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Judy - Interview 04

Age at interview: 46
Brief Outline: For Judy, the menopause started at 40 with a missed period and coincided with the onset of the autoimmune disorder Myasthenia Gravis. As well as irregular periods over the past 6 years, she has experienced hot flushes which have disrupted her sleep.
Background: Judy is a senior lecturer. She is married with two teenage children. She started the menopause at age 40. Ethnic background/nationality' White British.

More about me...

Judy’s transition to menopause started at the age of 40 when she missed a period. Unprepared for an early menopause, Judy thought at first that she was pregnant. However, another missed period several months later confirmed that she had started the menopause. She describes experiencing an early menopause as ‘a bit unfair’.

Over the past six years, Judy’s periods have continued to be irregular and unpredictable. She experienced hot flushes over a two month period especially when stressed, overheated, or in bed at night. As well as causing embarrassment, the hot flushes disrupted her sleep leaving her tired during the day.

For Judy, the onset of the menopause coincided with a diagnosis of Myasthenia Gravis, an autoimmune disorder which causes muscle weakness and double vision. She wonders whether there might be a link between declining oestrogen levels and the onset of autoimmune conditions in women in their forties. Although Judy has gained weight in recent years, she is unsure if this is associated with the steroids she is taking or with the menopause.  While interested in how HRT might affect her Myasthenia, Judy is not considering taking it at present because of her lack of symptoms and possible interaction with her existing medication. 

Judy feels that the menopause is downplayed in doctors’ surgeries and in the media, with a general lack of information available. She believes there should be more information about the menopause prominently placed in doctors’ waiting rooms, and support groups where women can talk to each other and get informed advice from health professionals.

Despite her greying hair and loss of fertility, Judy has found the transition to menopause empowering. Liberated from the need to feel attractive and impress men, she feels freer to express her opinions at work and has been promoted to a leadership position. For her, the menopause has also meant an end to pre-menstrual tension, and this has had a positive effect on her family life.

Judy was interviewed for Healthtalkonline in December 2008.

 

Judy talks about the lack of services for menopausal women in her GP practice

Judy talks about the lack of services for menopausal women in her GP practice

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Well for instance when I went for my flu jab there’s the main waiting room for the doctors and all of the posters up there are about flu jabs and about NCT [National Childbirth Trust] for childbirth and there was nothing for menopausal women. Whereas when I went round the side into a little closed corridor where the nurses’ offices are, where you go just for the jabs, there’s a tiny word processed poster advertising a menopausal discussion group. And just by the mere act of downplaying it onto just a word processed page and sticking it on the wall out of the way, makes you feel as though this is something that the GP’s surgery doesn’t consider to be a priority. It’s not something they want to recruit loads of women to. It’s not a service they want to push. And therefore if I was to say I’m interested in it, what sort of service would I receive, what other women would go for it and how would I be viewed by the healthcare professionals? It just didn’t send me the message that the changes that I’m going through are important enough for the surgery to take forward and so it didn’t entice me at all.

How do you feel about that?

I feel that they’re missing a picture. I think that for me I’m okay, I’ve got a supportive husband, I can do research on it if I want, I’ve got support groups amongst friends if I choose to pursue that but for other women this may not be the case. And I think it’s a service - I mean fifty per cent of the population are women, a hundred per cent of them are going to go through the menopause at some point. There’s nothing on the T.V. about the menopause. It’s something that society just pushes out of the way and it’s a reflection of the value that they place on older people in general and women in particular. And it’s a very important issue to deal with. I would imagine that for some women it can lead to significant levels of depression. The change in how you perceive yourself, how society perceives you and also the hormonal changes in themselves may engender some sort of endogenous type of depression and depression amongst the elderly is a significant issue for PCTs [Primary Care Trusts] so I think it’s an area which is very overlooked and should be addressed.

So what sort of information do you feel they should be providing and what sort of services do you think would be helpful?

I think they have to normalise it first and say every woman will go through the menopause at some point, that this is perfectly natural, it’s nothing to be frightened about, it opens up new opportunities rather than it is a loss of a particular phase but it’s an opening up of new ones and to put it across in a much more positive and upbeat way rather than a little grey poster on a wall saying “do you want to talk about your menopausal experiences?”. I think a support network is appropriate where you can meet people that you don’t necessarily have a friendship with but you’re just there because you’re menopausal and that in itself is self limiting in how you feel you’ll be perceived. You go along because you want to be perceived as a menopausal person but with your friends you don’t want to be necessarily seen as that. So that sort of peer group support is appropriate but with informed input from the professionals who know about this and if there are particular health issues which are arising as a consequence of the menopause then those can be identified and dealt with appropriately.

 

Judy took part because she wanted to help raise public awareness about the menopause

Judy took part because she wanted to help raise public awareness about the menopause

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The reason why I wanted to participate in this research was just the general lack of information around the menopause.  It’s not something that you generally talk about with your friends as it’s seen as something quite negative and reductionist as a woman, I think taking you out of your years of fertility it makes you sort of less attractive.  But it’s just this whole general issue about not talking about it, not knowing what the next step is.  How long the different, what are the different phases to it and how long they last. 

 

Did you know much about the menopause at this stage?

No, nothing. Absolutely nothing. I was shocked and I expected my bottom to fall immediately. You get a flat bottom because I thought that’s what happens as soon as you’re menopausal, periods stop, hot flushes and get a flat bottom. So that was what I was waiting for. So I’m pleasantly surprised that it hasn’t quite yet happened. But you just have all these extreme views.

You said that you didn’t talk to many people at all about the menopause. Did you look on websites or on the internet at all for information?

No. No.

No reason for that?

