The realities of menopause and money – it’s something every woman goes through, so why is it shrouded in fear?

“Shame,” “exciting,” and “going insane” were terms propagated by the participating women from their experience of this very natural life event.

Forget the occasional hot flash. It can mean depression, anxiety, weight gain, insomnia, bloating, palpitations, bladder problems, and joint pain. It sounds like standing on the brink of a terminal illness.

And many women just had no idea what was going on. From being misdiagnosed to being told they’re imagining it, or being too young for it, or dealing with dismissive doctors, previously strong, healthy women have become a puddle of concern.

Most of them – including this author – first learned the term “perimenopause” while they were in it.

The condition can last four to 12 years before menopause, according to the program. It goes undetected mainly because the big marker in menopause is monthly periods ceasing for 12 months. That, we are always told, signals “change”. Well, that’s more the medical definition than lived experience.

Changes of all kinds can occur from 40, even 30 and earlier if you have had diseases like ovarian cancer. Experts show that one in five will not have symptoms, but at least a quarter of the remaining 80 percent will be severe.

“It’s no coincidence,” says Breeda Birmingham, former midwife and founder of the Midlife Women Rock Project (midlifewomenrockproject.com), “that suicide rates among women peak at age 51.”

“The taboo subject of menopause has been surrounded by stigma, fear and silence for decades; something that hasn’t benefited women or society,” she says. “Until recently, no preparation, no education, and no public signpost of support has left too many in crisis. However, changes are happening mostly because women are starting to increasingly speak up about numbers.”

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“Ancient history disabled and limited women who were reaching the end of their reproductive years,” says Ms. Birmingham. “We need to change this story and we are changing it because too many of us still have a lot to offer to society. Women over the age of 50 are the fastest growing cohort in the workplace. You deserve to be supported. Organizations and businesses increasingly in Ireland see the value, experience and skills of women over 50.”

These include Vodafone, Bank of Ireland and Aldi, which have introduced menopause support programs.

perimenopause

The HSE defines perimenopause as “when you have symptoms before your period has completely stopped (starting) seven years before the end of the period. Your GP can usually confirm if you are going through menopause based on the symptoms. They may suggest a blood test to check your hormone levels.”

They can also refer you to a specialist clinic at National Maternity, Coombe and Rotunda and Nenagh General Hospital. Clinics in Galway and Cork are also set to open.

treatment

Treatment is usually offered as hormone replacement therapy. Either a “combined” approach of estrogen and progesterone for women with a uterus and estrogen only for women who have had their hysterectomy.

Medications come in the form of patches, transdermal gels, implants, tablets or a combination of these and your GP is best advised to advise you on the effectiveness and type.

However, HRT is not suitable for everyone. Ms Birmingham says: “It’s wonderful when you find an HRT formulation that suits you and doesn’t have side effects, but a lot of women do have side effects.”

State aid

Health Secretary Stephen Donnelly has said he recognizes menopause as “the most important health issue” for women. A women’s health taskforce convened in 2019 to examine this and other women-centric issues.

Her research found that menopausal women experience “a sense of loneliness and isolation,” with the subject feeling “mysterious and closed off, which contributes to taboo or stigma.”

“There is significant activity underway to improve support for menopausal women,” says Mr Donnelly, and the opening of dedicated clinics has been announced in September 2021.

GP education is recognized as a key aspect of care and webinars and conferences have begun further planning. The new position “Clinical Director of Women’s Health in General Medicine” is proposed.

Ms Birmingham claims this could be a “game changer”.

“A nationwide awareness campaign is something I was campaigning for even before Covid. I believe this will encourage all of society – women, men, families, workplaces – to start talking and discussing this transition.”

The cost of menopause

Aside from the personal costs in terms of health consequences, concerns and being away from work, menopause also has financial implications.

Hormone replacement therapy is not free unless you have a health card.

You can expect to pay at least €20 to €50 per month for the treatment, even if the VAT abolition announced in the last budget happens. Some women have to pay more because only certain products suit them.

The most popular transdermal gel is Estrogel, which costs €12.95 on Healthwave.

Estradot patches cost around €22.95 for a month’s supply, while the Utrogestan capsule for progesterone costs €22.95, but costs vary by pharmacy.

The Drug Payment Scheme caps monthly expenses at €80 but can still be a significant expense for many low-income women.

There is a 20 percent tax break for all non-reimbursable medications and GP visits.

Most private health insurers offer cashback on prescriptions. Upload receipts as you go to save each month. Check what your policy offers, but it’s usually 50 pieces of the receipt or a flat fee of around €25.

Women on HRT also need to see their GP about every six months, so there are additional costs involved.

Some women also like to take supplements like Well Woman 50+ (€16.99), Centrum 50+ (€8.99) or Cleanmarine €27.95 during this time to help with nutrition and symptoms.