Stephanie and Karen, two friends based in the north of England, recount their shared experiences of going through menopause and surviving breast cancer. They highlight the importance of a strong support system to get through “the really big stuff” and that it is never too late to form deep friendships.
This episode shares the stories of Stephanie and Karen, two friends based in the north of England. In addition to both experiencing menopause, Stephanie and Karen both battled with breast cancer. The two have supported each other through “the really big stuff” and underscore the importance of strong friendships in midlife. This episode demonstrates that it is never too late to form deep friendships and how valuable it can be to connect with others who are going through similar experiences.
Useful Links: Listen to more episodes featuring the experience of fibroids (Kathie’s Story and Sateria’s Story), hysterectomy (Deborah’s Story), and cancer (Rebecca’s Story), during midlife.
Are you interested in sharing your menopause story on the podcast? You can pass your contact details to the production team for further consideration by filling out this form.
Disclaimer: menopause: unmuted is designed to raise awareness, encourage communication, and share information. It is not designed to provide medical advice or promote or recommend any treatment option.
Host: Mary Jane Minkin
Producer: Freya Hellier for Studio Health
MJM
It’s time to unmute menopause.
Hello and thanks for tuning in to another episode of menopause: unmuted.
I’m your host Mary Jane Minkin. My work as an OBGYN and clinical professor at Yale University School of Medicine means that I have spent literally decades talking with women and their loved ones about menopause.
It’s a time of life where there is often a lot to juggle and having to deal with a major change like menopause on top of everything else can feel overwhelming. But through listening to other women’s real life menopause stories, we can be reminded that we’re not alone, and there are so many reasons to both support and be supported by the people closest to us.
So, whether you’re having a tough time with your own menopause, or you’re loving midlife, or you just want to understand it better so that you can be alongside someone you care about, I want to welcome you along and thank you for listening.
This season, we’ve already heard from husband-and-wife Karen and Mark, and sisters Becky and Suzanne about how they’ve navigated menopause, and today I’m bringing you two great friends who shared a very serious health challenge alongside their menopause.
Stephanie and Karen both live in a beautiful part of the north of England, they met online but have built an enduring friendship that’s seen them through the toughest of times. Let’s unmute their menopause.
Stephanie 00:00
Hi, I'm Stephanie. I live in North Yorkshire, and I have a daughter who is 14 years old, a son who's 20. And I live with my husband, Philip. We live in the countryside on the edge of the North York National Park, so very beautiful part of the world. And I'm a Registered nutritionist, and I spend my days helping women of our age, of menopausal age, lead a healthier, happier life, so that they have a better menopause journey. My hobbies are cooking, but it's gone a step further, where I've now started to grow my own food. When I've gone from being someone who would never have grown anything and was always far too nicely dressed to even entertain going into the garden, to growing huge amounts of tomatoes and salads and potatoes and I've got kale and cauliflower, and it's just such fun to do, and it's really a real gift, to be able to grow things and give them to friends to eat. So that's what I enjoy doing in my spare time.
Karen 01:07
Hello. My name is Karen. I'm 54, years of age. I come from North Yorkshire, and I live there with my husband, Gary, and four children ranging from the ages of 23 to 17. We've also got two dogs now, and life just feels very full on. Gary and I own our own independent opticians practices, and I've been lucky enough to take time out of our business to be able to write. So, I am now a published author.
Stephanie 01:38
Karen and I met we think about 10 years ago, and it was in the early days of Twitter, and I had just started a business focusing on nutrition as well as other health products, because I'm very much about the being healthy, sort of the inside and out. And I'd seen Karen's Twitter account, and I just thought, I need to reach out to her. But back in those days, you could only have 140 characters, so it was, how do I send a message without sounding totally weird? But I managed, because Karen replied.
Karen 02:18
There was the time, yeah, certainly Twitter was, wasn't as it is now [No] and I saw the message, and at the time, I was looking to do different things with our optician’s practice. And I just set up bridal eyewear and wanted to bring makeup and glasses into the practice. So, I was looking to learn how to be a makeup artist. So, we arranged to meet, didn't we in York it was like a blind date. [It was!] We met in a cafe.
Stephanie 02:46
We met in a café, in this shop and we had a cup of tea, and we've been friends ever since.
Karen 02:53
Yeah, I was... the timing of things. It's really funny, isn't it, when you're looking for something, then something pops up and yeah, there was yes, definitely yes.
