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Charlotte - Interview 03

Age at interview: 54
Brief Outline: Following heavy bleeding, Charlotte was referred to a gynaecologist and prescribed the drug Zoladex to induce the menopause. This led to severe hot flushes. Bleeding returned after treatment ended, however, and Charlotte is now considering a hysterectomy.
Background: Charlotte is a university professor. She is married with two adult daughters. She started the menopause at age 47. Ethnic background/nationality' Welsh/Caribbean.

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At the age of 47, Charlotte began to experience very heavy periods and flooding which affected her daily life. Diagnosed with fibroids, she eventually persuaded her GP to refer her to a gynaecologist who reassured her that there were ways of managing her condition other than hysterectomy. She was prescribed the drug tranexamic acid to stem the flow, but heavy periods continued leading to Charlotte becoming anaemic and run down.

In an effort to induce the menopause, her consultant prescribed a six month course of Zoladex, a drug injected into the stomach once a month and designed to stop the release of oestrogen. While this stopped her periods, Charlotte began to have severe unpleasant hot flushes throughout the day and night. After completing this course of treatment, Charlotte went without periods for three months, only to experience the return of excessive bleeding. The treatment was then repeated for a further six months, but again there was a return to ‘massive flooding’ nine months later. At the time of interview, Charlotte was waiting for an appointment to see her gynaecologist. She plans to ask for a hysterectomy.

In a prominent position in the workplace and in the community, Charlotte has at times found it difficult to maintain her public persona in the midst of embarrassing hot flushes and unpredictable bleeding. At home, night sweats have interfered with both her sleep and lovemaking, while enjoyment of shopping trips and holidays has been curtailed by the arrival of heavy periods. 

For Charlotte, the menopausal transition has not been a linear straightforward progression. She describes it as a ‘kind of zigzag process’ and remarks on how little she knows and understands about the menopause despite her intelligence. Unlike in the Caribbean where women talk more freely and joke about their health, Charlotte believes that in the UK the menopause is a stigmatised, taboo subject about which women are reluctant to talk. Given the time constraints on GPs, she feels that specialist clinics run by nurses in healthcare centres should be set up to provide a forum where women could meet, seek advice, discuss aspects of the menopause and have their questions answered.

Charlotte was interviewed for Healthtalkonline in December 2008.

 

Charlotte’s heavy periods and potential for flooding are ‘scary’ and embarrassing. Once she was ...

Charlotte’s heavy periods and potential for flooding are ‘scary’ and embarrassing. Once she was ...

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I remember having sort of heavy periods but they might have been more clotty periods early on and them being difficult to manage and not very nice but certainly this potential for flooding is scary. It’s scary. And I’ve been caught out. I’ve been in a situation where I drove to the Trafford Centre shopping with my daughter and I had tampons and pads on and I stepped out of the car and there was this woosh and fortunately my daughter’s a doctor so she’s quite comfortable, she wouldn’t have been embarrassed or anything by that. But I was terribly embarrassed. I couldn’t move, I couldn’t walk forward or backward and of course I had to send her into Marks & Spencer to get me some clothing, all of that. So it could be as bad as that standing up from sitting down somewhere at work and then realising your skirts or your trousers and got to deal with that kind of thing. Being kind of anxious about that possibility. Yeah, so yeah it can impinge on what you do. I tried not to let it impinge on things. I said I liked walking I try not to let it impinge on things like that but I’d be talking about stacks of supplies going round here there and everywhere with me that kind of thing. So, yeah, I think you perhaps know that other people struggle like that but you almost don’t say anything, sort of feel I’ve got to manage it, I’ve got to cope with it. I can’t say I’m going home now, I’m having a terrible day of it. You’ve got to just keep going.

 

Charlotte believes there is scope in her health care centre for a well-woman clinic dedicated to...

Charlotte believes there is scope in her health care centre for a well-woman clinic dedicated to...

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My sense is that a lot of us just don’t understand the process that we’re in and we’ve all got a lot of questions and they might seem small naive little questions but they need to be answered. And because you feel the GP’s time is so limited I would have welcomed I think an opportunity to be referred to the specialist nurse just to talk to her. In fact I prefer talking to women so if the GP had said “do you want some advice on menopause, do you want some discussion about it, have you got any questions? Well you might like to make an appointment with the nurse”, then, and I’m assuming a gender thing here which I probably shouldn’t assume, but probably our experiences guided me there. But an opportunity like that would have been good. I notice that in my healthcare centre there are other sessions available on other conditions where there is some nurse intervention or some small group are brought together. I think that might be valuable. At one time the Family Planning Clinic acted like a kind of Well Woman Clinic in [place]. I don’t know if that provision is elsewhere. But it’s since changed because of lack of resources and everything it’s mainly about contraception now but that model that you could make an appointment and go to a session where there were women who were having advice on contraception and general healthcare, that would have been great.

