28th Mar 2019
Helen Seymour is in Peri-Menopause, or at least she thinks she is. In her weekly column, we follow her on her journey towards the Menopause, learning as she does all about the big M.
Statistical data in the UK shows that early menopause (doctors refer to it as premature ovarian failure) affects 110,000 women between the ages of 12 and 40. It’s broken down into approximately one in every 100 women under the age of 40, one in 1000 under the age of 30 and one in 10,000 under the age of 20.
The Irish medical system is unfortunately not structured to data capture such accurate profiles, but it’s probably a fair assumption that we have a similar per capita record. Sadly, capturing accurate records is not the only thing Ireland is lagging behind on, as Claire, a reader of this column, found out just over three years ago when she went into a very sudden and complete menopause at the age of 35.
“I went into total shock”
“I knew something was wrong. I was hot all the time, I couldn’t sleep, I kept breaking out in a sweat, and I realised I hadn’t had a period in three months. I went to my GP, who ran blood tests and referred me to a leading gynaecologist in one of our national maternity hospitals. My GP didn’t tell me she thought that this was what it might be. She just sent me in. When I met the gynaecologist, she opened and read my blood test results in front of me, and her whole face changed. She asked me had I got someone with me, which I didn’t because no-one had prepared me. Then she said, “You’ve menopaused.”
I went into total shock, then I broke down. I had to leave the room. I sat in the grounds of the hospital sobbing, then I pulled myself back together and went back in. I asked the gynaecologist what happened from here, and she just shrugged and said ‘Nothing. You’ve menopaused. That’s it. I’ll talk to your GP about some tablets you can take.’
“I asked her about having children and she said she could run a test to see were there any eggs left but she doubted it. She ran the tests and called me about two weeks later to tell me there were no eggs left.”
Related: Cholesterol and menopause: the highs, the lows and the hormones
Claire’s GP put her on HRT tablets, but never explained to her properly what was in them, how they worked, or why Claire was taking them. “There was no education,” said Claire, who took the tablets for three years, but never felt properly well.
“They need to be told what their body is going through”
Claire read up a lot on menopause during these years. She came across this column and began to read it regularly. She made an appointment with Dr Deirdre Lundy in The Menopause Hub, who was shocked at how badly Claire’s situation had been handled. What was particularly concerning was the fact that the HRT tablets Claire had been given turned out to be a very low dose, just one-third of the amount a woman in Claire’s situation should be receiving. I spoke to Dr Lundy about the Irish healthcare system and the apparent lack of structure or support Claire had encountered.
“There is a complete lack of skill” Dr Lundy confirmed.
“Women who experience POI (early menopause) need a lot of counselling. They need information on how it might impact their fertility, their bones, their heart and their quality of life.
They need HRT immediately, and ideally, it should be offered in the most natural format, i.e. transdermal gels or patches. They also typically need it in higher than usual doses. This is all according to guidelines from the European Society of Human Reproduction. Despite this, Claire has given low dose tablets, not gels. She may now have other health issues as a result, and she had to live three years of her life feeling unwell when the correct dosage of the right hormones would have quickly brought her back to health. Women in this situation need emotional support and practical guidance”.
Dr Lundy continues, “They need to be told what their body is going through, and they need to know their options, particularly when it comes to having a family. Some women will manage to conceive by themselves but generally, they will need assistance. The real problem is accessing good hormone health advice. The GPs refer to gynaecologists, who quite often are not up to speed on Hormone Replacement Therapy or on Premature Ovarian Failure Guidelines.”
Claire is now receiving the treatment she needs. She feels it’s a shame she had to spend three years searching for it, when it could have been sorted in less than 3 weeks. “It all just felt very cold” says Claire. It was simply a case of ‘that’s it, you’ve menopaused. Here are some tablets if you want them’. Nothing else. No support, no guidance. Every bit of help I got, I got it myself. And that’s because I’m the kind of person who won’t let things sit. But what about the women who will just accept what’s being said? What happens to them?”
If you or anyone you know is going through early menopause, Dr Lundy recommends immediately visiting www.daisynetwork.org, an informative UK website dedicated to early menopause. Dr Lundy can also be contacted through The Menopause Hub at www.themenopausehub.ie
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