Mastering menopause: a gynaecologist on seeking an expert medical opinion

The menopause is one of the biggest events in any woman’s life and yet it is also one of the least talked about.

Most women cope with this confusing rite of passage by keeping quiet or making a joke of it. It doesn’t help, of course, that it occurs at one of the busiest stretches of a woman’s life. According to Annemarie Byrne, a nutritional therapist and coach, “Most of the women who come to me have the foot on the pedal. They have young kids, a career, ageing parents who need care. Stress levels are high. They are slow to realise they are in this period of change because they are last on their own list.”

Loretta Dignam is the founder of The Menopause Hub, a clinic for women going through the menopause that offers, among other things, GP assessments, nutritional guidance, physio and acupuncture. “I give menopause education and awareness training in the workplace and when I present the 40-odd symptoms women can get during the menopause, I see women connect the dots often for the first time. Because most know about hot sweats and loss of periods, but how many of us know about anxiety, panic attacks, joint pain, brain fog and memory loss? They are hugely relieved when they understand what’s going on because many of them thought they were going mad.”

Why do we know so little? “We are simply not educated about it,” says sexologist Emily Power Smith. “It should be taught in schools. This is a huge event in a woman’s life. It’s also inevitable. It will happen to you. Why don’t we know more?” In her experience, women don’t seek help until the symptoms have become overwhelming. This is why Annemarie likes to catch women in their late thirties. “Catch them later, and they tell me they don’t have time for self-care. And then I have to tell them that getting out of the downward spiral is going to take a lot more time than the self-care ever would have done.”

But attitudes are changing. In 2020, Vodafone announced its own employee commitment on the menopause, providing awareness training, sick leave and flexible hours. And there was the Joe Duffy show. Since it covered the menopause over five days last May, menopause clinics and mentors around the country found themselves inundated with calls. And last September 25th saw The Menopause Success Summit, a live online event featuring some of the top menopause experts (menopausesuccesssummit.com).

So what do you need to know? “Don’t suffer in silence,” says Loretta. “Get the right help from the right people.” With this in mind, we’ve assembled some of Ireland’s leading voices – meet Dr Shayi Dezayi, who says to;

Seek expert medical opinion

Dr Shayi Dezayi is a gynaecologist and a women’s health doctor at The Menopause Hub (themenopausehub.ie). She is also a member of the British Menopause Society.

“Women come to me with anxiety, bursts of anger. They cannot sleep, they don’t have any energy, they can’t concentrate. This can cause very real problems in work. Others are in pain – joint stiffness, muscle aches. They don’t want to exercise, everything hurts. Others have vaginal dryness or urinary leakage. I start with basic HRT. We talk about the risks and the benefits. The breast cancer association has contributing factors, such as BMI and alcohol intake, and we talk about those. And we talk about the benefits: better mood, better sleep, better libido, protection against heart disease, low bone density, cognitive function. A reduction in joint pain, improvements in skin and hair. It’s a personal choice: feeling well is the most important thing for some, not being free of a risk of breast cancer. Others want to try it, see how they go. For those experiencing vaginal dryness, I prescribe a topical oestrogen, which is completely safe. It is not a booster for HRT, there are no side effects, it is not absorbed into the blood-stream. It’s even safe for active breast cancer patients. I tell all women that their sexuality is central to their wellbeing. Some women say to me, I don’t need this, I don’t have a partner, but I say, this is about maintenance. It’s like a facial moisturiser. We also make lifestyle changes, reduce alcohol intake, consider exercise. Most of the women I see, see huge improvements in their quality of life. They say, I feel fantastic, I am back to myself. For me, this is very rewarding work. Others need more help. We try other treatments. I tell women to come to me sooner rather than later, when the first symptoms hit, around the age of 45. In my work as a gynaecologist, I see women in their late sixties with vaginal prolapses or recurring UTIs and they have been feeling terrible for a long time. There is no need to suffer like this. Educating women around this is really important. And every woman is different. Some women have symptoms but then their body makes the change, but others suffer for a long time.”

For more from Ireland’s leading experts on mastering menopause, see Loretta Dignam, founder of The Menopause Hub on speaking out here, Annemarie Byrne, nutritional therapist and coach on nourishing yourself here, sexologist Emily Power Smith on loving yourself here,  Sallyanne Brady on finding a community of support here, stylist and personal shopper Michelle Kilroy on feeling confident here, Dr Nina Bing Liu of AcuPlus on rebalancing here, physiotherapist Christine Gioia on getting moving here or see the full series here.

Illustration by  Anne O’Hara. This article originally appeared in the Autumn 2021 issue of IMAGE Magazine.