Grace Moore, a 37-year-old resident of Dublin city, was thrust into menopause prematurely after a prophylactic removal of her ovaries and Fallopian tubes due to her genetic predisposition to cancer. Simultaneously, she underwent surgery to insert a Mirena coil and was subsequently prescribed hormone replacement therapy (HRT).
Despite the treatment, Moore was plagued by numerous symptoms related to menopause; heightened agitation, inconsistent temperament towards her children, and severe bouts of hot flushes are among these. She admits that her temperament made her difficult to be around and her partner’s relief was palpable when her HRT dosage was reassessed.
While she was advised to take anti-anxiety medication, Moore didn’t find it suitable for her needs. She believes the HRT helps on most occasions, though it has made her hypersensitive emotionally, causing her to be greatly impacted by unsettling news stories more than ever before.
Eagerly, she awaits her appointment with a specialist doctor in menopause. She also hopes to amend her HSE dosage. If she forgets to reapply her HRT patch after bathing, her behaviour is erratic, much like a ‘psychopath’ as she describes it. Mother of four, Moore wishes a more holistic approach was available for menopause management in Ireland that would ideally encompass therapies and breathwork. She finds her Personal care to have been predictable and desires access to alternate options.
She ardently believes HRT should be available for free and trusts that the Health Minister Stephen Donnelly, working on similar plans, will accomplish this. However, her faith in the government’s promises is teetering.
Karen Coakley, a native of Bantry, Co Cork who currently resides in Kenmare, Co Kerry, observed noticeable alterations in her well-being upon reaching 40. Her sense of self seemed to be slowly slipping away, with anxiety marking the onset of an array of symptoms, such as cognitive difficulties, frequent loss of items, feeling less mentally agile, experiencing foot discomfort and suffering from frozen shoulder. Her athletic performance also took a hit, with her strength declining, and her previous enthusiasm for exercise dwindling to nothing.
This mounting anxiety began to see her struggle with everyday tasks, making driving an anxious exercise and causing her to often go off course. “Hot flushes were never an issue,” Coakley remarked. “I just felt as though I was slowly losing my sense of self. By the time I turned 47 or 48, I noticed a significant weight gain.”
Seeking support, Coakley joined an online Facebook group dedicated to providing guidance for Irish women dealing with menopause. However, she held reservations about commencing hormone replacement therapy (HRT). As her symptoms progressively worsened, she sought the advice of a general practitioner. Initially, the GP was hesitant to prescribe HRT due to her “youth”, she recalls. Yet, after returning to the GP some months later equipped with a symptom checklist, she was prescribed a combination of oestrogen and progesterone and was advised to consult a menopause expert.
Coakley reports a remarkable improvement in her overall wellbeing just a fortnight after initiating HRT, regaining her gym prowess alongside alleviation of her physical discomforts and feelings of being constantly overwhelmed. A few years later, testosterone was added to her treatment regimen. Maintaining optimal hormone levels has been of paramount importance, according to her. Now 50, Coakley has been receiving HRT for three years. “I strongly believe that consulting a proficient menopause specialist is the best course of action,” she advises, cautioning of many who hastily claim expertise in the area.
Coakley expressed hope for the forthcoming plans of Minister Donnelly to provide free HRT, asserting it could catalyse broader conversations and normalisation of the topic. However, she stressed, “availability of free HRT is futile if it’s not correctly prescribed.”
Residing in Dunshaughlin, Co Meath, Eilish Balfe became a mother to her third child at the age of 40. Post-delivery, her physical and emotional wellbeing seemingly transformed, which was initially attributed to hormonal changes common after pregnancy. However, even two years following childbirth, her condition showed no signs of improvement. Tragically, around the same period, her dementia-diagnosed father passed away.
Subsequently, Balfe observed an escalation in her forgetfulness and nervousness. After seeking medical help, she was informed that she wasn’t experiencing the stages of perimenopause, a diagnosis that came after a thorough blood examination at a clinic catering to menopause-related issues. As she continued to experience worsening symptoms, including severe forgetfulness often leading to her losing track of entire portions of her day or acquaintances’ names, she started to consider the possibility of possessing dementia herself, a conclusion driven by her family medical history. Balfe recalls a summer day in 2021 when she felt overwhelmed with despair and apathy towards her life.