Stephanie 03:02
Yes, the universe sometimes just [just] ticks all the boxes and [and] things fall into place. So, we, we've been friends for 10 years, and it's probably 10 years ago when I first really knew that I was on the menopause journey. And obviously, with being a nutritionist. It's something that was always on my radar and something I had quite a good and thorough understanding of. And I had my children very late in life. So, I had my daughter when I turned 40, and I remember going to the doctor, and I took my daughter with me or to the appointment. So, there she is, two years old, and I say to my doctor, I know this sounds ridiculous, but I can't remember anything. My brain is, I've just gone to mush. I know I've got a baby, and I know everyone talks about baby brain, but I actually think I've started on my perimenopause journey. So, we had a long conversation about it, and he was very understanding, but he also made it very clear from that consultation that because of my medical history, I couldn't look at some of the options that are open to other women for menopause because it just wasn't going to be suitable for me. So, I was kind of on my own, so, that that was a bit of a shocker. So, I came away from that and thought, oh, there has to be a better way. And I think that feeling has really driven me through my work, so that what I do now is I focus very much on helping women with their midlife health and filling all the gaps that aren't really out there for people. And that's it's been a journey of self-discovery and a journey of sharing as well as I find things out or work things out and [and] try things. So, for instance, today, when we arrived to do the recording, I produced my decaffeinated tea bags because caffeine isn't entering my body anymore, not unless I want to feel very hot and sweaty for another half an hour.[1]
MJM
Everyone has a different menopause experience, and some of you listening might think that Stephanie started to experience her symptoms quite early – in her early 40s, but her story is not an unusual one.
The average age of menopause is 51 in the UK[2] and in the United States,[3] and it’s perfectly normal that signs of perimenopause might start to show about 4-8 years before a woman officially reaches menopause. A woman has officially reached menopause when she has gone a full 12 months without a period.[3]
I have to commend Stephanie for recognizing her symptoms and seeking help, because for many women it’s not until they’re really struggling to cope that they seek help.[4]
Beginning that conversation with your health care provider early can mean that you are emotionally prepared for what is coming. And as you’ve heard from other women on this podcast many women know very little about menopause until it happens to them.
Stephanie also mentioned that she avoids caffeine. Everyone has different triggers for their menopause symptoms and hot flashes are one of the biggest gripes for women. A lot of people find that they become more sensitive to things like alcohol, spicy food and caffeine.[1,5,6] I wish I could give you a definitive list of things to avoid, but it really is a case of trial and error to find out what is best to minimize in your diet.
Let’s turn now to Karen, whose introduction to menopause was quite different.
Karen 05:15
Well, I didn't even think about the menopause or even think I was even going into it. I had four cesarean sections. Three were emergency, and number four was planned. And after my fourth section, I actually got sterilized because it wasn't safe for me to become pregnant again. So, I'd always thought, Oh, well, this is how my body is. No problems at all. I was still playing netball, I was still coaching, still working, still running around after all the children, and then I suddenly felt a bit weird and slowing down. But it wasn't, it wasn't the menopause. I ended up with fibroids, and again, I didn't know what all that was about. It was just I was doubled over in pain, and then I'd actually, I was actually coaching at the time with the junior netball team, and I just doubled over and the next day into hospital and then surgery unit, and then looked and said, No, you got this fibroid, and it needs removing. And I was basically told, you need to have a hysterectomy because of your age, we'll probably take your ovaries out, but we might, might not, and if we do take your ovaries out, it's absolutely fine, there's treatments for it, and you just get on.[7] But then I was diagnosed with breast cancer, so this is a few months down the line, after going through the fibroids, although they were still there, but we were waiting for different consultants. Then when they found out about breast cancer, it was right, we have to deal with the cancer first, and then we deal with the other bit afterwards. And again, it was sold to me. Well, you've got a small tumor, we'll just move, remove it, lumpectomy, radiotherapy, off you go. But then the next stage of it was right, really sorry we've diagnosed you with the wrong type of cancer, so we need to remove more of your breast. Went through another operation and then so sorry we haven't got clear margins. We're just going to take your whole breast off.[8] So I had a full mastectomy. But then after my third operation that year, I was then having my fourth operation of having a hysterectomy, and because of having the cancer that they took everything away, which then put my whole body straight into menopause.[7] And it was like someone took my internal heating system out, jumped up and down on it, kicked it, squashed it, put it back in and said, “Get on with it”, and it was one of the worst feelings ever going into the menopause was such a shock to my body. It was actually worse than having my breast off, in my opinion.
