A helpful and holistic guide to a little-understood subject

ANALYSIS: THE WOMEN'S Health Council research series, The Menopause and Me , represents the largest body of work ever carried…

ANALYSIS:THE WOMEN'S Health Council research series, The Menopause and Me, represents the largest body of work ever carried out on the menopause in the Republic.

By including different research strands, the council has adopted a holistic approach and produced a most helpful and relevant package of information.

Women's Experiences and Understanding of Menopauseprovides us with a valuable insight into how women feel about this significant time in their lives.

Almost 50 per cent of women said the experience of menopause had a substantial effect on them. These included a wide range of physical, psychological and social effects for the 260,000 Irish women who are going through some stage of the menopause.

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A survey of public attitudes to the menopause produced some interesting results. Fewer than 1 in 10 men described themselves as "informed" about this major time of change in women's lives. With just over half of women over 35 saying they felt well informed, it is not surprising that 60 per cent said they wanted more facts.

Underlining the diverse nature of symptoms associated with the significant hormonal changes that occur over a sometimes lengthy period of time, most women said they found it difficult to identify when exactly their menopause began and even questioned whether symptoms such as hot flushes, irritability and mood swings were real. Two in three women went to their doctor to confirm their menopausal status.

The blood levels of two hormones produced in the brain (FSH and LH) rise and the level of oestrogen drops significantly coming up to and during a woman's menopause. These dramatic hormone changes give rise to the night sweats and flushes experienced by 80 per cent of women between the ages of 47 and 55. Changes to skin, hair and nails as well as vaginal dryness can also be linked to hormonal swings. Mood and memory may also be affected.

Significantly, the review of the biomedical evidence for menopause treatment found that, in spite of a growing public interest in complementary therapy, "there is little scientific evidence to support its use".

But the Women's Health Council does endorse the use of hormone replacement therapy (HRT) for the relief of hot flushes and vaginal dryness. It notes the decrease in HRT prescribing since the publication of two major studies confirming a link between HRT and breast cancer, ovarian cancer and cardiovascular disease. While the majority of women use HRT for between one and three years, almost 20 per cent of HRT users have taken the drug for six years or more.

Despite the acknowledged long-term benefits of HRT, such as the prevention of osteoporosis, yesterday's report recommends that doctors prescribe the lowest effective dose for the shortest possible time. And it suggests that an individual risk profile be conducted for every womaconsidering taking HRT.

With women living longer and now likely to spend over a third of their lives in a post-menopausal state, this new source of quality, evidence-based information is essential reading. It can be found at www.whc.ie/menopause