[speaker001:] Suddenly everyone seems to be talking about the menopause so we thought that you'd better hear what women really think. [introduction music]
[speaker002:] There's still a lot of mystery, worse, misinformation surrounding this milestone in a woman's life. So tonight the wraps are off and I think you'll agreeably surprised by what you hear! I'd like to start with a vote. Do you want more information about the menopause? Button one for yes, and button two for no. And, in this hundred... goodness! Ninety one people say yes, only nine say no! Now, why did you, why did you say yes? Is it because yo, you you haven't got the information? You don't have enough? it's not available to you? Yes?
[speaker003:] I feel that there is an awful lot of... gossip and scare tactics about it and I'd like to, to have a real expert information on it.
[speaker002:] Have you tried to information before?
[speaker003:] Not ver, not very much. Mainly
[speaker002:] I
[speaker003:] mainly through, mainly through gossip!
[speaker002:] Gossip?
[speaker003:] Aha.
[speaker002:] And what does the gossip say?
[speaker001:] [LAUGHTER]
[speaker003:] Every, for everything er... from it's all in your mind to it's dreadful!
[speaker002:] [LAUGHTER]
[speaker003:] [LAUGHTER]
[speaker002:] Right, front line.
[speaker004:] Yes. I think actually I would like to get some, some more information and men should get some more information because they are the ones who are... dismissing and er... not sort of going along with it.
[speaker002:] Mm. Well out there, they're they're watching so... who else said yes?
[speaker005:] I'd feel the local doctors, your local G P's are needing to be brought more into... to line with it. I've personally had problems with one doctor... cos he was out of date, he wasn't... you know, wasn't aware of some of the treatments... and I had to actually enlighten him to some of the... the treatments that was available for people!
[speaker002:] Really?
[speaker005:] Aha. Yes.
[speaker002:] Ho and how did you know he was out of date?
[speaker005:] Because ee er, some of the subjects I brought to him but he didn't know nothing about them! He had to... you know, he'd, he'd to leave it and consult with colleagues or whatever. So I feel that
[speaker002:] And where were you
[speaker005:] you know, that G P's that's been practising for a long number of years... you know er, elderly G P's are probably not as up-to-date on these kind of things as they should be.
[speaker002:] Aha. This one.
[speaker006:] I had a few problems when I was about thirty... and my doctor told me it was just my age and the menopause! From thirty! And I started it about fifteen years later!
[speaker001:] [LAUGHTER]
[speaker002:] Now when do yo, when your doctor said that when you were thirty di did you believe him or her?
[speaker006:] It was a him.
[speaker002:] A him.
[speaker006:] A doctor younger than myself, and I didn't believe him! And, I just tu but... there was nothing else I could do! I couldn't... argue with him... I just had to go and say oh well it's just my age and get on with it!
[speaker002:] Yes?
[speaker007:] I'd like to know more about it because having gone through it without any eventuality I'd quite like to know what I missed! If anything!
[speaker001:] [LAUGHTER]
[speaker007:] And if, in fact, this H R T I'm really missing something, you see, that's what I'd like to know.
[speaker008:] I don't think that... er, I think that unfortunately some of the older doctors definitely were misinformed and weren't educated and I think nowadays that the doctors are becoming very much more educated and perhaps the ones who have the bad time are the fortunate ones in so far as they're getting the hormone replacement therapy if they're lucky and they have sympathetic general practitioner. And the ones who haven't had the bad time might well be suffering because they're not being allowed the benefits of hormone replacement therapy.
[speaker002:] Now you're a G P?
[speaker008:] Yes.
[speaker002:] And so obviously you're very well clued up. Th does that mean the older people here have had a raw deal? I mean,th those people who've gone through the menopause wo would any of you like to say anything about experience? Yes?
[speaker009:] Er, well
[speaker010:] Er...
[speaker002:] No, yes yes! Nelly?
[speaker009:] Na er... well of course I'm seve seventy nine but I can still remember most of it... and I did have a very bad time! Moods, bad moods and... going to... I gave my husband a terrible time!
