IN MUCH the same way as we never consider infertility, child-bearing or death until they are thrust upon us, women never give a moment's thought to the menopause until it slowly dawns on them that there may be an explanation for the recurrent sleepless nights and hot flushing that they've been experiencing of late.
And menopause, well, there's good and bad in it. On the plus side, it frees women from roughly 40 years of sometimes torturous periods and the dreaded fear of an unplanned pregnancy. But, equally, it causes, over its course, mood swings, loss of libido, sweats and flushing. And in its wake, a set of semi-permanent aches and pains, an ageing of the skin and hair, a profound effect on your sex life and a general accelerated feeling of ageing. And largely because the global narrative is a male one, we don't hear a huge amount about it.
In the distant past women just got on with 'The Change' and then, with the arrival of Hormone Replacement Therapy, they tried to avoid it altogether. However, as the pendulum has swung away from HRT – which, incidentally, only ever postponed the symptoms of menopause and never prevented them – we're back to largely grinning and bearing it.
Menopause is one of the few areas where I send women down the alternative route. Even though we know that plant oestrogens and supplements offer only a placebo effect, that can still be invaluable for a woman with profound symptoms. Sage, soya and vitamin E can all be used to relieve the hot flushes and night sweats, so that's generally the best place to start with management. HRT can, and is, still used in cases where benefit outweighs risk, and in fact recent studies have shown it to be probably safer than we'd thought.
So for women (and they do exist) whose lives are completely undone by menopausal symptoms, HRT may be the answer. Another simple trick for sleepless nights is to have two single duvets on the bed side by side rather than a double – to allow you to be at a different temperature to your partner and make it easier to change tog if needs be.
One of the biggest issues for menopausal women is the effect on their sex life. Loss of libido coupled with vaginal dryness can make sex less appealing or downright painful. Use of decent lubricants and sometimes vaginal oestrogen pessaries can make all the difference and prevent your sex life stopping at 50. I'd recommend avoiding the more 'clinical' types of lubes, which make you feel like you're about to undergo an internal examination and opt instead for a warm-to-touch kind, that can be used enjoyably, without freezing your nethers.
Mood swings are, for some, the worst symptom, and can be every bit as difficult as other types of mood disorders. They can leave women struggling with uncontrollable rage alternating with unexpected tears. If this is your issue, and if it's very bad, again HRT may be necessary, or even a low dose anti-depressant is sometimes used, to allow you to feel normal again.
Because of the multiplicity of the symptoms and the fact that you may not even realise that your current issues relate to the menopause, there's no harm in going for a check-up and having some bloods done with your GP. There are ways to manage and minimise the menopause, so it is relatively plain sailing. And in any case, like death and taxes – it's a certainty.
Dr Ciara Kelly is a GP in Greystones, County Wicklow
Sunday Indo Living