Take it from me: Four female doctors on their menopause experience

Four doctors talk to Helen O’Callaghan about their experience of midlife hormone changes and how it has shaped the care they offer women undergoing a similar transition

Fri, 06 Oct, 2023 - 12:43

Helen O’Callaghan

Menopause is a key transition — and every woman will undergo it. Yet it has not always been talked about openly.

Here, we talk to four doctors about navigating their own perimenopause/menopause. We asked each a range of questions: About when they first noticed signs of a hormone shift, about symptoms and how these affected their lives. What steps did they take to manage symptoms? Was HRT part of their solution? How important was family/friend support — and if they have an ongoing self-care plan?

We also asked how their experience informed their response to patients going through ‘the change’.

Dr Máire Finn pictured in Galway City. Pic: Ray Ryan

GP, educator, broadcaster and mum of two daughters, aged 17 and 20, Dr Máire Finn works in Ennis. She is 53.

“I’ve been a single parent for a number of years — my children’s father died. I’d always have been running on empty — par for the course for many working mothers.

“In my mid-40s things got a bit on top of me. To my embarrassment, I didn’t recognise the symptoms in myself — I had a regular cycle at the time so the parameters you’d normally look for weren’t there. I had tiredness, a feeling of being overwhelmed — the softer mental health issues.

“I had issues around my feet too – aches and pains that interfered with my ability to exercise as much as I’d like. I tried to manage it so as not to let my two daughters be affected.

“I found the greatest help was having good female friends, true friends to whom you can tell everything and who’ll be completely honest in their response to you.

“I did what a lot of women do — I reassessed my personal situation.

“Professionally, I moved into a group practice, where previously I’d had my own practice. I was acknowledging and embracing a transition in my life. It was an important lesson about looking at your life holistically — instinctively I was doing that.

“I made a demarcation between work and personal life — I didn’t bring work home. Developing that [habit] has really improved my life.

“I started HRT in my early 50s. Like almost every woman I know, I was a little nervous starting— my mother had breast cancer and my father had multiple blood clots. Traditionally, there would have been restrictions on hormone treatment in these situations. With newer, more refined hormonal treatments and topical HRT, I feel quite comfortable being on it.

“It has been very beneficial, but I recognise it isn’t for everybody. It evens out my energy levels. The hormonal fluctuations aren’t as much — I was beginning to suffer from hot flushes and insomnia. With HRT, I’m more balanced in general.

“Some of it could be down to other things I started. As a family, we’ve a very good broad-based diet. I try to manage stress better. I do a bit of yoga at home, I swim, I walk my two dogs. I never wear headphones when I’m out walking. I love to just be in it, let my brain focus on nothing for a while, just on the green around me, the sights and sounds. Nothing soothes me more than that.

“My experience has informed my work. Women go to women doctors. There’s a journey you go on together — fertility, pregnancy, menopause.

“You’ve greater understanding and empathy for patients if you’ve experienced distress in any way. I’d be more inclined to see the early, softer signs [of perimenopause] as something to be recognised — not always treated [medically] — but finding a holistic path through them.”

n Dr Máire Finn is a speaker at the National Menopause Summit at City Hall, Cork, on Friday, October 20.

Essential Menopause survival guide

Developing anxiety

Dr Deirdre Lundy is clinical lead in the National Maternity Hospital’s Menopause Clinic. She turns 62 this month. She was about 44 when she noticed some changes.

“I didn’t equate the gaps in my periods to the symptoms I was feeling. I was getting dizzy, getting headaches, very non-specific symptoms. Looking back, I would say it was anxiety. I had developed an anxiety about flying, for example, that was very severe. I had to ask the GP for a low-level anxiety drug. The weird thing was I’d never had this fear before — I loved getting on planes.

“I was as minimally educated back then [about perimenopause symptoms] as anybody else might be. I was putting the symptoms down to working very hard, to the kids — at that time, they were 13, 11, and seven, so I had a lot going on.

“When the GP suggested this could be anxiety, I believed him but I was slow to accept it. He put me on an SSRI mood drug. That was brilliant — it wasn’t addressing the core issue but it did take down some of the worry. It wasn’t ideal but it was better than nothing.

“It’s quite common for people in middle age with mood symptoms to be given mood drugs. In 2015, NICE (National Institute for Health and Care Excellence) identified mood changes in mid-life as often hormone-driven and said, in certain circumstances, it’s more appropriate to offer hormonal treatments, rather than mood drugs.