Stephanie 07:54
And I can totally relate to Karen's story, because just as Karen was coming away from her cancer journey and back on the road to health, I joined her on the cancer roller coaster because at the age of 53 I was diagnosed with breast cancer.[9] Which is always a devastating diagnosis to receive, and then you're off on this roller coaster of treatment, and you just go with it. And like Karen, I had mastectomy. I actually had a double mastectomy, and then to prevent any further risks, because of the genetic risk that I have, they also took away my ovaries, so, like Karen, whatever was going on in my body before after, I came out from the operation, I was definitely in menopause, because I was never going to have another period.[7] And although I'd been on this perimenopause journey for quite a while, I was still having periods after my mastectomy. I mean, if you want to know how cruel nature can be, [I had my mastec...], my first mastectomy, and the day I left hospital, I had one of the heaviest periods I've ever had. And you tried dealing with a really heavy period, a surgical draining and being completely, totally out of it after major surgery, it just was so not funny. So yeah, so that that was really a strange way to enter menopause fully. So, although I'd had a bit more of a run up to it than Karen did, it wasn't quite so abrupt from that point. It was totally, totally different, and that took quite a lot of adjustment, I suppose, for me, I was a bit luckier, because I had spoken to Karen, and Karen had given me a massive heads up. And I think that sharing your story and helping people be aware of situations is so important, and I've tried to do that so much with my work as I went through my journey up until that point, and it makes me even more passionate about carrying on afterwards and sharing what it's like to go through menopause unnaturally, rather than as a fully natural process. And we've had lots of discussions about this haven't we?
Karen 10:34
We have, yeah, yeah, it just we’ve been thrown into it. And if you feel like your bodies in shock and how we used to be able to do things, and suddenly you're a different person. I felt, probably to a degree, still now, a shadow of the person I used to be. And then the weights gone on, so suddenly I've gone up a dress size, and then having to look at myself again and what to wear and having to reevaluate myself in different ways. And also, I've really struggled with work. When I went back after my hysterectomy, going back to deal with patients, the computer system, normally I would have been on it, I would have been able to, yeah, dispense these lenses, sort out the glasses, deal with ordering frames, everything, running your own business. And I would be sitting at the computer screen looking at patients, thinking, I really can't even make my mind up which glasses look right on you, which [which] was always one of my skill sets, I could always, I always had a fair idea who looked good in what frame, and then having to think about the lenses and refractive indexes and [and] I just couldn't do it.
Stephanie 11:45
And I think that is the [the] one of the hardest things, because it makes, it gives you that real sort of sense of doubt. It's, you know, you're at a time of your life where there's an awful lot of change going on. Because, you know, your kids are sort of growing up and leaving home. People often have to look after their own parents as well. So, it's a busy time of your life, menopause in a different way, and you kind of need to be on your A game and busy and organized and multitasking and being super mum, and suddenly you just like, I can't. And Karen and I are both real doers and organizers and [and] if you need to rely on people, it's us.
MJM
Stephanie’s description of cancer as a roller coaster feels so accurate to me. I work with a lot of cancer patients and it’s a scary and upsetting diagnosis, no matter what age or stage of life you’re at.
Breast cancer is the most common cancer for women in the UK,[10] and in the US, the second most common after skin cancer.[11] Although the median age at the time of breast cancer diagnosis in the US is 62,[11] we certainly see many younger women dealing with it before and during the menopause transition. Fortunately, we have effective therapies available and of course, early detection is key to increasing your chance of a successful outcome.[12] Ask your healthcare provider what regular screening looks like for you.
It can be quite stressful for women to deal with menopause symptoms like hot flashes, fatigue, anxiety and brain fog at the same time they have the worry of cancer, and it’s treatment. This can take quite a toll on the body.
Although Stephanie had experienced some naturally occurring symptoms of menopause, both she and Karen went into a surgically induced menopause due to having both ovaries removed.[7]
Removal of both ovaries will cause a woman to experience immediate menopause, which can feel sudden and marked.[6]
Breast cancer is a consideration in deciding on how to manage menopause and it is one of the biggest concerns I hear from women when they come to see me. It’s really important to get good quality and up to date information, talk to your healthcare provider about your individual risks, medical history, and situation, they can give you personalized advice and discuss your options with you.
