It’s a natural occurrence which every woman goes through, so why is menopause still shrouded in mystery and mired in stigma?
Perhaps it harks back to our grandmothers’ time when nobody spoke about “women’s problems” or maybe because it usually occurs around the 50-age mark, so people are reluctant to admit that they are experiencing “the change”. But whatever the reason, it needs to be addressed and society as a whole needs to embrace the topic by talking about the symptoms which will in turn make it easier for women.
Sallyanne Brady can relate to this as she went through a very tough time which she now knows was early menopause. But at the time it was diagnosed as something else entirely and so began several years of health concerns, which resulted in her arranging an event to take place in Lucan, Co Dublin, on March 14th – The Irish Menopause – in order raise awareness of this very real life change.
“In 2015 I became a very anxious person for no apparent reason,” says the 42-year-old. “Every time I went to the GP I was told that it was ‘just anxiety’ but about a year later, physical symptoms became apparent and I would wake up with my heart pounding and an internal inferno, which would cause me to take my temperature several times a night. My GP kept putting it down to anxiety, but I didn’t believe it and after doing some research, I realised it was likely to be menopause.”
The sales manager who lives in Dublin spoke to her doctor about her concerns but was told she was too young to be menopausal, even though her mother had experienced it at a similar age. So the symptoms continued to worsen, and she also began to suffer with a loud ringing in her ears, pains in her face and teeth and severe tightness in her neck and shoulders.
Another visit to the GP saw her with a prescription for antibiotics, which had little effect, and as the weeks rolled on, the pains worsened as she saw several specialists in an attempt to find relief from the “hell” she was going through. She was diagnosed with generalised anxiety disorder, prescribed with anti-depressants and advised to try and be a “good patient”. But unfortunately nothing worked and if anything, she began to feel worse.
“One day in 2018, I left the house, got into my car and just sat there looking at the steering wheel – after 20 years, I had absolutely no idea how to drive,” she admits. “I was so confused and didn’t even know where to put the key. I cried my eyes out as it wasn’t the first time something like this had happened. This led to two CT scans of the brain which came back clear but I was very scared so as nothing further was happening with the GP, I made an appointment with a menopause clinic where I had an MRI of the brain and all the usual blood tests.”
Results of these tests revealed that Sallyanne was low in B12 and appeared to be “malnourished”. Her hair was falling out, she was losing weight and had to have a course of B12 injections which did help somewhat. But this was short-lived, and she was referred to an endocrinologist and had further blood tests which once again revealed nothing untoward.
“The next few months were horrendous with relentless symptoms – no sleep, migraines, joint pain, buzzing in ears, dizzy spells, panic attacks and lots more,” she says. “I began wishing that I would ‘just go in my sleep’ as I simply couldn’t face another hour, let alone a day. I didn’t want to die but I just didn’t have it in me anymore to keep going. It was like being encased in concrete from head to toe – I was a non-functioning person.
“I had done everything in my power and spent every penny I had on trying to feel better (on physiotherapy, massages, acupuncture, supplements, CBT, yoga, dietary changes, allergy specialists, exercise and even a new bed, pillows and air purifier). I couldn’t understand why I wasn’t feeling any better. I genuinely believed I was dying, slowly and that the doctors couldn’t find what was wrong or weren’t bothered. Then in October 2018, I booked an appointment with a gynaecologist who gave me a prescription for HRT (hormone replacement therapy). I got back into my car and cried – I knew I was intolerant to the synthetic progesterone she had prescribed – it wasn’t going to help, and she hadn’t even checked.”
Finally, Sallyanne received a cancellation for a doctor she had come across during her research and after the first appointment, her life was transformed. “The day I entered that room was the beginning of the rest of my life,” she says. “This doctor listened carefully, assured me I wasn’t mad, and I was going to be okay. He told me that I needed hormones badly and the process of restoring me began. Now I am feeling better than I ever have – every single one of my symptoms has disappeared, I sleep like a baby every night and enjoy being awake now too. Life is good.”
While her life has undoubtedly been transformed by the correct treatment, Sallyanne is determined that other women shouldn’t have to go through the same ordeal she did. So she co-founded The Irish Menopause in order to help others and raise awareness. “When I started to recover, I realised that I cannot be alone in this, so I did some research and discovered that there was very little information available,” she says.
“There were forums online and social media but all were about ‘natural solutions’, wellness, diet and supplements, which as per my own story, don’t work. I have learned so much and know there is nothing which can replace a hormone deficiency other than hormone replacement.
"Ladies are suffering and are vulnerable. I made the decision that this cannot go on, women are struggling, and marriages, relationships, jobs, homes and even lives are being lost, simply because of lack of education and awareness, hence the set-up of The Irish Menopause Facebook group/page.
"I take menopause very seriously as it almost cost me my life. Women need the correct information and our group supplies this. We aren't medical but we know our stuff, we have a British Menopause Society nurse practitioner as part of our group, and she validates all information. We are currently running a petition entitled The Irish Menopause Mission via Change.org which will be going to the Department of Health. We need education on menopause to be part of standard sex education and we need trained GPs or specialist clinics throughout the country."
Dr Brenda Moran, GP and BMS-recognised menopause specialist runs a weekly menopause clinic in Cork. She says women should not suffer alone or in silence and should seek advice until they find the support they need. "As in life, one shoe does not fit all, and each woman will experience a different menopause and menopause transition," she says. "Some don't experience any difficulties or troublesome symptoms, but for others, their sense of physical, mental and social well-being can be deeply affected.
“Women should seek help from their doctor at any stage if they are experiencing symptoms impacting on any aspect of their life, or indeed if they wanted to discuss any aspect of the menopause or perimenopause.”
While there has been some concern over the possible ramifications of taking HRT in recent years, Dr Moran says the benefits outweigh the risks. “Evidence from studies does show a small increased risk of breast cancer with HRT use which increases with duration of use,” she says. “However, it’s important to note the majority of women taking HRT will not go on to develop breast cancer as a result. In addition, other factors, including raised BMI and alcohol consumption, have a greater effect on breast cancer risk than HRT, which remains the most effective treatment option for severe menopausal symptoms.
“In general, the benefits outweigh the risks when started within 10 years of the last menstrual period or below the age of 60 when it comes to symptom control, reducing the risk of cardiovascular disease and for bone protection, especially with the newer types of HRT on the market. There is a small increased risk of breast cancer which increases with duration of use and may depend on the type of HRT used. This risk needs to be acknowledged but the overall benefits of HRT also need to be taken into consideration. For every woman, it should be an individual choice.”
– Menopause has occurred if there has been no period after 12 consecutive months for women aged 50+, where no other cause can be identified. For women under 50, it’s 24 consecutive months.
– In the lead-up to menopause, women’s ovaries no longer respond to hormones from the pituitary gland in the brain, and therefore no longer release an egg as the main hormones produced by the ovary begin to fall, which will eventually lead to cessation of periods.
– The average age range for women going through the menopause is 45-55 with the average age being 51. Age 40-45 is considered an early menopause and under 40 is considered a very early menopause or premature ovarian insufficiency. Conversely, some women can have periods until their late 50s.
– Symptoms associated with menopause include hot flushes, night sweats, insomnia, forgetfulness or poor concentration, anxiety, depression, tearfulness, reduced coping skills, lethargy, joint pain, palpitations, headaches, vaginal dryness, loss of libido, overactive bladder and increased susceptibility to UTIs.
– Treatment options include lifestyle changes (such as change of diet, exercise, quitting smoking), psychological therapies, complementary therapies, non-hormonal oral therapies and hormone replacement therapy.
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