to other people and see how they’re coping with it and how it’s affecting them because it might be that I’m having some of the side effects but don’t realise that it’s linked and just think it’s because perhaps I’m tired or it’s my age - things that I’m thinking are my age might not be.

Who would run those sessions do you think?

Other women who’ve been and experienced it. Definitely other women who’ve experienced it.

Would the GP or practice nurse be involved?


I don’t think you’d get them to be involved to be honest because I don’t think they’d want to do anything in the evening for a start off - well I’m pretty sure in my area they wouldn’t want to do anything after five o’clock and the practice nurses are finished anyway and the doctors go on till about half past six and I couldn’t see them wanting any time after that.

Sandra's husband died suddenly three years ago

Sandra's husband died suddenly three years ago

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My husband died 3 years ago which was unexpected so sort of very life changing that was.

Well it was very sudden because it wasn’t expected and it just happened. So we’d just finished building our own house as well so that did have quite an effect. The good thing was that I was aware, we did everything together so bills and insurances and everything like that, mortgages, it wasn’t as if I’d suddenly got all of this to deal with and didn’t know anything about it and how to do it. I think the thing that’s affected me most is the loneliness and not having somebody to, oh my daughter’s there but not having someone to go home to and discuss what you’ve done that day or sharing things. I would say it had more effect than even my father dying because it’s not. I went through the sadness and then I went through the anger because I thought he’s left me. I’m this age, I’m not going to meet anybody else because I’m this age and I’ve got that into my head now and I can’t get that out of my head and I probably don’t go out of my way to meet anybody at all because I don’t really think that anybody’s ever going to replace him.