Lorraine Keane: 'Let's change the menopause narrative - I want there to be less shame'

Today is International Menopause Day. Mary Cate Smith talks to Lorraine Keane about sex drive, guilt, and how we need change to happen on a grand scale when it comes to women's health

Lorraine Keane and Dr Mary Ryan: working to change the conversation around menopause with their podcast Let's Talk Hormone Health

Lorraine Keane wasn’t exactly chuffed when she was approached to front a campaign about menopause health. She had noticed her body slowing down, experiencing symptoms she automatically put down to stress and tiredness, never once considering it could be perimenopause.

“I was getting up in the middle of the night, probably three to five times and then it would take me ages to get back asleep. My mind would be racing.”

Lorraine would wake up the next day feeling really tired, sluggish, and irritable. She had almost no interest in sex.

“I was low and in bad form with absolutely no libido. I also had joint pain, restless legs, sore muscles, nerve pain, and itchy skin. Occasionally, I would have night sweats.”

As someone who has always taken pride in her appearance, Lorraine balked when she started getting brittle nails, adult acne, and thinning hair.

She tried the Cleanmarine MenoMin supplements and started to notice results quite quickly. Taking them was one thing but being the face of a menopause brand felt like career suicide to Lorraine, who had recently become self-employed.

“They wanted to call the campaign Let’s Talk Menopause and I said ‘please guys – I'm in a really ageist industry.’ Menopause just wasn’t a sexy subject.”

The more she thought about it, the more the guilt crept in. She knew she could use her voice to help other women, even if meant a slight bruise to the ego. She asked her husband Peter for advice.

“Immediately he said, ‘you're always talking about women supporting women, and you have been suffering.’ He noticed that I was so much better and said ‘I think it'd be great’.”

Lorraine still felt reticent and she approached her dad, knowing he had traditional values, asking him if he would mind. His voice steeled a little bit on the phone as he told her what he thought.

“He said; ‘Laurie, I’m so proud of you. Your mum went through it and it was a very tough time. I didn’t know what to do. I wish I could have been a better support. So, for men, it’s so important that you go out and talk.”

Lorraine Keane: "I want there to be less shame. I used to hide the fact that I was going for naps. I don’t do that anymore."

Lorraine began hosting the podcast, Let’s Talk Hormone Health in conjunction with consultant endocrinologist, Dr Mary Ryan. Once coronavirus restrictions began to lift, they toured the country, offering educational workshops for women.

She feels that it’s essential to start educating girls at a young age, and she notices that her daughter Amelia is very comfortable telling her boyfriend when she has her period.

“I changed the narrative. I want there to be less shame. I used to hide the fact that I was going for naps. I don’t do that anymore. I am so ready for menopause.”

Has she made many adjustments to her lifestyle? She is conscious of her diet from Monday to Thursday, she says, watching her carbohydrate, sugar, and dairy intake.

Another piece of invaluable information that Lorraine learned from Dr Ryan was that women over 40 shouldn’t be running long distances. As a long-time running refusenik, my ears perk up.

“Dr Mary Ryan always says slow down and plug yourself in – you need to recharge. If you do heavy exercise after 40, you're putting so much pressure on the pituitary gland and your hormone balance is completely shot.

“What we should be doing is 20-minute weight resistance classes - high intensity but not high cardio sessions.”

Consultant endocrinologist and physician, Dr Mary Ryan is passionate about disseminating the right information to women on their menopause journey. Hormones control so many systems in the body, says Dr Ryan, from your heart muscle to your bowel function, blood pressure, the nervous system, and more. They’re also the reason for experiencing feelings – they’re “the reason we fall in love,” says Dr Ryan.

“To work normally and optimally, the master control centre, the pituitary gland has to be well recharged. Hormones work in a lovely circadian rhythm. And the reason it’s so significant in women is that in puberty, women produce two hormones called FSH [follicle-stimulating hormone] and LH [Luteinizing hormone] that prompt the ovaries to produce estrogen and prepare the body for a period.”

Societal gaslighting is a problem, says Dr Ryan as women’s symptoms were often dismissed as psychosomatic.

“For too long, if a woman was irritable or got tired mid-cycle or emotional before a period, it was always passed off as it was ‘in their head’ and of course, we know it’s not.”

The flux of hormones at different times of a cycle can disrupt women’s physical and mental health, says Dr Ryan, and it needs to be tackled with respect and scientific understanding.

Hormone imbalance can affect your gut function, says Dr Ryan.

“The gut and microbiome are critical. 98% of our happy hormone, serotonin, is produced in the gut and is very important in controlling the immune system.”

Change is afoot but it needs to happen on a grand scale, says Dr Ryan.

“Women and society need to allow for that. If women are emotional, it's not that they’re making it up.”

Dr Mary Ryan: "Women now know what the previous generations didn't. They suffered in silence."

While the topic of menopause has been enjoying increased visibility of late, what about perimenopause? “Perimenopause is when the eggs are starting to deplete. Usually, that’s at the age of 45 to 50 but often it can be before that,” says Dr Ryan. The fluctuating hormones can cause irritability, sleeplessness, flushing, brain fog, and joint pain.

There are some restrictions with HRT, says Dr Ryan, but not to fret – there are several other options available, should you need intervention. Transdermal and micronized, progesterone gels can be used and these options have proven favourable in terms of not causing blood clots, says Dr Ryan.

“With families who have a history with breast cancer, it’s really about balancing things and finding out what's safe for people.”

The shortages in HRT needs to be resolved, says Dr Ryan and it is one of the main reasons she went on Instagram – so she could voice her concerns in a public forum.

“I wanted to throw a bit of weight behind [the HRT shortage] and get people out to rally because we all together, we have a huge voice.”

Menopause doesn’t discriminate and recently Dr Ryan saw a patient who went from being a self-confident assertive executive to being extremely anxious and loathe to leave the house.

“Once we treated her, she came in hugging me and saying ‘thank you so much, my life is back’.”

Women’s health has been left “in the doldrums” for years, says Dr Ryan.

“The positive thing about education and the Joe Duffy show is that women now know what the previous generations didn't. They suffered in silence. I hear the stories. Some of these women were wrongly put in institutions and never come out.”

Lorraine Keane: dealt with reservations on discussing menopause openly. Pic: Anthony Woods

At the age of 36, Sallyanne Brady had been experiencing low mood, accompanied by frequent bouts of anxiety, panic attacks, and intrusive thoughts. Her symptoms were so severe that she experienced suicidal ideation.

“Most women think they’re going mad. Go back in history to when women started outliving their ovaries and you see a pattern of women being institutionalized in asylums. The word ‘hysterectomy’ comes from hysteria. We have a very dark history when it comes to the menopause.”

When Sallyanne’s period stopped and she was eventually diagnosed with menopause, her doctor prescribed HRT, the hormonal replacement drug which she describes as “life-changing”.

While this brought about such positive change, it also highlighted the paucity in information. She vowed to dedicated her life to signal posting evidence-based medical information to her contemporaries. She particularly wanted to provide information about perimenopause which she felt was so shrouded in mystery, it belied its very existence.

“It’s sneaky and insidious. Women, including myself are vulnerable. We’d do anything to feel less miserable.”

She started with a private Facebook page with Claire Peel in 2019 which has grown to over 44,000 members in a relatively short space of time. Armed with information, she positioned herself as a menopause mentor and has built a community where women could support each other through these symptoms.

“How many women have we lost as a result of this one thing that’s so easily fixed? How many other women have been on the edge like I have – because I was suicidal in my journey.”

With women like these at the forefront of menopause education, the stigma of talking about hormone health is slowly but surely lifting.