The Rotunda Hospital Dublin

Welcome to The Rotunda Menopause Clinic

Who are we?

The Menopause Clinic in The Rotunda Hospital was opened in October 2022. We are a lovely team of GP Menopause Specialists, a dedicated nurse, physician associate and administrative staff.

We are based in the Gynaecological Department of the Rotunda Hospital, Dublin.

The Rotunda Menopause Team

From Left to Right
Mercy Ninan, CNS, Ruth Murphy, Physician Associate, Dr Caoimhe Hartley, Dr Nora Mohammed Mustafa Alalem

What is the Menopause?

Menopause is the medical term for our final menstrual period. If you are over the age of 50 and have had not had a menstrual bleed for more than 12 months, this is termed “postmenopausal”.

This loss of regular bleeding happens when the ovaries stop producing an egg every month (ovulation) and stop producing a hormone called Oestrogen, as they did before.

Typically, this happens due to a normal ageing process in the ovaries and the average age to have your final period is approximately 50 or 51.

For some women, they lose their ovarian function at an earlier age. This can happen for no obvious reason and may be due to genetics. For others, it may happen because of other causes such as after chemotherapy or other types of medical intervention.

Perimenopause is the term for the time leading up to the final period. During this time, the ovaries are still producing Oestrogen and may still be ovulating but in a less regular pattern. The Oestrogen production may be variable and less regular. Many women start to notice a change in their symptoms or how regular their periods are from the age of 45 or earlier.

Blood tests are not useful to “diagnose” perimenopause as the hormones fluctuate so much.

Common symptoms

Many women will experience what feels like a “broken thermostat” and approximately 80% of women report “hot flushes” or night sweats at some point through this hormonal transition.

  • For some, these flushes/ sweats may be mild but for others they can be severe, frequent and debilitating.
  • Perimenopause is often described as feeling similar to the few days before menstruation, but worse, “like very bad PMS”.
  • The symptoms experienced through perimenopause may wax and wane with some months/ cycles feeling much worse than others. For some women, their symptoms come and go.
  • Periods may be less regular through perimenopause and can occur more frequently or less frequently, depending on the person.
  • Many women report symptoms of depression or anxiety at this time also.
  • One of the most common and difficult symptoms is that of “brain fog” or cognitive changes. More than 80% of women report changes to their memory and “verbal fluency” (difficulty finding the right word/ name). This can be a very distressing symptom and negatively affect self-esteem and confidence.
  • Women often describe joint aches and pains, dry eyes, dry mouth, changes in their hair and nail growth, heavy or frequent menstrual bleeding, burning feet or burning tongue. How these hormonal changes affect each person is highly individual. Some women may have no symptoms (other than a change to their menstrual cycle) at all.
  • The loss of Oestrogen can also cause changes to happen in the vulval, vaginal region and the bladder. This may result in women reporting painful intercourse or pain with cervical smear tests. It can be common to suffer with vulval dryness/ itch/ discomfort, needing to pass urine more frequently, increased urinary tract infections or urinary incontinence (leaking).
Long-term Health Impact

The loss of oestrogen production from the ovaries triggers a change in bone density. There is, on average, a loss of approximately 10% bone density in the first 5 years. There are changes that occur in the cardiovascular system (the blood vessels and heart) when oestrogen declines. Over time, this can increase the risk of cardiovascular disease (heart attack and stroke). This is why we encourage women who have stopped having periods to look after their bones and their heart health

Who do we help?

We aim to see patients who are experiencing symptoms of perimenopause/ menopause and who may have other complex issues. Some patients with a significant medical history or medical condition, may need the input of a specialist team, which is what we provide. Many of our patients have had a history of cardiovascular disease, breast or other hormone sensitive cancer or blood clots.

Women experiencing menopausal symptoms that have not improved with treatment may also be referred to our clinic.

What is the referral process?

Your GP should be able to send us a referral by letter in the post or via “Healthlink”- the online GP referral system.

There are additional specialist Menopause services provided in the National Maternity Hospital in Dublin, Cork University Maternity Hospital, Galway University Hospital, The Coombe Hospital and Nenagh Hospital, Tipperary.

What happens at your visit?

You will be checked in at reception and seen by a member of our team. We will talk through your concerns, symptoms and medical history. We will discuss with you your management options and any further investigations that may be necessary. We will check your blood pressure, height and weight.

Useful Resources

General information:

Cognitive Behavioural Therapy online:

Information about hysteroscopy:

Information about Intrauterine Devices (“Mirena coil”)

Contraception:

Premature Ovarian Insufficiency