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Maggie - Interview 10

Age at interview: 49
Brief Outline: For Maggie, increasingly severe premenstrual tension (PMT) led to a missed period 18 months ago and the onset of hot flushes. Symptoms have now eased but she continues to suffer from insomnia. She feels a sense of loss at not having had children.
Background: Maggie is a psychiatric nurse. She is single with no children. She started the menopause at age 47. Ethnic background/nationality' White British.

More about me...

Maggie first noticed menopausal changes about 18 months ago at age 47 when she missed a period. She has since had two further light periods. She noticed that premenstrual tension (PMT) had increased in severity in her 40s, with sore breasts, bloating and mood swings for two weeks before her period. These symptoms had a negative impact on relationships. Hot flushes coincided with the loss of periods, taking place during the day and at night. However, they have now subsided as have the mood swings.

One of the main problems, however, has been ongoing insomnia; originally caused by the hot flushes but continuing beyond this. Maggie has used a range of herbal products, including valerian and melatonin to help her sleep, and has also been prescribed temazapam by her GP. She uses these sparingly, with 30 tablets lasting 5 months. She also had problems with cystitis in the 9 months leading up to missing her first period though is uncertain whether this is related to the menopause. Maggie has experienced vaginal dryness since beginning a new relationship in the past 18 months but uses a lubricant to relieve this. She uses condoms for contraception. She has also noticed an increased tendency towards thrush.

Maggie has not considered going on HRT as her symptoms have not been too problematic. She has not discussed aspects of the menopause with her male GP who she feels would be ill-equipped to deal with the issues other than prescribing HRT. Time constraints would also limit what could be discussed. She believes that there needs to be more specialist services available at the level of primary care for women going through menopause; perhaps a support group where women could get advice and share their experiences.

Maggie has no children, but has suffered 3 miscarriages in the past. Although not obsessed with having children, she has experienced a period of grieving since reaching the menopause, with the realization that she will never have children. She discusses aspects of the menopause with friends, one of whom has experienced intense grief at her childlessness.

Despite this Maggie sees the menopause as a positive transition and feels a sense of freedom at not having periods and PMT anymore. She feels lucky to have good skin and relatively few wrinkles and has not needed to dye her hair. She keeps fit and does yoga which she feels has helped her through the menopausal transition. She highlights the ways in which she and her friends are pushing aside the stereotype of the frumpy middle aged woman as they seek new challenges.

Maggie was interviewed for Healthtalkonline in January 2009.

 

Maggie had very mixed feelings - glad not to be having periods but sad that she would never have...

Maggie had very mixed feelings - glad not to be having periods but sad that she would never have...

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Yeah, I think when my periods first stopped and I noticed, well I realised I was going through some changes, that’s when I really took in that I wasn’t going to have children. And although I had of course been really realising that fact over my forties, because I was 47 by then, it still didn’t really hit home until my periods stopped. And I suddenly had to take in, well I did take in the fact that I wasn’t going to have children, which actually was really okay. It’s not something, I haven’t ever thought I had to have children to feel fulfilled as a woman, or go through that experience for any reason, and at the same time there was some grieving going on inside me, or some sense of coming to terms with that I would never have that experience, whether I wanted to or not. I couldn’t change my mind anymore. I couldn’t have them even if I wanted to. So I think there’s a kind of internal process of accepting where I was and also realising I’m a grown up, even though, actually some of me doesn’t feel very grown but I am a grown up woman and there’s no doubt I’m definitely a middle aged adult, and that to me felt a very empowering thing, actually, a good thing, especially coming with the end of my regular PMT cycle I felt excited about it, and a sense of a new energy and not being kind of a slave to my own physical cycles anymore. Yeah, very liberating. As well as a little bit sad because of thinking about the sense of loss of not having children.

So you’d never really thought about having children before?

I had at different periods of my life when I’d been in relationships. I did get pregnant three times and had miscarriages all three times, so there has been the opportunity, the possibility anyway of having children in the past, but I’ve never felt really attached to the fact that I’d have to have them, or one way or another, I thought I was just open really to what life would bring me. And no doubt I would have enjoyed having children if I’d had them, and at the same time I have a lot of freedom because I don’t have them.

 

Maggie’s had painful ‘cystitis-like’ symptoms but doesn’t know if the menopause is to blame

Maggie’s had painful ‘cystitis-like’ symptoms but doesn’t know if the menopause is to blame

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Yeah, it’s [my health’s] been very good apart from the fact that I had about nine months of very painful bladder symptoms, within that time, and I don’t know if there’s any connection with my hormonal level but I ended up having a cystoscopy and they removed some scarring and since then it’s been much much better.

And what were the symptoms?

Cystitis like symptoms, but not responding to any antibiotics. And not showing up any kind of bacteria, so it was very very uncomfortable and I had a specific pain sort of right at the urethra where the urine comes out and that was more or less constant every day, it was very uncomfortable.

Did they relate that to the menopause?

No. No. I did go to a gynaecologist for my first appointment, the consultant, and he gave me the all clear, from that side but that, it was so segmented, so the urologist didn’t refer to any kind of menopausal changes at all so I didn’t make any links, and whether there are any I don’t know, I tried to research it a bit, but I couldn’t find any,

And did that go away after the treatment they gave you?