[speaker001:] [LAUGHTER]
[speaker009:] I really did! But he was very understanding and, the doctor just seemed to think that that was a natural course I had to go through! But er, it lasted, I was... forty seven and it didn't finish till I was about sixty! But people complain sometimes about the flushes, but I was glad when I had a flush because I felt better after having flushes!
[speaker001:] [LAUGHTER]
[speaker008:] I think we've got to look at the other side of the
[speaker002:] Aha.
[speaker008:] as well that I personally a agree with the lady over there as I'm now, with all the talk of hormo, hormone replacement wonder what it was? How much better life would have been if I'd known about that... or used it?
[speaker010:] I'm from the group, the change you change
[speaker002:] Mhm.
[speaker010:] and er... when I was going through the change and I'm post menopause... er... and having terrible feelings, I'd nowhere to go! I went round all the hospitals in Edinburgh and Leith... all the doctors surgeries and there was nowhere and I ended up at the... the women's unit in Edinburgh... City Chambers... and I got help from the women's unit... and er... from there... we started a pressure group to get more literature to people, you know to get them into doctor's surgeries so as they would know what to do, what to expect.
[speaker002:] Helen?
[speaker001:] In... we've had a menopause clinic in Glasgow for the last twenty four years... erm, it's run by a male doctor erm... but we have been treating patients for that length time. We're extremely interested in the women... we try to treat them as individuals... we cope with a lot of problems... and... I think if we look as women as individuals, each individual woman has a different problem. We all basically have flushes, sweats, depression and various other problems, but basically the ladies who present with flushes and sweats are the ladies who in fact get help... for ladies who don't present with flushes and sweats finish up as osteoporotic... and they're the ones we are very concerned about! We don't see them until they're too late and they're having fractures of the spine and shrinking... two percent of bone less in a year!
[speaker002:] Are you suggesting that every woman going through the menopause should get some kind of clinical help?
[speaker001:] It should be offered to her
[speaker002:] Mhm.
[speaker001:] if she wants it. I'm not telling every woman to take me H R T, I'm suggesting that it's... preventative medicine. We don't stop diabetics having insulin. If the ovaries are removed, ovaries stop working... there is treatment there to prevent us having disease, why shouldn't we take it and why shouldn't we have a better life?
[speaker002:] Linda? I'm, er, the director of the National Osteoporosis Society and we started five years ago and... as Helen said just now, we are in the business of informing women, not saying all women should be going on hormone replacement therapy! Some women certainly will sail through menopause with never a hot flush and no problems at all, sadly that's no indication that they're not going to have problems from their bones later on. Now i, let's let's do a bit of definition of terms here, osteoporosis is what It's bones that are too porous literally, so that they break very easily Aha. and that accounts for the hip fractures and the... the er... spines collapsing in Mhm. older women, losing height... a lot of pain from these fractures and it's bones that are too porous so they're not holding you up sufficiently as you get older. And how can that be alleviated? By hormone replacement therapy, that's the main way of of helping. You can do things for yourself in the way of diet, exercise, good lifestyle, not smoking and so on... but, a lot of women will need hormone replacement therapy just to replace the hormones that dear old mother nature stop supplying to us at the menopause. Hundred years ago we didn't live this long! Now that we do live much longer with better health care generally, what we want is for women to be able to live that last third of their lives in health... and being able to enjoy themselves and contribute to the community, not feeling that they're crippled by pain. Now, am I right in saying that there has been... some controversy in the past about hormone replace, let's call it H R T, it's shorter, that er... that not everyone's convinced it's it's it's a good idea, that there are maybe some negative side effects. I mean,wha what is the latest information on on H R T?
[speaker008:] You were right in saying that there was very bad press given to hormone replacement therapy in in the early days when they used very high doses of of er un er, of normal oestrogens and this caused an increase in the amount of end of uterus, uterine cancer... and this I think has generally er mo mo mo... ruined the course for for the older doctors because they still think that it's associated with an increase in cancer and they haven't got up to date to realise that the more modern preparations are not causing this and that's where I think th the problems li lie.
