West Cork Menopause and Women’s Health Clinic
It is with great pride that I report my completion of the final hurdle of The British Menopause Society (BMS) qualification process: I am now officially a BMS Menopause Specialist.
I run The West Cork Menopause and Women’s Health Clinic, located in Bantry Bay Medical Centre. This service was set up in March 2024 and would not be possible were it not for the fantastic support of Bantry Bay Medical Centre’s lead GP, Dr Michael Kingston, who agreed to host the clinic. While women of all ages may phone to book an appointment to see me for 30-45-minute appointments, most consultations are for menopause, perimenopause and continence issues. I also work as a regular GP at the surgery, three clinics per week.
For high quality patient information on all menopause issues go to www.womens-health-concern.org and www.westcorkmenopauseclinic.ie
Menopause in Ireland: How are we doing?
In May 2021, RTÉ’s Joe Duffy devoted 10 days of his radio show, Liveline, to the subject of menopause. Most women I now see will remember where they were when what is described as the Irish Menopause explosion occurred. It somehow gave women permission to talk about menopause and resulted in a rise in patient demand for menopause consultations.
Readers will know that I worked as an NHS GP in the UK for 28 years before returning to my native Cork in February 2023. I was saddened at that time to learn how far behind Ireland was with regard to Menopause care provision:
Ireland did not have its own structured Menopause Society, like the British or International Menopause Society, which provides evidence-based menopause learning to members.
Your GP is your first port of call for any health issues including menopause. However, in my time at UCC, there was no education or training on menopause for medical students and I am not aware that this has changed. I trained as a GP in the UK and again I did not receive any training specific to menopause. So how do GPs attain the knowledge and skills needed to manage menopause for their patients? Is there an Irish qualification process for GPs to become a Menopause Specialist such as exists with the BMS? Not currently.
If a GP lacks the knowledge or skills, is there a menopause service in their area they can refer to? Not a publicly-funded general menopause service, no.
Then and now
We might have started at the back of the group when it comes to menopause but, since 2021, Ireland has been positively sprinting:
The Irish College of GPs set up online learning modules for GPs on menopause and urogynaecology, the latter dealing with continence and prolapse issues. This went live in 2022 and this has now also been made available to practice nurses.
In addition, any Irish doctor can become a member of the British Menopause Society and avail of the fantastic BMS online learning and training resources. Many GPs I have met are unaware of this.
This year we should be proud to learn of the establishment of The Menopause Society of Ireland (www.menopausesocietyireland.ie).
In terms of resources for clinicians and information for patients, it is looking at bit sparse at the moment, but it is a great start. The Society’s inaugural meeting will be held in Dublin on September 14.
Cork University Maternity Hospital, CUMH, set up a Menopause Clinic in September 2023, which is fantastic.
However, it is only for what they describe as complex menopause cases, and referral criteria are very stringent. They will only accept patients they deem need the input of their BMS Advanced Care Practitioners. It is expected that GPs will manage everything else.
We do not yet have a HSE funded menopause clinic to refer to for those Cork GPs who do not possess the necessary skills and time required to manage menopause.
What next?
The groundswell of public interest in menopause care provision in Ireland continues to rise. A question we need to all be asking is: The HSE provides free contraception consultations and medicines – why not free menopause checks and HRT?
I put this very question to The Leader of the Social Democrats, Holly Cairns’ team and she directed the following parliamentary question to Stephen Donnelly in July in The Oireachtas:
• 2366; Holly Cairns asked the Minister for Health if he would consider the implementation of a free menopause scheme, similar to the contraception scheme and the maternity and infant care scheme; and if he will make a statement on the matter.
Another parliamentary question was raised on the dearth of HSE funded menopause clinics nationally in July by deputy Niamh Smyth when she asked the Minister for Health for an update on the provision of menopause services; the number of clinics available through the public health service; the contact details for each clinic and the waiting times for a first appointment.
We welcome reports from Stephen Donnelly that he plans to introduce a publicly funded hormone replacement therapy (HRT) scheme.
The proposed scheme only mentions free HRT prescriptions. HRT is only a tiny part of a Menopause Health Check. What we need to see is HSE funded Menopause Health Checks for all women aged 45 and over.
As per the core principles of SláinteCare, these checks need to be delivered close to home and be independent of a woman’s ability to pay.
Have we reached a tipping point nationally and politically with regard to the provision of Free Menopause Care in Ireland or is this politicians giving pre-election and pre-budget lip service to a popular hot-topic?
The Contraceptive Train was a women’s rights activism event, which took place on May 22, 1971. Members of the Irish Women’s Liberation Movement (IWLM), in protest against the law prohibiting the importation and sale of contraceptives in the Republic of Ireland, travelled to Belfast to purchase contraceptives. In 1979, the Irish Family Planning Act was introduced, allowing contraceptives to be sold under prescription. Finally, in 1985 the laws relaxed to allow the sale of condoms and spermicides without a prescription. Contraception did not, however, become free until 2022.
Ireland has been a trailblazer on a number of issues such as the smoking ban and same-sex marriage.
Ladies, make some noise: let’s make Free Menopause Health Checks happen.
