I often carry out an initial general audit with new clients, because regardless of the issue they want to address, the elements of our lives are intertwined, and none more so than health. It’s crucial for women from their late 30’s onwards to understand their body’s biological journey, and how to travel through it as easily as possible. This article reinforces the most important message to women in midlife - mind your health and take charge of your body, and I’m incorporating my interview with Loretta Dignam, CEO and Founder of The Menopause Hub, as her story exemplifies why thriving in midlife starts with health.
Growing up in a working class background, Loretta, 58, was the first in her family to go to university, and she enjoyed a successful career in corporate marketing. When her marriage ended, she found herself juggling work and single parenting. “It was a very challenging time. I never felt good enough,” she admits, “as a parent, as an employee or in any aspect as it was so overwhelming. I look back and realise I did a damn good job, but of course at the time you think you aren’t doing anything well because you feel constantly pulled in every direction.”
Loretta joined the Board of the Abbey Theatre just weeks before the 2016 schedule was released, revealing little to no inclusion of female writers or directors, sparking the Waking the Feminists movement. “I was asked to Chair the Gender Equality Committee, introducing policy changes resulting in greater gender equality in our National Theatre, and women in the wider theatre sector. It’s been a fascinating time for women recently in Ireland, and the work I do now is part of that desperate need for women - in my case women’s health - to be recognised, prioritised and supported. That time showed me that it’s possible to make change happen.”
In her early 50’s, Loretta began to think about what she would do in the coming couple of decades, as her youngest was getting ready to move into her adult life. “I still felt I had so much to offer, but I’d done all I could in the area of work I was in. At exactly this time (which turned out to be the perfect time) I “discovered” I was going through peri-menopause, although I’d never even heard of the term.”
Loretta had put symptoms of exhaustion, mood swings and insomnia down to stress, when in actual fact, they were a part of her natural biological evolution. Just to clarify the terms - Peri-menopause is the stage (that can last up to ten years) when our reproductive hormones are reducing, and when we experience most of the symptoms; menopause is the day you haven’t had a period for 12 months, and everything after that is post-menopause.
“I began hormones replacement therapy (HRT), and immediately started to feel good. I was so shocked the symptoms I’d put down to stress and just accepted, went! The seminal moment came when I was with a successful woman I really admired. She suddenly started fanning her face, and when I asked if she was ok, she told me she was turning 60 that weekend and still having hot flushes. She told me there’d been nowhere for her to go for support. When I thought about so many women putting up with these symptoms for ten or more years, I was enraged. I thought, if I could wave a magic wand, I’d ensure that women are informed and supported at this crucial time of their lives. And so my mid-life mission was born.”
I’ve found the same with my own research, and the women I talk to through my work as The MidLife Coach. Women just didn’t, and still don’t, know what’s happening within their own bodies and are often paralysed with symptoms that could be alleviated with some help. Yet until fairly recently, no-one was talking about it.
Here’s why it is so important.
The average age of menopause is 51. In the 1900’s it was 47, but average women’s life expectancy was 49. Now we’re living into our 80’s, and spending a full third or even half of our lives post menopause.
Which poses two crucial questions:
What do we do with this unprecedented time;
and how do we manage the oestrogen deficiency?
The coaching I do with women is often focussed on the first, but nothing will happen easily unless the second is addressed.
Here is the critical thing:
Oestrogen deficiency (caused by hormone withdrawal) can not only cause severe symptoms during peri-menopause, but also severely impacts women’s long-term health. Once menopausal, the risk of heart disease in women overtakes that of men, becoming the number one killer of women. Women are also three times more likely to suffer from Alzheimers and cognitive function loss, and are also more at risk of osteoporosis.
Yet oestrogen protects our brains, bones and hearts in the longer term.
Now that we face decades post-menopausal, deficiency in oestrogen needs to be addressed.
HRT isn’t a one-size-fits-all pill, rather a cocktail of hormones that need adjusting as our bodies continue the process of changing levels. Just as in puberty, when certain hormones build up in the body for the purposes of reproduction, so peri-menopause is the staggered withdrawal of them once reproduction is no longer necessary. I often joke that we spend our 20’s and 30’s trying to find the right alcohol cocktail but we now have to find the right hormone cocktail! The desired result is the same - happy hour. Women need the proper support to keep that mixology right with regular reviews.
“HRT got a bad name years ago,” explains Loretta, “but most of that research has been debunked. Every woman’s body is different, as are her needs, and her GP should constantly be weighing up the benefits and risks of any treatment.”