I know it can be a very overwhelming time and there can be a lot of information to take it, but it really is important that you feel comfortable and fully informed. It can be very helpful to have a trusted friend or family member alongside you for those consultations as it’s easy to forget important questions in these moments.
We have a few previous episodes where women talk about fibroids, hysterectomy and cancer during midlife. You might want to listen to Deborah, Kathie and Rebecca from past seasons.
This is menopause: unmuted where we listen to real menopause stories.
I’m your host Mary Jane Minkin and if you’d like to listen to other women’s stories about their menopause experiences, visit menopauseunmuted.com
That’s also where you can get more information about menopause. No matter what you’re experiencing, all of us can feel the benefit of having a friend alongside us in tough times. That’s something that Karen and Stephanie know all about.
Stephanie
You really do see where the true deep friendships come from. You have lots of people that you know in your lives, but when you go through the really big stuff it, it can be sometimes the most unlikely people that are part of the circle of people that you know who become your strongest pillars of support. And yes, it can be really quite revealing as to where the love is in in your life and in your [your] universe, and it's, it's a very life affirming experience as well. You come out with bonds of friendship that you [you] could never have imagined how; how strong those friendships would ever have been before your diagnosis. But when the really big stuff happens, there are some friends in your circles who will just be marvelous. Karen's one of them for me.
Karen 13:35
Ah, thank you. But I know you mean it's, when you can talk to someone who's been through it, and I, I felt quite grateful that I could tell people about my experience, to hopefully help you and I’d another friend, [Yes] who's been through it, and actually just being able to chat to someone else who's been through what you've both been through, or [or] being able to give advice as, yeah, it's quite warming and it's it does help where you are, because I know what I was like. I was a little bit; I went into myself. I thought if I was diagnosed with [with] cancer or something, I would be wanting to go to Australia or wanting to do this, wanting to do that, but actually all I want to do is sit in our conservatory, have a cup of tea and watch the birds. Yeah, I just wanted to be around my family.
Stephanie 14:23
I think it kind of puts menopause a little bit more in perspective as well, in that cancer is big and tough to deal with, but menopause is a passage of life that women just have to go through, because you're going to go through it, and what we need is more support and lift. And that what we got for our cancer treatment. We need a little bit of that in our menopause journey, where we love each other.
Karen 14:56
Yeah, you just read my mind there, because there's a team of nurses and surgeons and everyone around you, and everyone wants you to do well and be healing. Whereas the menopause, it's a bit like, get on with it.
Stephanie 15:09
Yeah, get on with it. Deal with it, it’s normal. And you know, there for a lot of women, if you have to go and sit in a room for two or three hours with no toilet facilities, this could be a nightmare, because, let's face it, flooding happens to the best of us and at the most awful points in time and [and] it's things like that where people just aren't very understanding there's in the same way. No, no one's got a drawer in their office where they can just say, here's a pair of leggings and some clean underwear and some stuff. Go, go and get yourself sorted, and know what, what it's all about. No, we just sit there and stick it out. Just get on with get on with it. And yeah, and yeah, and think things have to change. And I know people do talk about menopause more, and I think our generation of men in our lives are a little bit more understanding than a few years ago, but boy, have we got a long way to go.
Karen 16:35
There’s policies now at work, because having a small business, Gary, my husband, is the menopause specialist at work.
Stephanie 16:42
Oh, that's marvelous.
Karen 16:44
So, we've got all the female staff. He says, I am the menopause person, but then he can understand and appreciate where we're coming from. And I mean, I was in such a lucky position, because after having the hysterectomy, and say, gone back to work, and I was so struggling. We had lockdown. So, I was quite glad of it, really, in a selfish point of view, because I was struggling just to get up in the morning, but just normal things like, oh, it takes me so long to do my makeup normally and quite quick this that and this sort the dog out, sort kids out. Couldn't do it. I really struggled and getting out of bed, and motivation.
Stephanie 17:24
Oh, getting out of bed is so hard. It’s bonkers!
Karen 17:28
And sometimes I feel really lazy because I just say, I can't, I can't get going. But in your mind, what happened? Where? Where have I gone? What happened to the person I used to be, and I was so competitive playing netball. Did all to keep fit. I really just happy walking a dog.
