'I had five years of pure hell — taking HRT early on in menopause might have helped'

Women no longer have to suffer distressing menopausal symptoms, thanks to those who campaigned for access to hormone therapy and government funding

Fri, 27 Jun, 2025 - 14:33

Sharon Ní Chonchúir

Irish women take their hormonal health seriously.

The Irish Examiner National Women’s Health Survey found 45% of premenopausal women said they would seek their GP’s advice when they start having menopausal symptoms. Some 10% planned to get help from other healthcare professionals.

Previous generations weren’t as proactive. Half of the women who have experienced menopause didn’t ask for any medical help, and 56% of women aged 65 and over went through menopause without healthcare.

Loretta Dignam, who was 56 when she founded Ireland’s first dedicated menopause clinic, the Menopause Hub, in 2018, says younger women are more likely to take action because they are more informed than their mothers and grandmothers.

“Even when I set up the Menopause Hub, very few people were talking about menopause,” Dignam says. “But, since then, brave women have started a national conversation. Now, we all talk openly about menopause, and young women know what’s coming down the track.”

Menstrual trackers and other health apps are another reason why younger women are more aware of their hormonal health.

“They are more educated than we ever were,” she says. “They will enter menopause forewarned and forearmed.”

Deirdre Lundy, clinical lead of the Complex Menopause Clinic in the National Maternity Hospital in Dublin, says there will always be a cohort of women for whom menopause is a gentle transition that requires no medication.

“That could explain why some of the women in the survey didn’t consult doctors,” she says. “The impact of menopause is so individualised; some are mildly affected while others are devastated.”

About 80% of women experience menopausal symptoms, while 20% don’t. Of those who do, about a third have severe symptoms, which range from sleep disturbance to joint pain, mood swings, and recurrent urinary tract infections.

“In the past, they might have felt they had to put up and shut up,” says Dignam. “But they are no longer suffering in silence.”

Lundy also wonders if the disparity between older and younger women’s attitudes might stem from the misrepresentation of HRT studies in the early 2000s.

HRT had been prescribed as a treatment for menopausal symptoms from the 1940s, but the later findings of the Women’s Health Initiative in the US and the Million Women Study in Britain suggested it increased women’s risk of breast cancer, clots, and strokes. This risk was subsequently disproven, but doctors remained reluctant to prescribe HRT.

“As a result, women know that even if they did seek help, the response would probably be: ‘HRT will give you cancer’,” says Lundy. “So why bother seeking help at all?”

She describes the situation today as “light years ahead”.

“Women and their doctors are better informed and know HRT can help,” she says. “And we have six free clinics that provide women with any specialist help they might need.”

Ireland leading the way

Clare Cromwell, a menopause specialist at the Mater Private in Cork and a co-chairperson of the Menopause Society of Ireland, identifies the recent introduction of free HRT as another major step forward.

“Having it freely available removes any financial barriers that may have prevented some women from benefiting from HRT,” she says.

The scheme may offer an opportunity to further our understanding of menopause.

Cromwell says: “Data from the women who register for the scheme could be tracked and used for research to influence future policy on women’s health.”

However, according to Laura Cullen, a Bantry-based GP and director of women’s health at the Irish College of General Practitioners, the scheme is not entirely free: “It doesn’t cover the cost of menopause consultations. These are often complex and can involve multiple consultations over several months. The HSE doesn’t resource this.”

Cromwell also cautions against focusing on HRT to the exclusion of other treatments: “There are women who can’t take HRT, particularly women who have had breast or other hormone-induced cancers. Their treatment can often induce menopause with severe symptoms, which can only be treated using non-hormonal medication. We shouldn’t leave them out of the conversation.”

The Government’s decision to make HRT available free of charge is one of the reasons why Dignam now ranks Ireland as a global leader in menopause care.

“We and the UK are in the top echelons when it comes to education, medical services, menopause training in the workplace and policy development overall,” she says. “The US and continental Europe are years behind us.”

