Menopause & PMDD Clinic

Menopause is the medical term given to the time in a woman’s life when she is no longer producing important hormones from her ovaries. A woman is considered to be menopausal when she has had a full year without a natural period.

This loss of hormonal production can have a significant impact on your emotional, physical and sexual wellbeing. Your long-term health is also affected by losing these hormones and the risks of heart disease and osteoporosis (bone density loss) significantly increase from the time of menopause onwards.

The menopause occurs when your ovaries no longer produce eggs and, as a result, the levels of hormones called oestrogen, progesterone and testosterone fall. The average age in Ireland for menopause is 51.

Oestrogen is an important hormone for our health and wellbeing. We have oestrogen receptors throughout our bodies and low levels can have an impact in many different ways. In particular, we know that the risk of heart disease (cardiovascular disease) and brittle bone disease (osteoporosis) rise significantly when we lose oestrogen.

Perimenopause is the time before the menopause when your periods change (they can be lighter/ heavier/ more or less frequent) and reflect a change and fluctuation in the production of hormones from your ovaries. Symptoms often start around the age of 45.

The fluctuation of these hormones can lead to symptoms which may range from temporary and mild to severe and prolonged. What symptoms you experience and how long they persist depends on many different things including your family history. Every woman is different. The average perimenopausal transition lasts about 4 years and has its onset between ages 45 and 55 in 95% of cases.

The most effective treatment for symptoms of the menopause is to replace the hormones your body no longer produces. Hormone replacement therapy (HRT) contains oestrogen, a progestogen (or progesterone) if required, and in some cases, testosterone.

The oestrogen can be given as a tablet, patch, gel or spray and the progesterone component as an oral capsule, tablet, patch, vaginal capsule or as an intrauterine device.

HRT also protects your future health from osteoporosis, heart disease and type 2 diabetes. For most women the benefits of taking HRT outweigh any risks.

There are also non-hormonal medications that can be helpful such as clonidine and SSRI’s (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) may help improve vasomotor symptoms.

Cognitive behavioural therapy is also very helpful towards dealing with low mood and anxiety.