Period. End of sentence?

By Geraldine Fitzgerald

“I had moments of absolute rage and profound sadness,” said 48 year old Sinead. “I was anxious. I was exhausted. I had no patience with my husband or my children - all completely out of character. It wasn’t until the migraines started that I went to see my own doctor.”

Her clued-in GP ordered a hormone test. Sinead was in perimenopause. A nurse of 28 years, accustomed to frank discourse with colleagues; she’d never heard of the cascade of symptoms.

This is not unusual, according to Irish menopause coach and researcher Breeda Bermingham. Her book ‘Midlife Women Rock, a Menopause Story for a New Generation’ was released on Monday – World Menopause Day.

Despite half a million Irish women in the 45-65 age cohort and 80 per cent of those experiencing symptoms, a veil of secrecy has inexplicably laid heavy on the subject for years.

A former midwife and public health nurse with a psychology degree and MA in sociology, Breeda said: “Silence, fear, embarrassment and denial were re-occurring narratives in my research. Women are doing each other a massive disservice in not talking to one another about this stage in life; the silence around this issue is adding to symptoms and mental health issues for midlife women.”

The symptoms are myriad and often notoriously nebulous, with the most common being hot flashes, weight gain, and sleep disturbance. In fact, there are least 34 currently reported imbalances, including loss of libido, headaches, anxiety, brain fog, burning mouth syndrome, and mood disorder.

Women report feeling ‘fobbed off’ by their doctors, often choosing to soldier on as specific treatment proves elusive.

On 25 May, RTÉ’s Joe Duffy was joined by Dr Deirdre Lundy, specialist in women’s health, in his Liveline studio for a discussion on menopause. The response was so huge that the topic was continued for five days, and the show set up a dedicated phone line for the first time in its history.

The topic snowballed. Discussions were spawned. Surveys were commissioned. Last week, Boots Ireland released new research revealing that almost two thirds of women say that menopause causes them to experience physical or psychological symptoms that significantly affect day-to-day life, reporting a lack of confidence and feeling less visible after they’d experienced menopause.

Many report feeling the subject is not taken seriously, despite the multitude of symptoms and the knock-on effect on issues such as gender equality, ageism and the health and wellbeing of women.

On World Menopause Day, the Irish Nurses and Midwives Organisation (INMO) published results of a member survey in which most respondents (82%) stated they had considered leaving work due to menopausal symptoms, with more than 1 in 10 (12%) of respondents already leaving or having left their profession as a result.

Almost half (47.8%) of respondents said that they were not at all prepared for menopause, and 16% stated they had no education or information at all about menopause. 90% stated that symptoms affected them at work, while 42% stated they had missed more than five days of work as a result.

The survey also highlighted the impact of stigma in the workplace, with almost two-thirds (62.9%) of respondents stating they did not inform their employer of the reason for this absence, and 37% reporting they would not feel confident discussing menopause with their line manager.

The INMO issued a position paper in 2019 on menopause in the workplace, making it the first organisation in the country to call for employer action on behalf of employees experiencing menopause.

It was announced last month that specialist clinics are to be set up nationwide as part of the HSE’s new approach to delivering care to women experiencing menopause.

“It demonstrates a positive shift,” said Breeda Bermingham. “However, the gamechanger in tackling the taboo will be the nationwide education campaign committed to by the Government. Education and awareness are key and transformative, there is a voracious appetite for information, women want to understand menopause in order to take control of their health, at a time when many are starting to think about themselves, rather than everyone else.”