[speaker002:] Yes?
[speaker003:] We are in the course of giving H R T. The ladies are monitored very carefully and scanned and sometimes they pick up cancer in another part of the body which
[speaker008:] Mhm.
[speaker003:] is a bonus and a benefit to the sufferer and that is er... an extra thing with H R T.
[speaker002:] Here.
[speaker004:] I'd like to say that I'm actually on hormone replacement therapy and I'm not being [LAUGHTER] monitored []. I've been on it for over three years and I'm quite concerned about some of the things I've heard tonight and I'm going to make an appointment
[speaker003:] Well that's all the things that concerns us.
[speaker004:] and see my doctor about it straight away!
[speaker002:] It's not only woman who need to be better informed it's the doctors as well!
[speaker001:] Here here!
[speaker002:] Yes?
[speaker005:] I would like to ask, if one of these medical ladies could tell us? How, how, what percentage of these signs of the menopause are inherited tendencies?
[speaker002:] Who would like to... who'd like to answer that one? Yes?
[speaker006:] I will. I I there is no evidence that it's an inherited or venereal problem... and this is the, you know you... we have... there has been lots of sort of studies done to see which woman might be more at risk and which women, you know, might have symptoms and th, the fact is that the reason why you, why the menopause occurs is because the ovaries stop functioning, they stop... producing oestrogen... and every woman's ovaries does this and they do it... you know, at all varying ages... the average age is fifty. But the most interesting thing about it is that i... the actual level oestrogen bears no relationship to your symptoms as er... Sheila has said, you can have... two women... with the sa exactly the same level of oestrogen and one woman is having awful problems and the other woman is, as we have heard, having no problems at all!
[speaker007:] A year I had all the symptoms... and I went and got a book and read about it and tried to find out as much possible about it and the book scared me silly because it told me all these things that could happen
[speaker006:] Oh yes!
[speaker007:] and... I was upset so I went to my doctor who's a lady doctor and she's young, she explained things to me and she put me on H R T and it changed my life completely! It... th, I was depressed, I had swe sweats, night sweats and my husband was... all, he couldn't sleep at night and it changed it completely! And, the worse thing for me was I lost my self confidence, I had no confidence whatsoever.,. in all areas, work-wise
[speaker006:] Mm.
[speaker007:] at home with my family, whenever I went on the H R T everything changed! I felt better, I looked better, I di I didn't feel, my skin was better, my hair come back, it was just marvellous for me! Absolutely marvellous! H R T
[speaker008:] Well women don't want to
[speaker002:] Le let Louise say!
[speaker009:] May I just say, I thi, I think it's important to point out that H R T isn't a miracle cure! And although it will grea, greatly help some women, unfortunately some women are unable to tolerate it, the side effects it gi, it gives them are worse than the actually symptoms they're having in the first place. It means having periods back again which after, and now, er several years break and erm, many women find unacceptable.
[speaker001:] We all have to have that.
[speaker002:] You don't have that?
[speaker001:] We do have, we ha, we have tablets for that.
[speaker002:] Yes? Over here!
[speaker010:] I must admit, after I'd finished with the menopause I felt absolutely great! I wasn't on H R T, I had a very easy transition from having periods to stopping having periods. Er, I did go on H R T because of the osteoporosis risk, but I was unlucky I was one of the... I think twelve percent who had developed breast trouble and had to come off it. I think that er... it is probably a very useful thing if you can tolerate it. But I must admit, having a lifetime of painful periods and not having [LAUGHTER] any more painful periods [] was absolute bliss! And that's one of the drawbacks of H R T, it all came [LAUGHTER] back again []!
[speaker002:] Down here. Yeah?
[speaker001:] I was just going to mention the fact that if you have had breast cancer you cannot go on H R T cos it was a hormone that caused it in the first place!
[speaker002:] Is that right.
[speaker008:] Yes.
