The sudden death of her husband Eamon Prendiville in 2013 is something Dr Mary Ryan will never forget. Looking back, the Limerick endocrinologist and consultant physician wonders how she ever got through those early days but she admits her three children – Seán, Michael and Úna – and her patients, kept her going.

Blessed with good support, great energy and a positive outlook, the next few years saw Mary research health inequality while working full-time and campaigning strongly to put menopause on the national agenda.

This month, she invites RSVP into her beautiful home in Nenagh, Co. Tipperary where she tells us about her new book It’s Probably Your Hormones and she explains how issues from weight gain to insomnia, fertility, low sex drive and acne are all hormone related. She also reveals why good hormone health is important throughout our lives, not just in midlife.

Congratulations on the book, Mary. It’s a great read that should be in every home for all the family to enjoy.

Thank you, I am thrilled with it. I have been working on women’s health for over 25 years and their stories have never been told. Women, because of their reproduction cycle, are hormone driven from puberty to menopause. So, hormone health affects women more than men and I believe that’s why it was neglected. The research into periods is dreadful, so that needs to change. I see women with seven-day periods – that is not normal, they should last no more than three or four days. Longer periods will cause a total wearing down of the body and hormones. Periods have been around since Adam and Eve yet there has been very little research and that’s not good enough.

Read more: Health expert Dr Mary Ryan explains why women face burnout more than men

Endometriosis is a horrifically painful condition, which has terrible consequences for fertility, pain and constipation and there’s little research in prevention. There’s loads of treatments like laser or surgical operations or putting someone temporarily into menopause, but there is very little known about prevention. It hasn’t been researched enough because it affects women, but now women, who make up 50% of the population, are rightly stepping up and demanding equality in healthcare and everywhere else.

When you first started talking about menopause eight years ago it was still a taboo subject but today that is no longer the case. That must make you proud?

Yes, that is wonderful, but there is still a long road ahead with menopause and a lot more research to be done. I started on this journey when I saw the link between hormonal health and a lack of self-esteem and I wanted to spread the word about how you really can enhance your life by understanding hormonal health. By putting themselves at the back of the queue in the family, women end up burning themselves out, throwing their hormones off-balance and making themselves sick. What they need to know is that this is not only affecting them but their families and particularly their daughters, who will learn that it is normal behaviour for a woman to work herself to the bone and burn herself out.

Dr Mary Ryan opens up about losing her husband and the realities of grief
Dr Mary Ryan opens up about losing her husband and the realities of grief

What do we do to change it?

We take control of our health and our bodies, we have a responsibility to educate ourselves about a healthy lifestyle. Often as doctors we are seen only as prescribers and we need to be communicators – we can prescribe a lifestyle change too. That should be a bigger part of healthcare, we have to be able to communicate with our patients about what is wrong, why it is wrong and how to fix it. If you don’t do that, they wouldn’t comply. Compliance will follow if we empower our patients with knowledge.

What are the basics of hormones that we should know about?

Hormones are chemical messengers that control our organs, our immune system and muscle. They determine our sex and control our periods, reproduction, menopause, ageing, weight, sleep mood and absolutely everything. We take them for granted and don’t realise what a powerhouse they are and how we can simply improve them for a better quality of life. The pituitary is the master control gland, which is basically like a charger that you use on your computer or phone, and just like these devices it needs charging too. Just like your phone, if your pituitary gland isn’t charged they won’t work – it’s that simple. If your pituitary gland is out of balance, you’re going to get muscle pain, IBS and broken sleep and low mood.

How can you recognise when your hormones are out of balance?

You could be feeling very tired, emotional, angry, have low libido, brain fog, craving sugar, poor sleep and struggling with long and painful periods. Your brain can’t function without sleep and melatonin – the hormone that your brain produces to help regulate it is at its highest at 10 o’clock, so we should be going to bed around that time to maximise it. Melatonin interacts with biologically female hormones and research has shown that it helps to regulate the menstrual cycles. It’s also believed to have anti-ageing benefits. So it’s important to keep your melatonin production high and you do this by reducing screen time, reducing caffeine, getting natural daylight every day and having a good diet. There are medications such as muscle relaxants which will calm the entire body and help sleep. I try to avoid sleeping tablets. There are some cases where they are necessary for the short-term but only as a last resort. Melatonin is a natural sleep hormone that a lot of people take and it works for them.

You speak in the book about the link between weight loss and hormones, can you tell us more?

Your weight is also impacted by ghrelin and leptin, these are the hormones that control your appetite. Leptin decreases your appetite, while ghrelin increases it. Some people have leptin resistance, and as a result, they put on a lot of weight. If these hormones are not working as well as they should, or if you’re overtired, it will cause you to overeat.

How can you improve your hormone health?

By eating a well-balanced diet and keeping well hydrated. There are lots of supplements like Menomin with vitamin D, omegas, biotin, and Revive Active has a similar supplement. Magnesium citrate is good to take at night because it helps with muscle relaxation. Magnesium has a laxative effect and when there is a hormone imbalance the bowels can get affected. The gut and brain communicate to regulate hormones through the brain-gut axis, so gut health is vital and magnesium can help with that. Simple things like juicing two kiwis and celery can be a great natural laxative. Hydration is vital for the bowel to function properly and a good probiotic is vital particularly around menopause when your gut is really relevant because it controls the serotonin access. You will get the antioxidants and minerals in green vegetables and the Mediterranean diet is rich in anti-inflammatory fruits, vegetables, nuts and omega-3 fatty acids, which are all great for hormone health.

