Grace Moore, from Dublin city, is only 37, but was plunged straight into menopause when she had her ovaries and Fallopian tubes removed in a preventive measure because she carries a cancer gene. She had a Mirena coil put in at the time of surgery, and was prescribed hormone replacement therapy (HRT).
Moore experienced lots of symptoms. She says she was very agitated, snapping at her children and experiencing intense hot flushes. She describes herself as being “very difficult to live with”, and says her partner was relieved when she sought to have the HRT dosage adjusted.
She says she was prescribed anti-anxiety medication but she doesn’t think this is what she needs. She thinks the HRT medication helps her most of the time, although she finds herself to be far more emotional, and particularly affected by distressing news items, than she used to be.
She’s waiting to see a doctor who is a menopause specialist, and is hoping her HSE dosage will be adjusted. She says if she takes her HRT patch off in the shower and forgets to put it back on, she’s “like a psychopath”. Moore, who has four children, says she wishes there was a holistic approach to menopause in Ireland, and would like that to include therapy and “breathwork”. She feels her treatment was very “textbook” and wishes she had been offered other options.
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Moore thinks HRT should be free, and she believes Minister for Health Stephen Donnelly, who is advancing plans for free HRT, will bring in this measure, although she notes she finds it hard to believe everything the Government promises.
Karen Coakley, from Bantry, Co Cork, but living in Kenmare, Co Kerry, noticed a change as soon as she turned 40. She didn’t feel like herself. Anxiety was her first symptom. Brain fog, an inability to think straight, constantly losing things, losing what she describes as her “sharpness”, foot pain and frozen shoulder all followed. At the gym she lost her stamina and could no longer lift the weights she had been lifting. Exercise became difficult as she had zero motivation.
The anxiety began to affect her ability to function in daily tasks. She was anxious about driving and started making mistakes like such as taking wrong turns. “I never had a hot flush,” she says. “I was just losing myself. By the time I was 47 or 48 the weight had really come on.”
Coakley joined an Irish menopause support group on Facebook but remained unsure about trying HRT. Her symptoms continued to get worse so she approached a GP. Initially, she says, the doctor was reluctant to prescribe HRT because Coakley was “too young”. But when she approached the doctor again some months later, with a symptom checker, she was prescribed oestrogen and progesterone to begin with. The GP suggested Karen see a menopause specialist.
[ Hundreds of thousands of women could access free HRT under new plansOpens in new window ]
Within two weeks of starting on HRT Coakley felt like herself again. Her strength in the gym returned. Her aches and pains eased, and the sense of being overwhelmed disappeared. She started on testosterone a year or two later. Getting the correct hormone balance has been vital, she says. She’s 50 now and has been on HRT for three years. “I think the way to go is to go to a really good menopause specialist,” she says. “But be careful because there’s a lot of people jumping on the bandwagon.”
Coakley hopes Donnelly’s plans to in introduce free HRT happen. “I think it will open up the conversation more and make it more normalised ... but there’s no point in women having access to free HRT if the people who are prescribing it are prescribing the wrong dose.”
Eilish Balfe, based in Dunshaughlin, Co Meath, had the youngest of her three children when she was 40. She noticed after her youngest was born that she felt different. Much of how she was feeling was put down to post-pregnancy hormones, but two years later things had not improved. Around this time her father, who had dementia, died.
Balfe’s anxiety and forgetfulness increased. She attended a menopause clinic where a blood test was done and she was told she was not perimenopausal. Her symptoms continued to escalate and her brain fog developed to the point that she could not remember whole parts of the day, or people’s names. Due to her father’s medical history, she started to fear she was developing dementia herself. “By summer 2021 I was in a really, really bad place ... I remember being in the car and driving along and going ‘Do you know what, if I got crashed into now and I died, I don’t think I’d care’, she says.
She saw a doctor and explained she had two emotions – “rage and despair”. She began to experience hot flushes.
Following a bout of Covid in 2022, she attended a different doctor for a lingering cough. She was prescribed HRT by this doctor. She tried HRT for 18 months, including a change from a gel to a spray which did not work for her. She says her rage increased, her breasts were sore and the hot flushes remained. Friends had told her HRT would change her life, but that didn’t happen for her, so she stopped taking it. Her periods are frequent and heavy. She is taking lots vitamins to support her symptoms and feels she is managing to keep the symptoms under control. Once this is no longer the case, she will revisit HRT, she says.
Balfe is delighted to hear free that plans for free HRT are being finalised. She works with women who live in poverty and says this is an area they would cut spending on in order to prioritise other expenses.
Brenda Griffin, from Navan, Co Meath, noticed she had become “very flat” during the summer that she turned 47. She felt annoyed with everyone for no reason and began to become withdrawn. She didn’t want to talk to people, or go out. She would attend her children’s sports matches but sit in the car rather than have to chat to other parents on the sidelines.
She became forgetful, unable to remember words. And she had night sweats, which she describes as “horrendous”. Her hair was failing out and she developed tinnitus. She would get up during the night convinced the immersion heater or central heating was on due to the pulsating in her ears. “I thought I was going mad at first,” she says.
After some encouragement from a friend, Griffin went to see her GP. She burst into tears during the appointment. She had previously had a Mirena coil fitted and had not had a period for years. HRT was offered, along with blood tests to screen other factors.
She started HRT straight away, needing only an oestrogen patch because of the coil. It cost €14 a month. Griffin says she felt the benefits within three days. “I became a different person.” Her hair stopped falling out and started growing again. The tinnitus stopped. And she hasn’t had a hot flush since she started taking HRT two years ago.
When the HRT brand Griffin was using was out of stock and she tried another brand, the transition was without issue. But she did notice one day, when she forgot to change her patch, the symptoms beginning to return within 36 hours. She has a check up with her GP, who specialises in women’s health, every six months.
Griffin does not see any reason why plans to make HRT free should not go ahead. “If they can do it for contraception up to 35, why can’t they look after those women a bit older?” she asks. HRT is a need, not a lifestyle choice, she argues.
Sinead Tracy, 43, from Dublin, had a hysterectomy last year. She was prescribed HRT immediately but, she says, with no instructions as to how to use it. A pharmacist, not the one she attends regularly, told her to put the patch on her arm, she says. She learned from reading the instructions this was incorrect. She placed the patch on her hip but was told by a friend in a changing room that she should have placed it close to her ovaries. She says she finds it ridiculous that some women are relying on friends for information, and can never be quite sure if the information they’re getting is accurate.
With a history of endometriosis she feels sometimes doctors are unsympathetic to women’s health issues. She also feels some older women can be judgmental because they may have gone through the menopause without HRT. She says trying to get advice, or be taken seriously, is hard. “If you don’t get the right person, you’re left in limbo”. She stresses she is keen to protect her future health and says women on HRT should be monitored regularly, and male and female medics should be trained in the area.
Cost is not a particular obstacle for Tracy because of the drugs payment scheme. She thinks free HRT will become available, but suggests it will probably be announced a few more times first.
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