[speaker001:] I think, one fact that probably, I'm sure yo, many of us know here... is that the actual number of women on the H R T is really very small in this country! It's probably less, about, between five and ten percent!
[speaker002:] Mm.
[speaker001:] So... I mean th... the instance of breast cancer is rising... the instance of breast cancer, the number of cases of breast is rising, it rises with age. Currently,th nu, H R T in this country will not be influencing the risks of breast cancer. On the other hand, and it is extremely complex... and it indeed, it probably erm... amounts to the fact that each wom woman has to consider how she feels herself
[speaker002:] Mhm.
[speaker001:] about whether she would wish to run the risks of A, B, and C. And the other condition we haven't mentioned is... er th th th the risks of coronary artery disease and strokes which actually do, are the main cause of death o, in Scottish women! And... it's it's almost like saying that the, if you take H R T er, this is in our sort of survey... that you will in fact erm, reduce the instance of heart disease... but ma, might you, in in fact, increase the risks of breast cancer.
[speaker002:] Your making it sound like a heads you lose, tails you lose situation!
[speaker001:] It's a, it's a very, very complex issue!
[speaker008:] I mean
[speaker001:] And un unfor, and this is in fact is why indeed, general practitioners and even specialists find it very complex! I mean, last month er
[speaker002:] And and, and that is you, I mean you are a consultant gynaecologist and
[speaker001:] That's right! And
[speaker002:] you're describing the complexity of it.
[speaker001:] Yes!
[speaker002:] If we're, if we're agreeing that women ought to be able to make informed choices, there's so much information it's actually very hard to make a, particularly if your
[speaker001:] Yeah.
[speaker002:] G P... isn't as up-to-date as as as you might hope with the information him or herself.
[speaker001:] Yes!
[speaker002:] I sailed through the menopause, but then had lots of back problems. And this was cracked fracture from osteoporosis... now, if I had been getting H R T at that time I might have been less disfigured. But, at least I'm on it now and hopefully, slowing down the osteoporosis and I don't care about the cancer, er scares! I'd rather... la, have the treatment and ha, and have a reasonable life. Yes?
[speaker003:] As a younger and have plenty of time to worry about the [LAUGHTER] menopause before it happens []
[speaker001:] [LAUGHTER]
[speaker003:] erm, all I can say is I'm glad to see that it's stopped being referred to as women's troubles, you know and we're actually bringing it out to the forefront. But, is there anything that my generation could do now that might stop us requiring H R T in the future?
[speaker002:] Alright. Mhm.
[speaker008:] I I think it's important, especially for for young women up to the age of about thirty five when your peak bone density is probably attained and after that you, you do go downhill, to maximise the calcium intake. Nowadays people are worried about... er, drinking milk and dairy products because of the cholesterol bit, but I think that we've got to remember that there's a lot of calcium in milk and you should drink milk and take plenty of exercise and that is the time when it's probably extremely important!
[speaker002:] Yes?
[speaker004:] Wha, what do you do if you're allergic milk? Cos I haven't drink milk from, since a baby... and...
[speaker008:] Well tha, that's a bit more difficult. There are other foods that you can get it from, such as ice
[speaker004:] Erm
[speaker008:] cream, sardines
[speaker002:] Yoghurt?
[speaker008:] yoghurt. No,co oh well you'll be allergic to that too.
[speaker004:] I'm allergic, I'm allergic to a lot of foods!
[speaker002:] Can I, I want to pick up er, something that that Margaret said which is, I've got lots of time to worry about it. Now, obviously, you know,yo getting the menopause out into the open so that everyone can talk about it, exchange information that that... it's not seen as a as a taboo or something to be particularly fearful of by men or women... isn't going to be much good if it just makes everybody worry... for er, for for the first half of o o o of their lives and, and then gibber through the second half! I mean,
[speaker001:] [LAUGHTER]
[speaker002:] there is an argument, [LAUGHTER] ha []... and it's been put by er a a noted writed who's recently written on the menopause that, work, and you should just make the most of being a crone... or a hag... or an old women!