It did yeah. I mean I get slight symptoms coming back every six months or something, and I might get some cystitis like symptoms but they seem to come and go quite quickly.

 

Maggie uses sleeping pills sparingly to relieve her insomnia

Maggie uses sleeping pills sparingly to relieve her insomnia

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And you mentioned the insomnia as being a bit of a problem for you. How often did that happen? Was there any pattern to that?

It’s still happening now, and it’s only got a pattern in the sense that I very rarely get a good night, a whole night’s sleep. So sometimes I’ll drop off no trouble at all and I’ll wake up at one or four or five, just a bit too early, and other times I just can’t drop off and I finally will drop off and then I’ll sleep very heavily until morning. Yeah. I mean I have tried various things for that, some of which worked, but not consistently, all the time.

Was there any link between waking up and the hot flushes?

Yeah, at first, I mean I don’t really have any hot flushes now, but definitely at first, I think that’s what got me into a pattern of waking up was feeling this heat and that was the thing that woke me up.

Yeah. I’ve used lots of different things, I’ve used valerian, in tincture and capsules. And they worked really well for a short time, then they seemed to not work. And they also worked really well for getting off to sleep, but not so good for when I wake up in the middle of the night and can’t get back to sleep. And I tried melatonin which again seemed to work fairly well for a while, and in amongst that period I was doing some night shifts and I was just not sleeping in the day, and I got a bit desperate so I went to the GP and the GP gave me temazepam. So I get thirty from him about every five months and I use them sort of very sparingly really, I take a half when I really need to, if I feel like I have to sleep otherwise I won’t be able to work the next day.

 

Maggie describes how she finds information and ‘nuggets of wisdom’ on the internet.

Maggie describes how she finds information and ‘nuggets of wisdom’ on the internet.

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Yeah. I mean I tend to just Google things on the internet so I’ll just Google and see what comes up, and sort of just sift through different sites, there’s a lot of sites from America I’ve found quite interesting, reading about people’s own experiences, and then I read a couple of books, there’s one, Leslie Kenton’s ‘Passage to Power’ which is quite good, and one about the perimenopause, I think it’s called, “What your Doctor hasn’t told you,” or “won’t tell you,” or something. And then talking to friends as well, people who’ve been through it so, those are the main ways.

Have you looked at any of the forums like, Menopause Matters those sorts of websites?

Yeah, I have from the States, I don’t know what they would be called though, I’m not sure if that’s one of them.

Have they been useful?

Yeah, they have, yeah.

How do you decide what’s good and what’s bad on the internet?

Yeah, I think there’s well, I think I can tell actually. There’s some that you can tell are quite professionally done and reliable, and others are kind of more subjective accounts which also are useful. I don’t really tend to read much that makes me feel kind of depressed or anxious, because I don’t think that’s very useful and you can always find information about people having a hard time, whatever subject you choose. So I tend to steer clear of those, but sometimes in people’s own personal accounts there are real nuggets of wisdom there, or things, little things that have helped them.

What have you learnt from the internet generally and sites that you’ve mentioned?

I think that everyone’s experience is quite different, but there are sort of similar trends and themes within that, and that people can do a lot to help themselves, actually.

 

Maggie’s periods have become increasingly irregular in the past 16 months.

Maggie’s periods have become increasingly irregular in the past 16 months.

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My periods were fairly regular up till September, not last year, the year before, 2007, so at that point I just stopped having periods for about a period of six months, and again I wasn’t too concerned about it, I thought perhaps, I started to think then, I started to do a bit of reading about the menopause about the perimenopause, as I realised that’s probably what was happening. And sorry I’ve lost the train of thought now.

So yes I didn’t have periods for six months and then I started a relationship and I got one period in the same month that I started the relationship, and then again a gap of about eight months, and again some light bleeding for about two or three days, and that was a couple of months ago. So I think in the period of time of about sixteen months I’ve had two lots of quite light bleeding.

 

Maggie rejects the stereotype of the frumpy older woman

Maggie rejects the stereotype of the frumpy older woman

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I am aware of my face changing and lines coming, but it’s not something that really worries me. So far I’m enjoying the sense of being older and being more womanly, and I certainly enjoy it in my friends as well who are my age. I love being around people my own age and just celebrating where we are really, without, I think there’s a lot of it’s quite liberating to perhaps not be the stereotype of your age, but be who you want to be at your age, that’s quite nice. I mean middle-aged just sounds quite frumpy to me, as a term, but I know I am middle-aged, but it’s not something I would say about myself really, but that’s because of a lot of cultural kind of norms I think that perhaps we take on consciously or sub-consciously about what we should be at a certain age.

And what should we be?

Yeah. Exactly. Yeah. So I think that’s what’s exciting as well, about being older and yet feeling still quite young and not caught up in those kind of stereotypes necessarily, so we can be who we want to be really.

What is the stereotype? Can you just describe what you think that is?

Well I think it’s from when I was younger perhaps, where I used to think of middle-aged as, well quite frumpy really and someone who’d let themselves go a bit and not really kind of a bit of a couch potato maybe and not very active, a bit bowed down by life.

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