An “entire generation of women” have lost out on a full quality of life and proper wellbeing over the past two decades because of misinformation and the spread of “unnecessary fear” about menopause treatments, an expert in the field has said.
Dr Deirdre Lundy, a specialist and trainer in care for women going through menopause, says the public perception around hormonal treatments for menopause has resulted in countless women “suffering in silence”.
“Some women struggle so badly they leave jobs, they become depressed, they leave relationships, it can be life altering,” Dr Lundy told The Irish Times.
She said those women who did eventually use hormonal supplements “often felt so guilty that they were doing a terrible thing to themselves by taking HRT”.
However, a recent change in public perception means women, who previously would have been prescribed anti-depressants when they presented at the GP with menopausal symptoms, are starting to access far more effective medication along with support and guidance from medical professionals.
In December, the Government announced the establishment of the State's first dedicated menopause clinic at the National Maternity Hospital with three more specialist clinics set to open in Limerick, Galway and Cork in 2022.
While the majority of menopause care will continue to be provided by GPs or practice nurses, these multi-disciplinary clinics will offer another layer of support to women experiencing complex menopause symptoms. They will also provide advice on menopause to GPs in the community.
Dr Lundy believes the funding needed to open and run these clinics was prompted by a week-long discussion held on RTÉ’s Liveline show last May.
“A lady called Sallyanne Brady, a life coach who had struggled with a lot of menopausal symptoms, wrote to Joe Duffy about how she lost five years of her life to menopause. She wrote about this huge groundswell of women of a certain age who are struggling to keep working, look after family, children, elderly parents, and when they went to the doctor for help with hormonal changes they’re told they’re very stressed and given anti depressants.”
Dr Lundy describes that week of radio programming as a turning point in the Irish conversation around menopause. "It all happened overnight really. Within weeks of that show I got a phone call from somebody in Holles Street saying the Department of Health has given us money to start a menopause clinic."
In September, Minister for Health Stephen Donnelly announced that a number of dedicated menopause clinics would open around Ireland.
Confusion and fear
Dr Lundy says much of the confusion and fear around menopause treatment dates back to the 2002 US-based Women’s Health Initiative study which reported a link between breast cancer or cardiovascular disease and the HRT treatment.
“That study has a lot to answer for, it’s estimated an entire generation of women lost out on a full quality of life and wellbeing because of the misinterpretation of that 2002 study and the unnecessary fear engendered about the use of low dose hormonal supplements to weather the transition.”
It is now clear that the benefits of HRT far outweigh any risks, says Dr Lundy. Women who drink alcohol or who are are overweight are much more likely to develop breast cancer than those taking HRT, she added.
In 2015, the UK’s National Institute for Health and Care Excellence reported that HRT did not raise the risk of cardiovascular disease when started in women younger than 60 years and that oestrogen-only HRT was associated with no or very little change in breast cancer risk.
It did acknowledge that “combined HRT can increase breast cancer” but that the risk falls again after stopping the treatment.
The UK study also advised doctors to stop prescribing anti-depressants to women going through menopause. “They said the woman just needs hormone stability and these products are very safe,” said Dr Lundy.
“Then things started to improve. You could see the mood around menopause getting more positive after that and the narrative around using hormones at that stage in your life getting more supportive in the UK. And now that has trickled over here into Ireland.”