This doesn’t mean there isn’t more to be done. The Irish Examiner National Women’s Health Survey found that when women did seek medical help, 22% rated the professionals’ understanding of hormonal issues as poor, and 21% said the information they received was poor.

They were more likely to be critical of male GPs, with 24% ranking the care they received from male GPs as poor, compared to 15% who attended a female GP.

Allocating more time and funding for GPs to upskill in menopause care could help tackle this problem, says Cromwell, who added: “Other healthcare professionals, such as physiotherapists and psychotherapists, should also be trained to recognise menopause symptoms, such as pelvic floor problems and mood issues, when they present.”

Cullen suggests that a standardised mid-life health check for women would further improve menopause care: “Menopause is a great time for women to assess their overall health and get informed about the steps they could take to keep themselves healthy in their post-reproductive years. Oestrogen levels become negligible in the 10 years after menopause, and — as it’s known to be protective for heart and bone health — women need to especially look at risks in relation to conditions like high blood pressure, diabetes, osteoporosis, and ischaemic heart disease.”

Dignam has already called on the health minister to introduce such a health check: “It would help in so many ways,” Dignam says. “It would educate women about menopause and the proactive steps they can take to protect their long-term health. It would also ensure early detection and treatment of medical conditions. We know that women live longer than men, but they do so in poorer health. A midlife health check would enable them to live fuller, healthier lives post-menopause.”

Five years of 'pure hell'

Tina Brennan: “My family and friends were great. So were the people at work, always telling me to go home and rest whenever I felt unwell.” Photo: Gerry Faughnan

Tina Brennan wonders if she would have had heart problems if she and her doctor had known more about menopause when she first developed symptoms 10 years ago.

The 59-year-old civil servant, from Roscommon, started getting palpitations in her late 40s.

“I’d suddenly feel so unwell I’d think I was going to pass out,” she says.

It took five years and countless doctors’ visits before a menopause specialist told her that hormones caused her symptoms.

“Those were five years of pure hell,” says Brennan, who often felt dismissed by medics. “At one point, I remember asking if my symptoms could be menopause related, and the consultant wouldn’t even entertain the idea, telling me that women blamed everything on menopause.”

A decade later, Brennan’s symptoms are finally under control.

“I take medication now, but I question if taking HRT early on might have helped me,” she says. “I did try it for a while, but I’d had palpitations for years by that stage. It was probably too late.”

She considers herself lucky to have had support during those tough years: “My family and friends were great. So were the people at work, always telling me to go home and rest whenever I felt unwell.”

Her employers now run lunchtime seminars on menopause.

She says: “I think that will mean the next generation of women will know more about it. The awareness of the impact menopause can have on women’s lives simply wasn’t there when I went through it.”

Sleepless nights

Kathleen Ormond was in her early 50s when she suddenly stopped being able to sleep.

“I’d be lucky to get two hours’ sleep a night,” says the now 69-year-old, from Wexford.

Mood swings accompanied her subsequent exhaustion.

Ormond had little patience with her family and experienced bouts of road rage.

Eventually, she realised her problems could be due to her hormones. So she asked a doctor about taking HRT.

However, she was flatly dismissed.

“A female GP told me that it would be like using a sledgehammer to kill a fly,” says Ormond.

“She gave me sleeping tablets instead.”

Another sleepless year was to pass before her daughter recommended she see a menopause specialist.

“What a different experience that was,” says Ormond. “She asked questions and listened to my answers.”

She also gave her a prescription for HRT, which had what Ormond describes as“incredible results”. She was able to sleep again. Her mood lifted: “It even improved the condition of my hair and skin.”

Her advice to other women is to speak up and get help: “I couldn’t continue living the way I was when my symptoms were at their worst, and my family found it hard to live with me too.

“But going for that second opinion led to me finding a solution to my menopause problems.”