Women need protection, and support to thrive in post-menopausal years, instead of feeling ill, weary and worried that more sinister health issues are at play. There is also the emotional onslaught that can be experienced in peri-menopause. Mood swings, anxiety and depression can be frightening, and many women can feel they’re going mad. I have at least one client who claims that looking back, she realises that menopause contributed to the end of her marriage.
Women need to have information to know their options to make the best informed decisions for their bodies and health. "80% of women will get symptoms. In many ways this is a good thing,” explains Loretta, “because they may well seek help. The 20% of women who don’t experience symptoms are the ones I worry about - they may be feeling relief, but actually they aren’t seeking help for the longer term impact of oestrogen deficiency on their heart, bones and brain. Symptoms are our body’s way of telling us to pay attention so we can live a long, healthy post-menopausal life. Yet when I ask older women who say they’ve sailed through menopause, how are their bones, I discover they’re suffering from osteoporosis and making no connection that their current symptoms are related to not addressing menopause at the time.”
Why MidLife marks the New Lease of Life
This is an opportunity women have never had before - to thrive during menopause by choosing options that will optimise their health, and then having unprecedented time to engage in a new phase of life, not centred about reproduction, but where they can devote energy on themselves.
Like Loretta. “I made the decision to wave that magic wand and do something practical to support women, and also give myself that “thing” I’d been thinking about to focus on now that my parenting role had lessened. I spent a year developing The Menopause Hub, opening our doors in December 2018. It was a bittersweet moment though, as my mother actually passed away the evening before we opened, after only being ill a short while. When she passed away, although it was an incredibly difficult time, I feel almost she was letting me go, free to start this new phase of my life, and so proud of what I was doing.”
Another reason why this can be such an important time for women is the reduction of what’s known as the “cuddle hormone” oxytocin. Known to create the nurturing feeling essential for women during childbirth and raising children, its decline is another way of helping us move on from being a constant carer to living more for ourselves.
“When I look back at my life, there have been three phases after my childhood. I loved feeling zingy and enlivened in my post-education phase, starting my career and building my adult life. Then during my parenting phase, I was working full time and juggling everyone’s needs. Now this phase feels similar to my 20’s phase, like I have the chance to create something completely new. I get to give in a way that doesn’t take as much from me.”
Loretta’s mission is twofold: to provide a medical practice dedicated to menopause, and to advocate for better information and services, including working with the Department of Health on their implementation plans for the Women’s Health Strategy. She wants information to piggyback on existing health programmes such as cervical and breast checks, or provided via GP surgeries for women from the age of 40. She’d also like to see a dedicated HSE Menopause portal, a Helpline and mobile units that travel the country, providing information and health checks.
“Savings to the Health system in the long run, in terms of conditions like heart disease, Alzheimers and osteoporosis would be significant but we need political willpower. I also worked with the IMNO on menopause in the workplace, as companies over 250 employees will soon be required by legislation to have policies supporting women experiencing menopause like the MET Police, Channel 4 and others already do in the UK.”
The M Word.
Education for women is critical, and will drive demand for better supports and services. But a significant barrier to women seeking the information and support they need is an historically negative view of menopause that exits. In her educational workshops, Loretta sees huge levels of denial, and negative connotations, and I see it too; a reluctance to admit stepping in to a space no longer represented by existing stale stereotypes. Part of my work, and it seems Loretta’s, is to help bust damaging myths about midlife and menopause when it’s in fact a healthy, biological development, that, when managed well, will give women a new lease of life for several decades; and to empower women to take charge and strive to find the opportunities that come with ending their body’s reproductive phase.
“Do I mourn the loss of being able to have children at 58? No! The fact is I’m giving birth back to myself,” explains Loretta. “My new baby is The Menopause Hub! Do I mourn my perceived loss of status in society and, before I sorted my symptoms, my vitality? Yes. We live in an ageist society against women, so we need to show women living vibrant, meaningful lives. We’re starting to see role models such as Liz Earle, Mariella Frostrop and Meg Matthews flying the flag that we can thrive but we need more, especially in Ireland. We don’t want to sugar coat it, because parts of it are difficult but the key message is to get the help you need, be that physical, emotional, mental, or medical and then enjoy the benefit from this new stage of life.”
I like the idea that once women can no longer give birth to babies, inclined to nurture others above themselves, they can birth a new lease of life for themselves. It’s a transformational time, and I really encourage women to arm themselves with knowledge, make choices that are right for them, and embrace midlife - a decades long stage of life now between youth and old age - redefining what it means for the generations to come.