I don’t really want to know. I’m quite happy for it to unfold and if anything cropped up that I was concerned about I might look it up on the internet. I would have preferred to be forewarned which would have made me forearmed for the situation to arise so at school told about sex education and child birth and all of that sort of thing. It would be nice to have it fully integrated, bringing the whole reproductive cycle from start to finish at that time although it would mean not too much at the time but you carry all of that information forward. So I would have preferred to have been informed in a fairly neutral environment where it wasn’t affecting me at the time. Now that I’m in the middle of it, I don’t really want to seek out further information either from the web because you can always interpret that in its worst case scenario. I would prefer to, if there were more accessible isolated support groups, from friends organised by the PCT [Primary Care Trust] then I would find that as something that I could dip into or out of as I preferred.

 

Judy explains that she did not want to be defined by her menopausal status; she is aware of some...

Judy explains that she did not want to be defined by her menopausal status; she is aware of some...

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So I have more recently just talked about it once on the phone with a friend who lives in Australia. We’ve known each other for many years and I’m happy to do that because she’s quite far away and we don’t have to see each other when we’re talking about it so it’s not too embarrassing. But that’s something I’ve consciously tried to do because I think it’s worthwhile doing that but that’s the only conversation I have really with anybody about it.

Why wouldn’t you talk to your colleagues or your friends here and people like that?

I think it just ties into my whole of view of it might be conceived of as a weakness. Some, one of my male colleagues did make a joke about being menopausal to me and I just laughed it off but it’s not something I’d want to bring into work. I want to be at work and be just a colleague, who teaches, admins and researches and has some sort of relationship with them but I don’t want to be seen as a woman in various changes. I don’t want to be seen as that because I think they would see me as something lesser than what I’d want to be seen as.

And does the same thing hold for your girl friends outside work?

There’s always an element of competition I think, so one friend’s not got any grey hair and she’s very proud of that fact. And it’s not something I’d want to discuss with them either because I see them on a regular basis and I wouldn’t want their opinion of me to change because I would then become [name] who’s perimenopausal rather than just [name] who is this that and the other for what I achieve or what I can do rather than biological changes which I have no control over.

I guess it depends on the way they’ve been brought up. I think I’m maybe slightly on the periphery and that I’ve always from the word go considered periods and all of that sort of thing as something that you don’t talk about. For those women that don’t have that perspective, and I think that’s the right perspective to have, well then just talk about it with friends and that’s the best way to do it. It’s not to have a forced environment and just to talk about these things as they occur as you do when you have your children and you talk about the issues “what’s the best thing to give a child who’s got earache”. You just have a naturally evolving support group which isn’t forced and that’s the best way for it to proceed. So you’re part of a community, your friends are of a similar age, these are just changes that affect everybody and you would just discuss that on an as you come basis.

 

Judy’s periods have gradually become more irregular. An unexpected period, coming ‘out of the...

Judy’s periods have gradually become more irregular. An unexpected period, coming ‘out of the...

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It was just a gradual change really. So instead of having one every month it might be one every two months, so that would be six a year and they’d alternate between being very light and being slightly heavier. And then it came to the point where I no longer tried to predict when I was going to have one and I’d go for maybe three months and then they’d come out of the blue and I’d be completely unprepared. So the last one I had was in October when I was on holiday, the one week of the year when I went abroad and I got one there. And I just thought it’s a joke really. So that’d be October and I can’t remember when I’d had one before then.

When I had my last one in October it was a complete shock so I had no tampons or anything with me. In fact I had to ask my daughter if she had anything and she didn’t have anything either. So I just managed. It was slightly inconvenient, I had a slight bit of pleasure that I still had one so that gave me a degree of satisfaction but it’s not a problem for me I’m used to it now. I mean it’s been going on and off literally for six years so I just take each day, each week, each month as it sort of rolls by now.

 

Judy’s diagnosis with Myasthenia gravis, an auto-immune condition, coincided with the onset of...

Judy’s diagnosis with Myasthenia gravis, an auto-immune condition, coincided with the onset of...

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But the main issue for me is hitting 40 and that first change in what was a very very regular cycle coincided with a change in my health. Which I’ve subsequently been diagnosed with Myasthenia gravis, which is grave muscle weakness and I’ve developed this autoimmune condition in which my body creates antibodies against receptors in my muscles where my nerves and muscles meet and the upshot is I have double vision. And I just think there’s too much of a coincidence about the coinciding of the beginning of my menopause with this and I think it’s the protective factor of the reproductive cycle and removing that, or just sort of changing that, has had a change in my health and it was just a watershed really. So it wasn’t just a change in my fertility but also a whole change in my health.

 

Judy believes anti-ageing products and treatments take advantage of vulnerable women

Judy believes anti-ageing products and treatments take advantage of vulnerable women

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Do you do anything to counteract the effects of ageing like anti-wrinkle creams and those sorts...

No.

of things? How do you feel about all that and cosmetic surgery in the future?

All my friends talk about it. I do tell them, like for example Botox, tell them it’s one of the most virulent bacteria and it’s used to treat spasticity, it’s got a role to play but for them to use it for removing lines from their forehead is a complete waste of time and in fact it doesn’t make any difference anyway. They have to return to it, it’s expensive and it’s a complete waste of money and when they talk about all these adverts where these, I can’t remember what you call these new proteins that they identify, it’s just a load of rot really. I think it’s taking advantage of vulnerable people.

So do you think older women are vulnerable?

Yes, many, yes I mean the whole if you’re not attractive and if you don’t look young, what about all these programmes on how to change your look and look ten years younger? The whole force of the media is driving you to think less of yourself as you age and not so maybe your flexibility and problem solving may become slightly more difficult but your wealth of experience and guidance and advice stay, develop and it’s the same, and nothing’s new. It’s all happened before but all of that is not negated but undermined really. If it doesn’t come in an attractive vessel then the strength of the message is undermined really.

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