 

Charlotte’s office was a safe haven when emotional symptoms became too much. She couldn’t talk to...

Charlotte’s office was a safe haven when emotional symptoms became too much. She couldn’t talk to...

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I’d changed my job and come to work in [place] and my demeanour is generally very happy, I don’t get stressed particularly, I’m not quick to anger, I’m one of those kinds of even people and I’ve found myself in my first year at [place] really quite anxious, quite miserable. I could close the door of my office and come in and cry my eyes out and I didn’t know why I was crying and it would be because I’d said something silly or I felt silly or I felt embarrassed.

I could not tell anybody. There were other women I saw around me of my age but I didn’t feel I could say, “I feel so I don’t know why I’m crying but I’m crying” and all the rest of it.

 

Charlotte’s hot sweats and heavy bleeding affect love-making

Charlotte’s hot sweats and heavy bleeding affect love-making

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How did it affect your relationship with your husband?

 

He was very very good. Because certainly it’s very visible, he could see how challenging it was and he’d tease me and things like that. Certainly if we were having sex or anything I would be very hot and so it did kind of interrupt in that way or it certainly I think it would have had an impact on love making. Not in a negative way just trying to find a way around it because “Oh I’m too hot, lie like that” or “Oh don’t come near me”, that kind of thing because obviously that would be another trigger. I could get hot flushes if we were making love, that kind of thing. So, yes, but it didn’t affect our relationship in terms of how we relate to each other because he’s a very very sensitive person like that. He could see it was horrid.

And was it the same when all the bleeding was going on, before you had the treatment?

Yeah, he would be very tolerant. That would interrupt obviously and he’d say, “Oh we look forward, we’re going on holiday”. Because that was another trigger if I went on an aeroplane, “we look forward to going on holiday” but he’d say, “We know what will be coming, you’ll be having your period for the whole holiday” and that kind of thing. So fair dos to him, he has coped well with it. And he has never ever put pressure on me to have a hysterectomy although I think he feels probably it’s the most sensible course of action for me now. But he certainly has let it go at my pace. He hasn’t been a pressure.

 

Charlotte loves getting older but would like to see a few older women role models

Charlotte loves getting older but would like to see a few older women role models

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How do you feel about embracing later life, getting older?

I really love it to be honest. I’m one of those people who think 50 is a great age and beyond is great. I know myself better, I’m happier with myself, I’m not afraid of, people start talking about the wrinkles and the this and that, I think you can present yourself well in whatever age category you’re in and that won’t go away just because you’re older.

Where are these shops we can buy clothes for women of our age that we like. So it’s more like that, so not so much about the makeup products.

And do you think there are those shops, do they exist?

No. No they’re very difficult to find because our age isn’t trendy, it isn’t, it is quite difficult for us I suppose in that respect. It isn’t profiled in any way as a good age. You’re either work driven and written off because there is no sense other than that you’re..., or you're in the housewifey kind of mode. So, I think that is a problem. And I think it is a problem of this transition we’re talking about, how to manage that. And those kinds of things would be in my mind. Perhaps more than some of in body image not body image but how to present ourselves and how we can present ourselves in different social situations in a positive way that makes us feel good about ourselves. And that’s to do with clothing and what’s available and so on. So I do like it when I see adverts where there’s a woman portrayed who’s a bit older or some kind of situation or film or something where there is a woman positive looking role model.

And do you think there are enough role models for women our age?

Probably not of the type we would want, I mean the Americans are very good at the kind of skinny, ”I am Madonna and I’m now 40 something”, or whatever age she is. They’re good at that kind of person but not of the more average well rounded 55-year-old woman. So you don’t see her so much I don’t think. Certainly in terms of, oh I haven’t talked about ethnicity at all but certainly in terms of black women I think that would be good to be able to see more women, mature, successful, successful in terms of successful to themselves and how they present themselves.

 

Charlotte encourages other women to push for the menopause services they want.

Charlotte encourages other women to push for the menopause services they want.

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I think that to others I would say “You direct the process you’re in”, “You tell your GP what you want”, “You ask those questions about services of your GP and even if they’re not there so that we do get them through our demand of them”. So it’s good to ask for a woman doctor if you would prefer a woman doctor. Or it’s good to ask for half an hour with the nurse just to talk about it. So, sort of pushing the services forward through our demand I think is important. And get a good gynaecologist that you feel confident in and stay on his or her books through the process. Try and be able to go back to them even if things are going okay, you can still go back.

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