Menopause, the end of regular menstruation, is a significant time for women and everyone will have a different experience. As society becomes more comfortable with female reproductive health and well-being, menopause is increasingly discussed in the open, more so than it was in the past. With rising life expectancy rates, women in most parts of the developed world can live up to a third of their lives in the post-menopausal state.
The most widely reported symptoms are hot flushes and night sweats, known as vasomotor symptoms, but anxiety, low mood, vaginal dryness and loss of libido are often real sources of distress for women. Successfully managing menopause and perimenopause will mean a trip to GP for an increasing number of women and hormone replacement therapy (HRT) is an important option in symptom relief. For women with milder symptoms, lifestyle management can yield very positive results and drug-free options to help manage symptoms are available. Aisling Grimley’s website, mysecondspring.ie, takes the approach that while it can be challenging, perimenopause and menopause “is a completely normal life-stage, and not a disease to be treated.” Grimley tells Irish Pharmacy News that there is not enough information out there for those who are going through the change. “When I set up My Second Spring five years ago, it was in response to dearth of good solid menopause information online. Thankfully that has changed.”
Grimley’s site is visited by women all over the world who are seeking proactive solutions to their menopause symptoms. “We wanted to both provide effective advice on symptom management, but also to reframe the ideas around menopause,” she explains. “In China the menopause is known as the Second Spring and it is regarded as a time when women often find a new and more confident voice. Women at midlife are valued for their wisdom and respected for their life experience and so menopause is something of a badge of honour.”
Through the course of her own journey and research, Grimley found nutrition and exercise to be the most helpful in managing symptoms and also praises the benefits of taking omega supplements from perimenopause right through to post-menopause. “Many of the symptoms are in fact indicative of decades of nutrient deficiencies catching up with us. If you don’t eat (non fried) oily fish three times a week you are likely to be low in omega-3. Plant fat such as sunflower spread with omega-6 can help some women with hot flushes and in the maintenance of healthy hair and skin. Dairy products containing omega-7 can help with skin dryness and vaginal dryness during perimenopause.” Pharmacists can also provide supports to women during menopause, Grimley suggests. They can recommend nutritional supplements to patients who believe their dietary intake is inadequate, and can also offer cholesterol checks and bone density tests and advice on achieving an ideal weight.
Catherine O’Keeffe, also known as The Wellness Warrior (www. wellnesswarrior.ie) specialises in perimenopause. O’Keeffe tells IPN what women can expect from a drop in hormone levels. Anxiety, for example, a lesser known but often distressing aspect of menopause, results from the loss of oestrogen’s calming effect on the system. “Hot flushes, night sweats, insomnia, increased migraines, low libido and memory loss often give rise to health anxiety as women try to figure out if they are going crazy or merely growing old fast. And very often women have not made the connection that hormonal shifts are triggering anxiety. Once they realise that, the response is initially relief. Then they can take back some kind of control over their anxiety and moods. If women are slightly prone to anxious thinking before their fourties, this can really escalate with the arrival of perimenopause. We have seen this first hand over the last few years: many competent, levelheaded women become really blindsided by menopause’s anxiety acceleration. The fluctuation in oestrogen and progesterone in the menopausal years has been known to cause anxiety and depression.”
Grimley and O’Keeffe have partnered together in their shared quest to help mainstream the conversation on menopause and how it affects women. They both believe that Irish society has adopted an ‘ostrich approach’ to the topic. “It’s like mental health,” says O’Keeffe. “It has taken people a long time to start talking openly about [menopause] and there is still a way to go. While [it] is certainly talked about more than it was in my mum’s generation, the symptoms can feel deeply personal to most women. I find that many don’t even talk to their best friends about symptoms and also find it hard to discuss it with their partners.” Opening up to the realities of menopause can help to improve options for patients. Improving understanding and education on the topic could mean women will be more inclined to approach their health care providers to ask for help with solutions. Pharmacists should be poised to assist those in their communities who are in need of therapeutic intervention for the treatment of menopause. Having information and helpful products to hand will help towards dispelling unhelpful taboos and will reassure patients that not only do you understand, but that you are also ready to help.”