Having just launched in Dublin, Dr Mary Ryan’s new book, It’s Probably Your Periods, is out now, and will have its Cork launch this Wednesday.
RTÉ Today show presenter, Maura Derrane, will launch the book at what promises to be a very exciting and interesting event.
“Everyone is welcome to attend,” says Mary, a renowned consultant endocrinologist who is also a talented musician and glam fashionista. “Maura is absolutely terrific and a great friend of mine. I want everyone to come along as it’s all about education. I’m going to talk about periods, but at these events, people always ask me about menopause, perimenopause and thyroid issues. I’ll answer those questions as well, and whatever else people want to ask regarding hormone health.”
Mary’s first book, It’s Probably Your Hormones, was a bestseller, and she was delighted with the reaction to it.
“It dealt with everything, but focused on menopause and perimenopause as well as on hormones,” she says. “I felt it went very well, and I wanted to bring it back to the very beginning – with the period – with this new book.”
“This is because I deal with so many patients who don’t know what a normal period is. And if they don’t know what a normal one is, then they don’t know what an abnormal period is. As an endocrinologist, I would see patients coming in with fertility issues, and when I go back to the beginning, I often find their period has been off since they were 12 and 13 and it’s an issue that should have been sorted a long time ago.”
“A normal period is 3-5 days maximum, and not 7-10 days, which an awful lot of women think is okay. But if you’re going around with a period like that from the age of 12 right up to, say, 54. and you’re losing an awful lot of iron, then you’re absolutely exhausted for your prime years. That’s not good for your physical or mental health.”
“If you’ve got a period that’s extra long, not only is it taking so much from you, it also means an imbalance of hormones. It means the two main hormones controlling the period are completely out of their circadian rhythm, and once hormones are out of balance, you get inflammation, and once you’ve inflammation, you’ve disease.”
“And the problem is we’re only getting in at the end, when people are trying to get pregnant, and they’ve had 20 years of suffering by that time.”
Mary is convinced that having prolonged menstrual bleeding is the precursor to debilitating gynaecological conditions like endometriosis and adenomyosis. She also feels that part of the issue is that the whole area of women’s health has been neglected for far too long, which is why perimenopause and menopause have only been spoken about publicly in the last decade.
“I really want to educate everyone about periods – women, GPs, parents, men, partners, sports coaches – everyone,” she says. “The other thing women need to be educated about is what to expect, so that they’re not going to be put off by someone saying that when they have their first baby, everything will be okay.”
This dismissal of the problems that women have been suffering is what Mary describes as “dreadfully degrading”. It enrages her to think that as recently as the 1970s, women had to be “churched” after giving birth. This was where mothers – and they had to be married women only – were given a church blessing a few weeks after giving birth.
While it was posited as a blessing, many people at that time considered that childbirth made a woman “unholy” or “unclean” because it resulted from sexual activity. This blessing allowed the woman to re-enter the church in a ‘state of grace’.
“You had to be blessed by a priest at the door of the church before and let everyone else pass you out as if you were a complete demon,” Mary fumes. “And it was done at the end of the mass, so you’d have to wait outside like a leper. It was horrendous. It’s about time that people called out that we women were treated horrendously for too long.”
For Mary, bringing this book out is about educating patients as well as doctors, nurses and carers. Aside from furthering knowledge, her hope is that it will bring about further research in the area.
“This is what happened with the previous book when we spoke about perimenopause and menopause, and now you have a whole lot of research going on that should have been done generations ago,” she says.
Mary believes that conditions like polycystic ovaries should be caught much earlier, and says that a lot of women only present with this condition when they’re trying to get pregnant. And it may have caused them problems for years.
“You’ve got cysts on the ovaries that produce too much bad insulin, so people have difficulty losing weight, even though they’re eating really healthily. That’s so frustrating for them, and on top of having to deal with that, they’ve got excess estrogen from the cysts that’s converting into androgens, which is causing excess hair and excess acne.”
If these issues were addressed at the very beginning, it would prevent affected women – and young girls – from suffering for years, Mary believes. She also points out that there are extra risks associated with obesity, including the risk of diabetes and atrial fibrillation, so it’s important that women are listened to rather than being sent off and told to put up with it.
“This is what mothers and grandmothers used to say, because that’s what they were told themselves, but the narrative is actually very different,” says Mary. “A period shouldn’t be excessively heavy, and you shouldn’t be going around anaemic and in pain.”
“You should only have mild cramps, and if you are having major cramps, pain and vomiting, which a lot of these women have, that means excess prostaglandin release. And the prostaglandins are these hormone-like substances that cause major inflammation, so if you’re having disease, we need to get in there with natural cyclical progesterone to reset the circadian rhythm in time. But unfortunately, we’re not getting these patients on time, and that’s the problem.”
Mary educates her patients that they should follow a good Mediterranean diet and cut back on sugar, because hormone health depends on it. Her patients tell her that excess sugar affects their skin, for example, and she says that it is very important to get the hormones under control and circadian rhythms working normally.
“We have to eat healthily, we have to recharge, we have to exercise, and we have to get that balance,” she points out. “But in addition, we have to get in there on time and help these women and these young girls. Addressing that was the real reason I wrote the book, and we need change because the suffering is dreadful. Everyone needs to know about it, otherwise we’re not going to enact change and we’re not going to normalise talking about it, and we’re not going to bring about further research, which is so definitely needed.”
Mary has heard horrifying stories of what women have put up with, and it also worries her that having difficult periods can impact how women fare while playing sports. She feels that normalising discussing periods and developing a greater awareness of their impact on women can only be a good thing.
“Coaches need to understand the cycle as well, because they could be pushing a girl very hard when she’s ovulating, or she might be in a period,” she points out. “We need to bring it out into the open and understand that periods are a very normal, wonderful thing that happens. It means that when a woman’s body is working right, she can have a baby down the road when the time comes. Equally, it needs to happen so that we can cause evolution to go on.”
Mary feels that as women, we also have a duty to call out injustice and poor treatment around women’s health, and says that if we equalise the playing field, we’re going to help girls of the future.
“We have to stop being so nice and so meek and afraid to say it,” she says. “We’re not here to be afraid to speak out, because if we don’t, we’re not doing anything for the women who were not listened to and suffered dreadfully in the past as a result.”
Maura Derrane will launch Dr Mary Ryan’s book, It’s Probably Your Periods, at Eason, Patrick Street, Cork, on Wednesday April 15th at 6pm. All welcome to attend.
