Alison O'Connor: What's next after women shared their intimate menopause issues?

There is a drastic shortfall in proper medical care for women whose bodies are simply crying out for oestrogen replacement
Alison O'Connor: What's next after women shared their intimate menopause issues?

It was a chat with a female GP acquaintance of around my own age. We were discussing matters menopause, a stage of life relevant to both of us. She recalled how, back then, as a young doctor, she used to view those women coming into her surgery, as the “heart sink patients”.

Needless to say, after the passage of years, she is in a different place now. In her opinion, less than 10% of women get through these years of hormone depletion unscathed. That’s a hell of a lot of women who could do with help with a lot of issues. As the British Department of Health recently tweeted, there are 34 different symptoms of menopause and every woman will have a different experience of it.

The good news is menopause is going from a thing that was discussed in whispered tones as “The Change” to now being the subject of social media accounts, podcasts, and documentaries.

But anyone who heard RTÉ’s Liveline last Wednesday, Thursday and Friday, and again on Monday, Tuesday and Wednesday may view this as a watershed moment in public discussion on menopause in Ireland. 

As far as I’m concerned Joe Duffy is an absolute hero for taking on the subject and listening patiently as woman after woman, many in tears, discussed their experiences and how their lives were left devastated. 

With empathy and compassion, he discussed hot flushes, fatigue, joint pains, vaginal dryness, vanishing libidos, the breakdown of marriages, suicidal feelings and so much more. This was public service broadcasting at its best

It wasn’t news to me, but to anyone unfamiliar with the subject it was crystal clear from the off that there is a drastic shortfall in proper medical care for women whose bodies are simply crying out for oestrogen replacement.

There was an absolute deluge of contacts with the programme team barely able to keep up with the pace of calls, texts, emails and tweets. Owing to the large volume the show set up a special WhatApp line for women to leave voice messages. Usually when such a subject has fired up the Liveline phone lines — especially for a few days consecutively —  there is widespread pick up from newspapers. In truth, I was unsurprised to see this did not really happen here.

On Day 6 (Wednesday) Joe said he estimated there are up to  600,000 Irish women in that age group who are going through menopause. It all kicked off with a letter from SallyAnne Brady who wrote to Joe about how in her own case how she lost five years of her life. She listed a horrific number of wide-ranging health issues she had endured from depression to tinnitus. I was interested in this subject anyway but my ears really pricked up when I heard vertigo mentioned.

Personal experience

I had my first and hopefully only bout of this horror a few weeks ago. When I could finally get out of bed to go to my GP my first sentence to her was: “I refuse to believe this is unrelated to the evil menopause.”

 There was a sense of a dam bursting in the avalanche of contributions, with an underlying thread of trauma. There were women who never even knew there was such a thing as perimenopause — the period in the lead up to the actual menopause which can last years. Those very many who had been dismissed by their GPs when they explained how they were feeling with comments along the lines of: “sure, you’re a middle-aged woman”. There were those who had simply been refused HRT when they requested it; and those who’d had hysterectomies and not even been told they’d be entering into a surgically induced menopause as a result of it.

How savage is that? To my mind, it borders on criminal. Bad enough to have the hormones gradually decline over years without them falling off a cliff overnight

 I know of a woman who had a full hysterectomy over a year ago and was sent home by her female gynaecologist without as much as a mention of HRT.

I began HRT myself two years ago and not a day passes that I am not thankful for it. For so long before that, I agonised about the decision since my mother died aged 44 from breast cancer. On top of that back in 2002, I had been a Health Correspondent when the infamous Women’s Health Initiative Study (WHI) was published and reported on it.

The result of the WHI was a bomb blast through the prescribing of HRT all over the world. Doctors stopped prescribing it. It was during this time my GP friend mentioned at the start they would have felt she had nothing to offer these “heart sink” patients. Increasingly women were prescribed antidepressants instead. Doctors lost their skills in treating menopause symptoms over twenty years. Obviously, there are some great GPs, and many who specialise in female health. But many doctors remained as HRT gatekeepers even though the WHI study had been so well debunked.

What now?

So what happens now that the women of Ireland have shared their most intimate menopause issues on the national airwaves? For starters, it is quite clear there is a major lack of resources. GPs are busy and menopause consultations do take time, but any woman who tries to book in with a doctor which specialises in women’s health will know the demand is so high there can be a wait of months.

Dr Deirdre Lundy, a GP who is also a trainer for the Irish College of General Practitioners in women’s healthcare — known as the “Menopause Whisperer” among some of her colleagues — was mentioned by a number of women on Liveline. On Friday, she made an appearance, and in person on Wednesday and answered so many queries.

She also explained that in the UK there is a Faculty of Sexual Reproductive Health which deals specifically with menopause. However, there is no such equivalent in Ireland.

Sallyanne Brady, who wrote that letter to Liveline, is the founder of The Irish Menopause on Facebook. It has started a petition to be sent to the Department of Health highlighting the severe lack of medical support. “We need GPs to have the correct training to help our female population manage their menopause in the best way possible, we need our younger generations to learn about menopause as part of standard health and sex education.” We also need menopause clinics in hospitals all over the country.

Since listening to those stories on the show, I’m glad to say two female friends have started HRT. My final thought goes to the friend who has had  surgery in recent weeks. She is now minus her womb, cervix and ovaries. Upon discharge from hospital she had to request a prescription for HRT. There was mild surprise in response to her request, but a script was written. Recovering well, she’s looking forward to seeing her gynaecologist shortly. She has a question for him. She’s going to ask him how men might feel, after having both testicles removed, to leave hospital without as much as a leaflet on explaining what to expect, never mind a prescription. I look forward to hearing his answer.

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