Sylvia Thompsonlooks at the 'personal side' of the major study on the menopause which was released at the weekend.
A TABOO WAS lifted from Irish society at the weekend with the publication of the Women's Health Council studies on the menopause.
This, the largest body of research to date on awareness, attitudes and experiences of the menopause, has shed light on a significant part of every woman's life which has until now been clouded with uncertainty and a lack of information.
One of the most interesting parts of the research is on women's various experiences of the menopause. One participant in the study neatly summed up her experience of the menopause with the following comment: "It's the one stage of your life where there's major change, because you're leaving . . . the childbearing years . . . but if you're caught here and you don't know what the hell is going on with you, you can't move on.
"How can you move on when you're sweating half of the night, or hot flushes during the day and you're thinking you're losing your marbles."
While the medicalisation of the menopause has been criticised by some commentators, the study found that most women sought a medical diagnosis of the menopause as a means of explaining various symptoms.
"For somebody to actually say that you are menopausal when you think you're going off your head, it makes a huge difference. It's reassurance that you're not losing the plot," said one woman.
The study's lead researcher, Dr Abbey Hyde, nurse and senior lecturer in the School of Nursing, Midwifery and Health Systems at University College Dublin, says the research has pointed to the need for more information.
"What surprised me most about the women's experiences was the sense of isolation they had before their menopause was confirmed medically."
However, the researchers also pointed out that some women had mixed feelings at the realisation that they were menopausal - on the one hand they were relieved that their symptoms were not indicative of a disease, while on the other hand, they were not ready to embrace a menopausal identity and its connotations of ageing.
Some women also had difficulties receiving a medical diagnosis of the menopause - despite many subjective experiences of bodily changes - if their periods hadn't stopped.
The psychological aspects of the menopause are often the ones that women struggle with most, wondering if indeed they are linked to other life experiences or not. In some cases, the study found that women's mood swings were more easily identified by other family members than by the women themselves.
One woman said: "That it happens at a particular time of your life when there are so many other things going on that it is actually hard to pick out what is a symptom and what isn't."
The women who participated in the research were drawn from women's organisations throughout the Republic.
Many women also expressed anxiety of becoming dependent on Hormone Replacement Therapy (HRT), yet the study found that it remains the most effective pharmacological intervention for relief of hot flushes and vaginal dryness.
The researchers recommend that an individual risk profile (need for treatment, age, family history, etc) should be carried out for every woman considering HRT. The study also found that there is insufficient evidence to support the use of complementary therapies in relieving menopausal symptoms, even if they may benefit general health and wellbeing.
According to Hyde, women working outside the home felt that they couldn't go public on the menopause. "One has to be careful in highlighting the issue of the menopause not to fall back into the view of women ruled by their hormones and unfit for public life. Yet, there needs to be openness about the really distressing experiences some women have during the menopause. Maintaining a silence about the menopause won't help these women," she says.
Similarly, Hyde believes we need to find a middle ground between the one extreme view that the menopause is a natural process that women just get on with and the other, that it needs to be controlled medically.
"Neither of these extremes is helpful," she says.
Hyde is keen to point out that women interviewed for the research were, in general, positive about ageing itself and most participants said that they had a new self-confidence as they got older. One woman said: "I'm so much more self-assured than I used to be . . . Some of the social conditioning kind of disappears a little bit after the menopause."
Many also said that they looked after their health to a greater extent than in earlier parts of their lives.
Interestingly, the study found that some of the women who defined themselves at being at the end of their menopause tended to look on life more positively that those in the menopause.
One woman said, "I think it's good now . . . When I was in the menopause, everything used to race in front of me and I used to think of all the bad things that could happen. I don't think like that anymore - I think of all the good things that could happen."
See www.whc.ie/menopause