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Jennifer O’Connell: Why don’t we want to talk about menopause?

Liveline has put welcome focus on topic shrouded in taboo and HSE neglect

If there was no sex in Ireland before the Late Late Show, was there any menopause before Liveline?

There certainly wasn’t much talk of it on the national airwaves, or anywhere outside the health supplements or women’s magazines. The first – and for over 50 years afterwards, the only – mention of menopause in an article in this newspaper was in 1907. It appeared in Medico, a brusque, no-nonsense medical advice column which intriguingly printed only replies, leaving the reader to guess what the question could have been. “Housekeeper,” one reply goes, “Your friend no doubt meant ‘menopause’. It is not a disease, but it is a natural change, which is apt to be accompanied by functional disturbances, such as you have experienced. Take one tabloid varii three times a day.”

It's fair to say, I think, that public discussion of the menopause in Ireland has not advanced all that much beyond Medico's breezily dismissive reference to "functional disturbances". Or it hadn't until Joe Duffy got hold of it just over a week ago, at first through a letter from the heroic Sallyanne Brady, founder of the Irish Menopause group. Duffy went on to devote, at the time of writing, a record eight days of programming exclusively to the topic. It turns out the heir to Gaybo was right there in our kitchens all this time.

Hot flushes, tinnitus, body pains, migraines, vertigo, brain fog, anxiety, insomnia, exhaustion, depression, cognitive issues, weight gain, lack of sex drive, suicidal ideation

Duffy didn’t need to do much more than to be the conduit as the symptoms and the stories poured forth, and to listen with empathy, humility and distress as those functional disturbances began to take alarmingly real shape. Hot flushes, tinnitus, mysterious body pains, joint aches, sore feet, migraines, vertigo, brain fog, forgetfulness, anxiety, digestive issues, insomnia, exhaustion, depression, apathy, isolation, loneliness, cognitive issues, weight gain, lack of sex drive, even suicidal ideation. One woman likened herself to a slow puncture. One felt as though she hit a brick wall. Another said it was like being hit by an exploding bomb. Caller after caller said they knew something was wrong, they just never associated it with menopause. Many had never heard of perimenopause, the years leading up to menopause in which many punishing symptoms come crashing into women’s lives.

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Hidden truths

He interjected every so often with a question. Right, he would say. Tell me what a hot flush is. It was riveting, powerful radio, given the space it needed by Duffy, who listened without explaining the women’s experiences back to them, as other presenters might have done. There was a sense of deja-vu about it all, too. Here we are again engulfed in another torrent of the hidden truths of women’s lives. Listen up, folks, as more women tear their own skin off to help shatter a taboo.

Many of the women who spoke to him had ended up on social media after they hit a dead-end looking for information about what was happening to them. The menopause information on the Health Service Executive website was last reviewed a decade ago, in July 2011. “The menopause . . . is marked by the ending of menstruation (when a woman’s periods stop),” it states confusingly. In reality, the plummeting hormones that are responsible so many distressing symptoms go into freefall long before periods stop. The site lists only four symptoms – hot flushes, sleep disturbance, vaginal and urinary symptoms.

The big question is why did it take a man to unlock these stories? The airwaves and the national media are not short of women, this one included. Part of the reason is that women talking about their bodies is still seen as faintly profane. Mostly, I suspect, it is the chilling effect of the patronising, dismissive tone of the little discussion there is in public about menopause. The HSE’s leaflet on “menopause at work”, for instance, urges employers to “recognise the impact the menopause can have on women at work. Take a proactive approach to the menopause: break the taboo.”

Professional concerns

If you’re at the age where menopause is hurtling down the tracks, the very last thing you want is to hand your employer yet another excuse to decide you may be less than fully committed or capable. In your 20s, you were too often dismissed as less experienced than the nearest, equally qualified man. In your 30s, you were a “possible pregnancy risk”. By your early 40s, you were “distracted by family commitments”. Just when you’re finally wriggling free of all that, it’s not you talking, it’s the menopause. The HSE leaflets advises that “many [women in menopause] won’t be able to meet their full potential at work” without support, which is uncomfortably close to the kind of sweeping statement Medico might have made in 1907.

The menopause information on the Health Service Executive website was last reviewed a decade ago

Why don’t we talk about menopause? Because we’ve had a lifetime of being reduced to our fertility cycle and we’ve had enough. Because we’re socialised to be ashamed. Because we’ve only just moved on from blue liquid in tampon ads. Because the porn industry is bigger than Hollywood, and a reality TV star who boasts about grabbing women’s pussies can be elected US president but, to paraphrase one woman on Liveline, who wants to hear about vaginas from women themselves? Because we don’t know that there is help, or we’re frightened by the flawed research that put many women off hormone replacement therapy. Because while there are many GPs who offer excellent menopause care, there are others who have had little training in it. Because of the attitude that still prevails that menopause, like periods and pain in childbirth, is just another part of the penance to be endured uncomplainingly by women. Because women’s health is taken so seriously in this country that the HSE hasn’t reviewed its menopause information in a decade. Because we are sick of being written off as hormonal. Because, until now, no one wanted to hear it.