Stephanie 17:47
There's not an appreciation of at this time of your life, what you used to do is now a really big ask. You can still do it, but physiologically, biologically as human beings, there is a change, and it's hard. Things need to have a bit of a rethink the pattern of how we get through our day. You know, not starting so early in the day can make a massive difference. And I think we just have to be kind to ourselves and go, well, so what? But it's a very hard adjustment when you're busy and like you say, competitive.
Karen 18:24
And give yourself time to say it's okay to sit and have a cup of tea. It's okay to stare out of the window. You don't have to keep going full on. [No] no, but yeah, it is hard.
Stephanie 18:33
There's a big social adjustment that has to come to [to] just be kind to people that are a bit older, I think our lifestyles have also changed, so that in the olden days, so probably more our grandparents really, than our parents’ generation, but women of our age were normally much more at home and not doing much and pottering around the garden like we do, but in a not as another thing on the list, but as a way of filling their day, and life had slowed down, but society doesn't really offer us that anymore, does it? You know, we’re full on, we're full on. We're at 50, we're like, we're still 35 and some things just do have to give. And a better appreciation of that is really where society needs to head to have a better menopause.
Karen 19:23
Definitely. But then I feel really lucky that I've been able to take the time out, yes, because, and I remember Gary saying to me, what would you really like to do? And I just said, I just want to walk the dog, be in a field, middle of nowhere, and write. And our son came to work for us, and he said, right, you've got an opportunity if you want to take six months out of the business. Daniel's here now, and we can work it out. And I remember thinking brilliant but then I felt so guilty I wasn't working, even though I was then writing to sort of try and get in my head that was my new job. [Yes], But through having that time out, I'm now a published author. So how life can go and change?
Stephanie 20:12
Yes.
Karen 20:13
If I was going to give any advice to somebody going through it, or before they get there, certainly be kind to yourself. Just be realistic. You're not going mad, you're not on your own. And get yourself a thermal mug, which you can get ice water so yeah, ice water stays cold all night. So, when you are flushing in the middle of night, you can have a sip of cold water.
Stephanie 20:39
I absolutely agree, the one word that comes to mind for anyone who is embarking on that perimenopause journey and beyond is kindness. I think being kind is a virtue that we [we] do lack a lot in society. If menopause was a bit more at the forefront of our mind, we could maybe be a little kinder and little less frustrated with others. And if people are less frustrated with you, then you feel less stressed and if you feel less stressed, you have fewer hot flashes.[4] Certainly. Yes, so yes, kindness and patience, yes, definitely, yeah.
MJM
Something that really struck me about Karen and Stephanie’s conversation was just how honest they were about acknowledging that we might need to change what we expect of ourselves at midlife.
Maybe you’re a mom who is always there for the kids, a professional woman carrying a lot of responsibility, you might be caring for an older relative, or perhaps you’re doing all of those things
If you’re going to truly show up for others, you have to be in a good physical and mental state yourself. It can be difficult for other people to accept that you might have to dial back what you were previously capable of, but the biggest battle is often with ourselves.
Stephanie and Karen have shared some really fantastic examples of learning to recognize how and why things needed to change in their lives. And I want to emphasize that they have both gone onto achieve great things in midlife – this is about thriving, not surviving!
I want to say a huge thank you to them both for sharing their stories with us. I wish them both the best of health and success in their lives.
I’m Mary Jane Minkin, and thanks for listening. I have another menopause story for you coming very soon, but in the meantime, you can check out the show notes of this episode where you can find more information on how to get in touch to share your own menopause story.
And if you know someone who would enjoy this episode, please share it, and help to spread the word
Before I go, I’d just like to say: don’t suffer in silence. Don’t worry about speaking up about your menopause.
Women should be able to discuss menopause with their health care providers. A woman can speak out about menopause with her OB/GYN, primary care provider, or nurse practitioner. There are even designated menopause practitioners that a woman can visit.
Special thanks to the Women's Health team at Pfizer and to Studio Health for producing this series.
Talk soon.
[Disclaimer]
This podcast is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. Please speak with your healthcare provider regarding any health questions. The opinions expressed in this podcast are the opinions of the individuals recorded, and not necessarily opinions endorsed by Pfizer. The women in this podcast are participating voluntarily and have not been compensated for their appearance. The host has been compensated by Pfizer. The podcast is only intended for residents of the United States.
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References