“Back then, I was seeing other women coming in with similar symptoms.

“I was also travelling a lot to meetings, like those of the British Menopause Society. I thought [my symptoms] could be menopause.

“I put myself on HRT and I started to turn a corner. I was about 45 at the time.

“I found my own way. I started on a good HRT cocktail. I tweaked it over the years and I’m still on a relatively modest amount, going on 17 years.

“I’ve no desire to change that.

“I might eventually drop my oestrogen load — you can taper that down to suit your needs. I don’t have any desire to ever fully come off it.

“I went for one-to-one counselling with a wonderful counsellor. That’s a big thing. I’m very lucky — I’m not shy about mental health. My family and friends were very supportive. It was a journey of self-awareness. It made me a better clinician. When I meet women in the menopause clinic who are clearly struggling with wellbeing and mental health issues, I say to them that menopause can bring these things to the fore.

“I changed a lot of my lifestyle. I started trying to pare back a little, learning to be more cautious about my own stress and time. Prior to that I’d have been ‘of course’ when I was asked to do something. I started hiking, which is now a passion but back then it was brutal. It’s something I get joy from now.

“I walk with two lovely women, but I’m still the one whinging!”

Irregular periods

Dr Mary Ryan pictured at her offices in Limerick City. Pic: Brian Arthur

Dr Mary Ryan, consultant endocrinologist and senior lecturer at the University of Limerick Medical School, is author of It’s Probably Your Hormones and a mum of three.

“I’m in my early 50s. In the last three years, I noticed irregular periods that were a little longer than they should be. I also felt a bit tired, where normally I’d have buckets of energy. My sleep wasn’t as good either.

“I’m getting off scot-free though — I meet women with brain fog, terrible hot flushes, anxiety, vaginal dryness.

“I didn’t get emotional or anxious – for me, it’s just tiredness, not sleeping, the odd flush, all normal and what you’d expect.

“I work very hard, I love what I do, but I have to be more aware of pulling back, of pacing, of recharging more so that the hormones can rectify themselves. I’m very regimental about what I eat and about getting good sleep. I take vitamin D to prevent osteoporosis. I upped my resistance exercise, which is important for preventing osteoporosis. I keep an eye on my cholesterol.

“I take Cleanmarine MenoMin, which helps to relax muscles during sleep so I take it at night. It has magnesium, which has really helped my bowels come back to normal.

“I take a probiotic because the gut microbiome is important for regulating hormonal health. I’m not on HRT but some definitely need it.

“And if you can’t have HRT, there are other medications, and so much you can do yourself — rest, pacing, supplements, good diet, exercise.

“For me, it’s about pausing to look at life, a kind of reset, seeing what I can do to make myself healthier.

“Every day, I hear dreadful stories — like a woman wrecked from her periods, who’s now having a dreadful menopause.

“Such suffering is unnecessary — once you know what’s ahead of you, you can deal with it.”

Sub-optimal performance

Dr Shayi Dezayi is a senior registrar in Beaumont Hospital’s gynaecology department. She has a special interest in women’s health and works at The Menopause Hub. Married to a surgeon, her two sons are aged 15 and 21. Now 49, Dr Dezayi was 46 when she began experiencing insomnia, which she soon realised was linked to perimenopause.

“At first I didn’t know why I couldn’t sleep. It affects everything — your social life, your work, your family. Energy is low so you can’t perform optimally.

“I checked my blood pressure and realised it was very high. I have a family history of high blood pressure so my GP said I should start anti-hypertension medication. It clicked in my head: I’m not sleeping and my blood pressure is going up – fluctuations in oestrogen exacerbate blood pressure. I started HRT and the blood pressure medication together.

“My blood pressure settled, my sleep normalised. I had small symptoms like joint and muscle pain, waking up with muscle stiffness — these all went. I know that it’s very important to address and manage perimenopause symptoms to ensure better heart, bone and brain health.

“For me, the insomnia was the most horrible symptom because it affects you in every way — your mood, your concentration.

“Menopause is my field, so [my family] know about hormonal changes. My boys always ask ‘are you taking your hormones?’

“I think anyone who can take HRT is lucky. I had no nervousness about taking it.

“Because of my experience, when I speak about perimenopause, my patients can see the truth in my face.

“When you communicate to the patient that ‘you will feel better, maybe not today or tomorrow, but you will’, I know the impact that has on them. It’s why I like working in this area.”