As well as diet you speak about mindset in your book and mention that guilt is a women’s issue?

Women suffer from guilt more than men, we have inherited that through the generations. Many women tell me they feel guilty if they are away from their kids, I never hear a man saying that. We are nurturers because we carry the baby in the womb and that bond is there. My mother worked and I worked – it’s about the quality and not the quantity of time you spend with your children. I have seen that in my own children and they have turned out great. It is very important for a child to see a parent, and especially a mother, empowered. And it is important that families rear boys and girls equally and empower both. Even in contraception you’ll find inequality. We are way behind in this country in relation to vasectomy. When women come to me looking for contraceptives after their family is finished, I suggest that the partner has a vasectomy. But the answer is nearly always “Oh, he wouldn’t even entertain it.” Women have put enough hormones into their bodies so it’s now time for the man to take responsibility.

You address the importance of sex and pleasure in your book as well.

Sex has multiple benefits, from intimacy to reducing stress and increasing happy hormones, self-confidence and even as a form of exercise. If your hormones are off-balance and you feel tired and burnt out, you won’t have the energy for sex and I see this a lot around menopause. Also, at this time, the effects of low oestrogen can result in vaginal dryness and pain during intercourse. Vaginal pessaries and KY gel work really well for dryness and painful sex. Sex doesn’t always have to include penetration so it’s important to be able to communicate with your partner.

You have been working tirelessly to put women’s health on the agenda for the past eight years yet your husband died only 10 years ago leaving you with three young children – that must have been traumatic?

My twin boys were eight and my little girl Úna was five when my husband Eamon died suddenly. That was a big shock and looking back I wonder how I got through it. My children kept me going. I have great parents, siblings and patients as well. Shock protects you and you just continue on autopilot because you don’t have time to process. We had only moved in here and decorated our beautiful home which had been a busy and stressful undertaking because it was a listed building so it was a tough time. Poor Eamon died suddenly and all of our dreams and visions vanished. It was difficult working full-time as a doctor while trying to be both parents for three children. I wanted to make sure that they got everything they needed while looking after my patients too. I am a great believer in the holistic approach and I have a positive outlook which is what kept me going.

It must have been heart-breaking having to tell the children their father had died.

Yes, it was. I went for counselling afterwards and the councillor gave me the wonderful advice that children look forward – adults look back. That took a lot of pressure off me. As a mother you always worry about your children and while I couldn’t change the fact that they lost their father, that advice made it easier for me. Once I knew they were doing OK, I was going to be OK. We always talk about Eamon, the children are well aware of their dad’s involvement in their lives.

Who are the children like, do you see Eamon in any of them?

Seán, who is a kind and sincere young man, has his colouring. He is big into his sport and is studying Business in college. Michael is gentle and very creative and looks like both of us. He is in college doing Law. Úna is a wonderful confident young woman, who looks like me although she has her father’s colouring with dark hair and sallow skin. She is still in school and has her heart set on studying Medicine. Even though I love my career, my children are the best part of my life and always have been. Eamon would be very proud of them because they are good, respectful kids, who are enjoying life and are happy. They are very close and that is one thing I want for my children.

You must have been exhausted rearing three children and working long days.

I am blessed with great energy and I come from a lifestyle of healthy eating – my mother is a teacher and my father’s a farmer. I would always be in bed early and I know when to crash to allow my body to rest. A lot of women don’t do that because they feel they should keep going. They also feel they need to be taking their children out at the weekends and that can be exhausting if you are working all week. Children just want to be around you – you don’t have to be doing activities all the time, they’ll be perfectly happy if you just crash on the couch on a Sunday afternoon while watching a film with the family.

Photography by Pawel Nowak, Hair by Trish Toomey for Hair Art 086-2045620, Make-up by Aideen Cleary, @AideenClearyMakeup
Photography by Pawel Nowak, Hair by Trish Toomey for Hair Art 086-2045620, Make-up by Aideen Cleary, @AideenClearyMakeup

What’s next on the agenda for Mary Ryan, professionally and personally?

Personally, I would love to meet someone because my children are now getting to the stage of independence. My boys have gone off to college in Dublin and my daughter will be going in three years. I think it could be lonely in the long-term on my own. I would love someone to go on holiday with or to go out to dinner. Professionally, I will continue keeping women’s health at the top of the agenda. There hasn’t been enough education done by us doctors. Men need to understand women’s health too just like women need to know about men’s health for more harmonious living for all.

Photography by Pawel Nowak

Hair by Trish Toomey for
Hair Art, 086-2045620

Make-up by Aideen Cleary,
@AideenClearyMakeup

It’s Probably Your Hormones by Dr Mary Ryan is on sale now.

. Get the latest RSVP headlines straight to your inbox for free by signing up to our newsletter

READ MORE