[speaker001:] [LAUGHTER] No!
[speaker002:] Now, I'm not saying I se, but it's a view that has been put forward,wha wha what do you think of that? Yes?
[speaker005:] I wouldn't actually say that... you know, one has got to suffer unduly, but I think we do have to be very, very careful that we don't just play into the hands of the drug manufacturers! See, they've got most women hooked on, on er... contraceptive pill for all their reproductive life... and they're dead keen that we should all get so worried about menopause that we would also be buying their products until we die! Now, although I have great respect for er, the representative of the Osteoporosis Society... I se, I still think as a epidemiologist... that there haven't been enough women on... H R T for long enough
[speaker002:] Mhm.
[speaker005:] for us to prove one way or the other that that, that that they co, the advantages out weigh the disadvantages.
[speaker002:] So you think we have some guinea pigs here?
[speaker005:] You have to be cautious!
[speaker002:] How long do you want them to be on H R T for? We've been following a group through in Glasgow who've been H, on H R T now for twenty three years! Up there.
[speaker006:] I think if you went and saw our own doctors a lot of our... fears would be allayed because... most of the young doctors wouldn't, would recommend to you, my own doctor asked me all the questions and different things and then he says... he's a young doctor, he says if I were a women and if I'd answered all the questions as you did, I would go on H R T. So, there might be a lot of doctors who would... do.
[speaker002:] Right. Beside you? Yes. Yes?
[speaker007:] I think you really highlights on working alongside with your doctor. I think you'll be able to read up as much information as possible and see a doctor and consult... and especially th where women's clinic are, a great boom! And we should attend
[speaker002:] Mm.
[speaker007:] it more often.
[speaker002:] Up there.
[speaker008:] I would just like to say that erm, it's not all gloom and doom!
[speaker002:] Mm.
[speaker008:] The menopause isn't necessarily the end of... our life, it can be the beginning of so many new different things.
[speaker002:] Yes?
[speaker009:] I I think erm, that it can be looked at to, without H R T or looking at it medically, because lots of the women at Dean Terrace, in fact have
[speaker002:] That's a family planning
[speaker009:] er problem That's right!
[speaker002:] situation. Yep!
[speaker009:] but erm, have erm... problems with what this lady has described who can't come to terms with
[speaker002:] Mhm.
[speaker009:] the... er loss of their fertility... and the loss of their children... and, have sexual problems and problems like that, and they don't necessarily need H R T... they need lots of time, which they're given. And I think that helps them an awful lot!
[speaker002:] Is it impossible that your sex life might improve after the menopause? I mean I I wo er... would anything like to say anything about
[speaker001:] Do we have to? No!
[speaker002:] a friend's experience or anything like that?
[speaker001:] [LAUGHTER]
[speaker002:] Nelly?
[speaker009:] Yes I would like to say, it was smashing after the
[speaker001:] [LAUGHTER]
[speaker009:] because you didn't have to worry that you were gonna have another child!
[speaker001:] [LAUGHTER]
[speaker009:] So, though I had a bad time, well I had a, I've had a great life since!
[speaker001:] [LAUGHTER]
[speaker002:] Good! Up there?
[speaker010:] What do you do about er, a doctor who says no? I mean, do you... change your doctor or what?
[speaker001:] Yes.
[speaker002:] Who would like to answer that one? Yes? Get more information first, so that you know all your facts and if you... ask us we'll send him a booklet without saying who er, who asked us to send it and then go in and see him and say, now the Osteoporosis Society have said this... and it's a very brave doctor who will then say... absolutely no! I'm, I'm not listening to you! But, in the final analysis, if you can't get any help, if he won't refer you to a specialist for help... change your doctor! Because if the garage did your car badly you wouldn't have any hesitation in in changing your garage and your body's a darn sight more important than your car!
