Learning about our menopausal bodies and minds is crucial - and these three books will help

We've come a long way from the shame and silence we long associated with menopause. Three new Irish books on the topic leave no stone unturned, from vaginal dryness to hot flushes, and crippling anxiety

Deirdre Lundy: “The science is actually pretty simple and the knowledge is there,”

You wait generations for a decent Irish book on menopause and then three come along at once, two written by doctors and the third by a menopause coach. Given how erratic the general medical profession can still be when it comes to menopause support and information, learning about our own menopausal bodies and minds is crucial. We are the menopause generation who are no longer prepared to put up and shut up, but to have this all-encompassing mind-body phenomenon placed squarely in the conversation, and in the wider culture.

We know about hot flushes and a lack of vaginal lusciousness, but what about dry eyeballs and a strong desire to rip your life up and start it again, if only you had the energy and could remember where you put your keys? Until five minutes ago, we were not talking about any of this. Now we can’t stop. There’s even a touring stand-up on the subject — Irish comedian Anne Gildea, fed up of being fobbed off, wrote a one-woman show, 'How To Get The Menopause & Enjoy It'.

It's all-natural, so why not be upfront and just talk?

Dr Deirdre Lundy, whose Twitter handle is ‘radiant goddess of menopause’, dedicates her comprehensive manual The Menopause: The Essential Guide To Managing Your Health In Mid Life  (Penguin)  to those who, in May 2021, rang RTÉ’s Liveline and got the Irish menopause conversation irrevocably rolling, and also “for every menopausal woman who left a doctor’s office feeling worse than when she went in.” She starts by explaining what is happening to our bodies and minds (“What is the menopause? And why the hell is it happening to me?”) because this basic medical information — affecting 51% of the population - is still not widely taught, shared, or known.

“The science is actually pretty simple and the knowledge is there,” she writes. Silence around menopause has been down to “misinformation, embarrassment and a complete inability to just talk like grown-ups about vaginas and wombs and periods… that drives me nuts.” She adds, “It’s all-natural and the help is sorely needed, so why not be upfront… and just talk?” 

The Menopause

 Lundy had a rotten one herself. “My own menopause was a lot worse than it needed to be, I believe,” she writes. “I learned more from my own life than any ‘mental health in primary care’ lecture could ever convey. I think — I hope — that I have become a better doctor as a result of my own ill health and the struggle to find the right fix.”

 She urges us to remember that menopause is “a whole body phenomenon that affects every major organ, including the brain.” 

 Dr Lundy heads the Complex Menopause Service, a specialist clinic at the Rotunda hospital which works with women who have medical conditions such as thrombosis, cardiovascular disease, cerebrovascular disease, hormone-sensitive cancers etc, which makes their menopause even more complicated than the common-or-garden kind.

As well as guiding us through the latter, with chapters on how to look after our bone, brain, breast, heart, and vaginal health, she includes information for those dealing with menopause in conjunction with endometriosis, breast cancer, excess body weight, diabetes, thrombosis, migraine, lupus, and HIV.

She includes a chapter on the transgender experience of menopause, despite a lack of specific information “because the necessary clinical studies have not yet been conducted.” And then there’s medical menopause, where surgery or chemo kickstarts it overnight. (I experienced this, and it was not fun — not just the crashing physical and mental symptoms, but the total lack of mainstream medical support. I was on my own with it.)

Dr. Mary Ryan, consultant physician & endocrinologist. Photograph Moya Nolan

Get your hormones checked

Endocrinologist Mary Ryan’s book, It’s Probably Your Hormones (Gill Books), explores the wider impact of hormones on health – appetite, sleep, periods, libido, gut health. If you are wondering why you’re exhausted, have painful periods, feel angry, have low libido, worrying you may have early dementia, can’t sleep, and are putting on weight — get your hormones checked. In menopause, everything from bowels to anxiety levels can be impacted; it is crucial to seek treatment, rather than suffer alone.

One case study outlines how a previously calm 53-year-old woman presented to Dr Ryan with severe anxiety, which was impacting on her professional and personal life; Dr Ryan prescribed HRT and the symptoms alleviated. This is not a dramatic story, but anyone who has endured menopause anxiety will know how isolating and debilitating it can be — hence the need to educate, treat, demystify, normalise.

It's probably your hormones

Another case study describes how a 47-year-old woman presented with year-long insomnia, restless leg syndrome, brain fog, no libido, and increased mood swings. She felt overwhelmed by her teenage kids, and unable to have sex because of vaginal dryness. Sounds familiar? The husband was in the waiting room, and Dr Ryan called him in. After dealing with the hormonal — by prescribing HRT and vaginal oestrogen — she got the husband to make a housework rota, involving the teenagers. It’s not always just hormones which need rebalancing.

Even our cultural perception of menopause is limited — we think of it purely as the end of periods, accompanied by a whole raft of unpleasant symptoms. Dr Ryan reminds of the Japanese term used instead of menopause, Konenki, which roughly translates as ‘years of regeneration and renewal’. “It is thought that having a more positive word for the experience frames it totally differently in one’s culture,” she writes. “Cultural significance can change everything.”

Catherine O'Keeffe, Wellness Warrior

Menopause strategies in the workplace

 Menopause coach Catherine O’Keeffe is the founder of Wellness Warrior, and runs the Menopause Success Summit — as well as educating women (and everyone else) on what menopause involves, she’s all about structural change and implementing comprehensive menopause strategies in the workplace. Sometimes we need more than an electric fan, or being able to open a window.

“Menopause needs three things in the workplace,” she writes in her book All You Need To Know About Menopause (O'Brien Press).  “Support, education, and understanding.” Her experience, having spoken “in hundreds of workplaces both in Ireland and globally” is that “employers are eager to understand what menopause is and how best they can support their employees.” 

She adds how “every single symptom of menopause you experience will have an impact on your daily life at work". Which makes it all the more important for women to know all about menopause so that we can best articulate our needs.

From the office to the bedroom, it’s on us, but because of all the brain fog, coruscating anxiety, and your bones turning to dust, sex can get lost in the mix. The WHO describes female sexuality as a basic human right, yet menopause throws cold water on our libido — 69% of us experience a drop in sex drive.

All you need to know about menopause

“The good news is that you can rekindle it,” writes O’Keeffe. “It is crucial we become more comfortable talking about this aspect of menopause and its closely aligned sister – vaginal symptoms.” As well as the usual stuff – lube, vibrators, oestrogen pessaries etc — there’s a bit on testosterone. We are slowly realising that this can help with libido and overall menopause health.

“Clinical trials showed that two-thirds of women responded well to testosterone, but the response is not always immediate,” writes O’Keeffe. So if you decide to try testosterone replacement therapy, be prepared to take your time with it — commit to three to six months, under clinical supervision obviously — and see if it makes a difference.

“Feeling exhausted, stressed, and hot will not help your appetite for sex,” writes O’Keeffe. “But if you look at your sexual health as another aspect of your menopause that needs attention, now and for the future, then you may start to prioritise it more and realise that if you wish, it can be another invigorating aspect of your life now, where you know what you like and have the confidence to communicate it.” 

Absolutely. Orgasm lowers blood pressure, releases oxytocin and serotonin, boosts antibody production, and boosts mood — in other words, free natural medicine for menopausal women everywhere.