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Chapter 1: Who is Dr. Eleanor Galvin and what expertise does she bring?
The Pat Kenny Show. With Timber Living Log Cabins. Saturday and Sunday from 10am. On Newstalk. Conversation that counts. And it is time for Ask the Expert. And joining me for the slot this morning to answer your medical questions is Dr. Eleanor Galvin. You're very welcome to the program. Good morning, Ciara. You have no food for me, do you?
I have no food for you. I'm so sorry. I might steal some of yours.
You can, but you have all of your expertise. So looking forward to getting through all of our listeners' questions this morning. I'm actually just going to put this first question to you, if you don't mind, Eleanor. I had a stem cell transplant four years ago. The chemo put me into menopause at 41 years. but I had no symptoms at all at the time aside from period stopping.
Blood tests show I'm post-menopausal, but in the past two weeks I've experienced hot flushes and brain fog. Should I be on HRT now or is it too late?
No. So there's kind of a whole new thinking about HRT and it's a much more kind of individualised approach and kind of we talk about better ways of giving it in to people and using what's appropriate for you and your medical history. So generally, it's positive to start HRT up to the age of 60. And even a little bit beyond that, as long as you pick the patients well and they need it.
And while we're all post-menopause, well, I'm certainly post-menopause, none of us are ever post-menopause, we're just always in an oestrogen deficit for the rest of our life once our period stops. It doesn't just magically all get better. So like how long people take it, why they take it, that all changes, doesn't matter. If it's only now she's getting symptoms, why should she suffer?
She should go have a discussion, perhaps about her history to make sure there's nothing in it that would mean she can't take it. But I bet there probably isn't. She had a stem cell transplant. That is not for breast cancer. And even people who have non-estrogen dependent, there's a whole different approach to HRT now, which is person centred.
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Chapter 2: What should I know about starting HRT after menopause?
If you're suffering, don't be suffering. Go and see somebody and have a chat about what kind of HRT might suit you. And even if you couldn't take the normal ones, there are other ones. There's vaginal estrogen, what are her symptoms? And there are medication even for people to help menopausal symptoms. That can't take HRT. So there's lots of options there for people.
Most people haven't run out of time for trying it if they're suffering. No, I think the person must be about 45, 46 years of age. That's an early age to end up with no oestrogen in you.
Okay, get yourself to the doctor. There's help out there. Speaking of women's health issues, we're going to talk about polycystic ovary syndrome, which is not being called that anymore. It's now been renamed after a very long campaign to PMOS. What does that stand for, Eleanor? And why was the change in the name so important to, I suppose, the understanding of what this is?
Is it indeed the treatment for it? So it's changed to polyendocrine metabolic ovarian syndrome to reflect the fact it's a whole body disease and not just a disease that is dealt with by gynae spout infertility. So women are more than their reproductive capabilities. Newsflash. Yeah. So if you have a disease, it is affecting you in more ways than maybe it might be harder to get pregnant.
So we shouldn't be just looking for polycystic ovaries for people's reproductive capacity. Yes, of course, that's important. But there's a whole load more to PCOS, which is now PMOS, because it... People can have acne, hair loss, as well as too much hair, tiredness, chronic fatigue, mood changes, insulin differences. And so there's an awful lot more.
And it's really a symptom that should be treated with medication under the care of a team, not just a gynae who's trying to make your periods regular. So it should be under a team, an endocrinologist, as well as a gynae, as well as a GP, as well as regular follow-up, not just something that is kind of pushed under the carpet. One in eight women have it in some form or another, which is a lot.
So it's better to have a better understanding of something that is so complicated that can make people's, women's lives harder.
Yeah, so for a long time, all of those other wider issues associated with this condition and indeed the long term health implications of having all of those side effects were kind of ignored, weren't they?
Yeah, and it was kind of like test them once and you're done, whereas now you kind of test maybe girls come in late teens and their periods aren't regular and you say maybe they have a bit of PCOS and maybe they don't and then we check them again at 25 because it mightn't be that regular. But it's also the other pieces, the spots, are they always just trying to get ahead of their spots?
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Chapter 3: What is the significance of the name change from PCOS to PMOS?
Has it been doing anything? Has it been itchy? Has it been bleeding? All of those things are really important to think about. But if you get a new mole and it looks funny to you, or it even doesn't look funny the next time you're down your GP, shove it out, show it to me. I'd love to see it. And we can have a look at it.
Chapter 4: How can PMOS affect women's health beyond reproductive issues?
And if it is looking dodgy, you are better off to deal with it faster rather than waiting to see how big does it get.
Yeah, I think we tend to underestimate sometimes, don't we, the danger of those. A, B, C, D, E, asymmetry, border, colour, diameter, evolving. That's what they stand for. That's fabulous. They're like, oh, I've learned something new every day. Dr. Eleanor Galvin, thanks so much for coming into us on the Pat Kenny Show. The Pat Kenny Show on Newstalk. With Timber Living Log Cabins.