[speaker001:] I think women can sail into a beautiful old age with enthusiasm for hobbies, taking up new interests of all sorts and... I've taken up skiing after the age of fifty and I'm, I feel I'm getting on well with it and this fresh air and and you know, getting out and... finding who you really are... after, you know, looking after children is is a wonderful thing! And this will keep you young! I don't have H R T, I didn't have any problems luckily, with the menopause... but I feel I've... I've found a bit more of who I really am, you know!
[speaker002:] I'm very interested in that
[speaker001:] [LAUGHTER]
[speaker002:] because that is what Germaine Greer says in her book, it's only after the menopause that you have the freedom and the liberty, to find out
[speaker001:] Yes! Yes it
[speaker002:] who you really are! Does
[speaker001:] Exactly!
[speaker002:] does does does anybody, yes! Yes. Well I had a hysterectomy when I was forty nine... and to me life really did begin at fifty! I go dancing! I'm now sixty two and I go dancing twice a week! So, I mean apart from arthritis... life's quite good! Here.
[speaker003:] Can I say, I'm thirty six and had a hysterectomy a year ago.
[speaker002:] Mhm.
[speaker003:] I'm taking flushes and whatever but I feel brand new compared to what I felt... before I had a hysterectomy cos I was totally lifeless! And I can agree with the ladies that say... life begins once you get by all these... problems that you had before.
[speaker002:] Up there.
[speaker004:] As a younger person I, I would expect that I've... probably got another fifteen years to go to the menopause, but I'm looking forward to it as a relief from pre-menstrual syndrome!
[speaker002:] [LAUGHTER]
[speaker004:] And, I wondering if any of the experts can say if there's erm... a link between the severity of... menopausal symptoms and pre-menstrual... symptoms?
[speaker002:] Okay a final, final expert view on that. Who would like to offer a
[speaker001:] fortunately no. Yo erm... your er... it isn't your fate in life to have all this pro, though major problems erm, and I think P M S is a major problem. And, in fact er... I would hopeful that you will be... feel better.
[speaker002:] Yes.
[speaker004:] Mm. I have a question to the politicians. The N H S cannot cope in the moment with you know, regular sort of cervical cancer smears.
[speaker002:] Mhm.
[speaker004:] How can they cope in the future with sort of er... monitoring the effects of H R T?
[speaker002:] Well er, that's for politicians watching, think about it to care about! Yes?
[speaker001:] Well if er, more women do take hormone replacement therapy and we cut the osteoporosis we will in fact have far money in the health service besi, because it costs a hundred and eighty million pounds a year to treat hip fractures alone at the moment!
[speaker002:] Germaine Greer has coined a term which you may have read, which is er... which is called PM... zed! Or PM zee, I suppose in America which she terms post-menopausal zest! Is post menopausal zest something that er... every woman... could look forward to if she gets the right advice, the right
[speaker001:] Definitely!
[speaker002:] treatment?
[speaker001:] Yes,! I think this being an old hag is what is all in the mind! If you're determined to enjoy the rest of your life you will! Be positive! Be positive about it, yes! I don't agree with that Sheena! No! You only have to listen to what women here have told you and it's not psychological! It's a myth! It is physiological! And there are plenty of people who have spoken here tonight... have substantiated that!
[speaker002:] Mhm.
[speaker005:] , my first years... had two children, had no breast problems and I'm having a horrendous time just now... and I'm on H R T, I'm on my third different kind! And I've had so, examinations... and my doctor is very good! Do, the doctor I have now is very good and very sympathetic! But she feels there's nothing you actually can do to help me with!
[speaker002:] Final word?
[speaker004:] As I've said, I've been on H R T for three years... and, I have since went back to work after being on H R T... I don't think I'm an old hag! I don't want to be like a film star, but... I do want a better quality of life and I've got that with H R T!
[speaker002:] We're going to have to end and I'm sorry about that because er, it's been very interesting! You've heard a very broad range of views, erm, of all sorts! I think the most important thing that we've done is talk about it. Ninety one people here wanted more information. There is information available. I hope you can find it, er if yo if er if you want and... and the important thing is to keep talking about it, keep exchanging information. Thanks everybody here for your experiences and information! Goodbye! [closing music]