‘Menopause’ Talking about the taboo - a journey you don’t have to take alone

IT’S kind of whispered about, ‘menopause’. And I just want to scream it from the rooftops. I’m in perimenopause. It’s normal. I’m getting treatment and I’m doing great.”

These are the words of a Limerick woman talking about something that affects every woman at one stage or another in their lifetime. Menopause.

Dr Caoimhe Hartley, who has her own menopause clinic in Dublin called Menopause Health, offers the following definition of menopause: “After a full year of no bleeding, without another cause such as pregnancy or medication, this is menopause.”

Dr Hartley went on to explain that a common symptom of menopause is hot flushes, or night sweats to some. “They can be accompanied by palpitations or anxiety and are usually described as a sensation of rising heat and sweating followed by feeling very cold.”

However, to many women, these symptoms and many more, have massive, if not life-changing, effects on their lives.

Denise Ruth, living in Limerick city, recalled her experience of entering menopause and how quickly things changed for her. “In 2013, I was diagnosed with oestrogen-positive breast cancer. As part of breast cancer treatment at the time, I was told to go into surgery, chemotherapy, and radiotherapy. Chemotherapy would give me, what’s called, a chemically-induced menopause.”

“The symptoms started overnight,” Denise explained. “Hot flushes, mood swings. Because I was undergoing other treatments I didn’t know what was related to what. Whether it was chemo or whether it was menopause.”

Denise said that she felt like she was walking in the dark. “I wasn’t even given a leaflet,” she pointed out.

As the symptoms began Denise didn’t realise how big of an impact menopause would have on every facet of her life. “I knew what menopause was, I understood what it meant. I didn’t actually understand how it would affect me and my life and the impact it would have before I started going through it. Even the effect it would have on relationships.

“It was tough,” she asserted. “And no supports at all. I used to have a lot of side effects during the menopause, particularly bladder infections, UTIs, and cystitis. Going to the doctor and simply being told ‘that’s a symptom of the menopause…’ And you’re asking ‘how can I fix it? How can I prevent it?’ And they’re telling you, ‘no, it’s just menopause. Just get on with it’.”

Another woman from Corbally who spoke to the Leader but wanted to remain anonymous similarly said that before she got treatment, perimenopause was having a big effect on her life.

“I was constantly tired,” she noted. “But then I had insomnia even though I was so tired. That was adding to it. I had awful brain fog. A job I had been doing with confidence for years I was second guessing myself. I was having to double-check and triple-check myself.”

The woman also explained how she had been rattled with anxiety because of the menopause. She spoke of waking one morning filled with anxiety. As the day went on she explained that the anxiety just grew gradually worse.

“I’d never felt this way before,” she remarked, “I eventually ended up telling my husband. I just broke down saying I’ve awful anxiety, I don’t know what’s wrong with me.”

The women who shared their stories to the Leader all said that, to them, there appeared to be a lack of conversation and education around menopause, even though every woman in the world will be affected by it at some point.

Dr Caoimhe Hartley shared her own theory on why menopause remains largely undiscussed,

“It is wrapped up in our attitude, as a society, towards aging and women in general. We have a youth-obsessed culture and confronting the concept of menopause and the loss of your reproductive life is challenging. A lot of people view being menopausal as being ‘old’ or no longer relevant, an attitude that really needs to change. It is a privilege to age and we should celebrate the experience and freedom it brings.”

She continued, “Women's health issues have for a long time been ‘taboo’ and discussed in hushed voices. It took a long time for men to be allowed on maternity wards and periods to be discussed on television. I think menopause is part of that continuum.”

There are currently several treatments for menopause, the most common of which is Hormonal Replacement Therapy (HRT).

“I ended up starting HRT treatment in February 2020. I’ve found it absolutely fantastic. It alleviated nearly all my symptoms, from night sweats to anxiety.”

Due to medical studies released in the late ‘90s and early 2000s, Hormonal Replacement Therapy has gotten a bad name. However, as Dr Hartley explains, these studies were deeply flawed.

“These studies were poorly designed and the initial reports overstated the risks of breast cancer and heart disease. Unfortunately, this led to an almost 50% drop in HRT prescribing rates globally. It has taken a long time, and a lot of new research, for our opinion on the risks and benefits of HRT to change. I think the lack of being able to have an effective discussion about treatment options for menopausal symptoms meant it fell off the radar altogether.”

Hormonal Replacement Therapy can have a great effect on many menopausal women. However, it may not be a suitable treatment for some. It is thoroughly recommended that you consult your GP or a menopause specialist to see what treatment would be suitable for you.

One thing that many of the women who spoke about their experiences of menopause had in common was the comfort they drew from talking about it with other women who are going through the same thing.

There is a group on Facebook called The Irish Menopause. Women often share their questions and experiences through posts on the group. It currently has 20,000 members.

One Limerick woman, who again didn’t wish to be identified, explained the positive impact it had on her. “Seeing other women’s experiences was a total lifesaver. I’m on it everyday. It makes you feel ‘it’s not just me.’ It’s not something else to worry about, it’s just perimenopause. It’s great to talk to other people.”

There are also two lecturers in the University of Limerick who are conducting research into menopause or, more broadly, the whole lifecycle of periods. Dr Kellie Morrissey and Dr Muireann McMahon have started a project called Cycles - Co-designing the Future of Menstrual Health and Wellbeing.

They are working with women at every stage and cycle to try and produce products that will benefit them. They are doing so by actively listening to the needs of people who menstruate or are in menopause. Currently, they are still at the beginning of their project but they are ones to watch in the near future.

There are many different supports for women in menopause. Dr Caoimhe Hartley is based in Dublin but offers Zoom meetings to everyone around the country. Elite Medical and Aesthetics, run by Dr Asma Kahn, is also very popular here in Limerick for menopause treatment.

“I would really like to get it out there that it’s not something to be feared and it’s not something to be suffered through,” said one Limerick woman. “You’re not going crazy. Your body is not breaking down. You might feel like a hundred years old but it’s just your hormones.”