She confided in a physician about her fluctuating emotions, which predominantly alternated between “despair and rage”, along with the onset of hot flashes. After falling ill with Covid-19 in 2022, she consulted another doctor for a residual cough and was suggested to try HRT (Hormone Replacement Therapy). Despite enduring HRT for 18 months and even changing the method of administration from a gel to a spray, Balfe found her physical discomfort and mental agitation to remain unaffected. She remarked that while her peers had promised exceptional benefits with HRT, the results were disheartening for her, leading her to ultimately stop the treatment. Balfe continues to experience frequent and extensive menstrual cycles and relies heavily on vitamin supplements to manage her symptoms. She steadfastly believes that if her symptoms worsen, she may consider resorting to HRT once again.
However, Balfe’s spirits were lifted at the news that complimentary HRT services are being contemplated. Given that she collaborates with underprivileged women who often compromise on their health expenses, she firmly believes that this new plan would significantly alleviate their financial constraints.
Brenda Griffin, a resident of Navan, County Meath, realised that there was a change in her usual emotional state during the summer she was on the verge of turning 47. She began experiencing persistent irritability, started distancing herself from others, and was hesitant to engage in conversations or social outings. When her children participated in sporting events, she chose to stay in her car rather than mingle with other parents.
She started experiencing memory loss and finding difficulty recalling words. The night sweats she was having were termed as “dreadful” by her. Other unsettling symptoms like hair loss and tinnitus were also present. Given the ear pulsations, she used to wake up at night suspecting that the immersion heater or central heating was switched on. “It initially seemed like I was losing my mind,” she recalls.
Buoyed by a friend’s support, Griffin decided to consult her general practitioner. During her consultation, she found herself crying uncontrollably. She had a prior insert of a Mirena coil, hence, she had not menstruated for several years. Upon evaluation, Hormone Replacement Therapy (HRT) along with pertinent blood tests were suggested as next steps.
Griffin commenced with her HRT immediately, requiring just an oestrogen patch due to her coil, at a monthly cost of €14. Remarkably, she started feeling the difference in a mere three days. “I felt like I had transformed,” she states. Her hair loss ceased and new growth began, the tinnitus disappeared and she hasn’t experienced a single hot flush since beginning the HRT two years prior.
On one occasion when the HRT brand that Griffin was accustomed to was unavailable, she switched to another brand without any complications. But when she missed changing her patch once, she noticed a return of her symptoms in just a day and a half. Every six months, she gets a health check-up from her GP who specialises in women’s health.
Griffin questions why the proposal to provide free HRT should not be implemented. “If contraceptive provisions can be made free up to 35, why can’t the same be done for slightly older women?” she queries. Arguing that HRT is a necessity and not a lifestyle option.
A 43-year-old Dublin woman, Sinead Tracy, underwent a hysterectomy last year. Despite being put on HRT immediately, she was given no guidance on its usage. She recounts how a pharmacist, not her usual one, told her to attach the patch to her arm, information she discovered to be incorrect after reading the instructions herself. She then applied the patch to her hip, only for a friend to advise her that it should have been placed near her ovaries. She finds it absurd that women are forced to depend on friends for information, unsure of its authenticity.
Tracy, with her past experiences of endometriosis, holds the belief that doctors can often show a lack of sympathy towards women’s health concerns. She feels that older women who may have experienced menopause without HRT can at times be judgemental. She articulates the difficulty of seeking advice and being taken seriously, stating “If you don’t get the right person, you’re left in limbo”. She is passionate about safeguarding her future health and advocates for regular monitoring of women on HRT. She also calls for adequate training for medical personnel of both genders in this field.
Tracy is not particularly bothered by the cost aspect due to her inclusion in the drugs payment scheme. She foresees the provision of free HRT in the future, albeit predicts a few more announcements before it becomes reality.