Tennis star Chris Evert provoked controversy when she said the menopause had contributed to the breakdown of her marriage to Olympic skier Andy Mill.
Evert, who won 18 grand slam titles in the 1970s and 1980s, had three sons with Mill before she went on to marry golf star Greg Norman, who was a former friend of her husband.
However, her marriage to Norman only lasted 15 months.
"We had a rough couple of years, because I married Greg Norman, who was Andy's friend," the 61-year-old said of her relationship with Mill.
"I don't know, I was going through menopausal stuff that doesn't get talked about enough - what women go through, you know, at 50ish."
Evert also told the The Forward Podcast with Lance Armstrong she had remained friends with Mill, not least because of the fact they have three boys.
"Andy and I are still a family without living together. I think that's the best way to put it," she said.
However, there is no doubt the tumultuous events caused much heartache.
Speaking to US Elle in 2011, Evert said she broke Andy's heart and those of their three sons when the marriage ended.
"I broke a lot of hearts. I broke Andy's heart and I broke my kids' hearts and I brought that into my next marriage," she said.
So, can the menopause prove life-changing in all sorts of ways?
Mum-of-two Joanne Sweeney, who is divorced and lives in Belfast, went through the menopause in her mid-40s and opted not to have HRT. She says:
I think that I’m through the menopause now, as I was among a small number of women to start it in my mid-40s. And hopefully the worst is far behind me now — though given the infamous menopausal sweats and hot flushes, you can never really quite be sure.
Indeed, personally I found those complete meltdowns — not in temperament but in body temperature — the hardest physical part of the process that I had to contend with. Emotionally, too, the loss of fertility and the inability to bear another child did impact on me.
It wasn’t that I missed having a period — what woman does? — but the possibility of not being able to conceive a child and all the happiness that goes with it was hard to accept.
While the effects did not contribute to me having a major mid-life crisis like Chris Evert, who has blamed the menopause as the reason for why she left her husband for his best friend, I did harbour some wild thoughts of a surprise baby. Of course, looking back, I’m so glad that I wasn’t tempted to have an ill-advised late-life baby. Now, I’m happy to wait for some grandchildren that will hopefully come along in future years.
My menopause happened to coincide with one of the most difficult periods of change in my life, all of which made it hard for me to single out symptoms and say exactly if they were down to ‘the change’.
Life was incredibly tough and stressful during these years.
I lost my brother and mother to cancer within five years, so grief and stress were consistently present in my life. But the menopause took me by surprise.
Around 10 years ago I started to experience really horrible night sweats for a couple of years. They’d be so bad that I would need to get up out of bed and take a shower in the middle of the night to cool down.
When I also started to flush and ask others if it was too warm in a room and they said no, I realised that something else might be going on with me. I remember one woman rather cattily asking me if I was “going through the change” and I quickly replied that I was far too young for that.
But the thought stayed with me, so I decided to go to my GP to check where my fertility was. I had been on the contraceptive pill for years and wondered if I was still regular.
I came off the Pill and a simple blood test showed that I was in perimenopause — the stage before menopause when a woman’s periods fully stop. I was slightly younger than the average woman to be going through this, but not by that much.
While I had one very uncomfortable period about four months after that, that was the end of my cycle and I was no longer fertile from the age of 44 or 45. I was offered Hormone Replacement Therapy (medication to replace the lost hormones).
I declined and went cold turkey as having a family background with cancer, I wasn’t prepared to take any chance with my health (at that time there were some concerns of HRT having a possible causal link to some cancers).
I was also given a bone density test, which happily turned out to be okay, and after that I just got on with life.
The menopause wasn’t something I felt like rejoicing about, as some women do. Nor did I mention it to my friends for a long time. It wasn’t that I felt ashamed about being menopausal, but it just wasn’t something that I wanted to broadcast either.
I certainly felt under pressure at times. I was divorced, raising two teenage daughters and running my PR consultancy business during the recession. While my hormonal levels were wonky and on the wane, my daughters’ levels were also wonky but very much on the up.
So ours was a very hormonal home, one way or another. And there were a few screaming matches — mostly from me.
The main symptoms that I experienced were night sweats and flushing, and difficulty sleeping as a result.
I remember some fraught times such as when I would be cooking dinner and was convinced I was literally going to spontaneously combust.
And there was one truly embarrassing business meeting with a client where I had to tell him that I was flushing as perspiration was dripping down my cheeks and I very nearly passed out.
How do I feel now? Well, I don’t miss the incredible dips in mood that I used to have just before my period.
I still also have regular skin breakouts, just as I used to, but apart from this, it was the flushing that took its toll on me over the years.
Having come through the menopause, I’ve come to terms with it all and have accepted that it was just another important and inevitable stage of my life.
But I can’t help but wonder if those years could have been made easier with HRT?”
Mum-of-three Karen Ireland, from Co Down, had a hysterectomy at 32, and began hormone replacement therapy (HRT) to help with menopause symptoms. She says:
Just after my 30th birthday I was told I couldn’t have any more children and to prepare for a full hysterectomy. I was shocked but I had really bad endometriosis for years, a miscarriage, and more gynae operations than I could count.
So, I started to prepare for the inevitable. My then husband and I had discussed more children but, with all my problems, felt blessed with our two lovely boys, Jesse (16) and Korey (14).
Indeed, I was preparing for yet another routine pre-op investigation for the big op on the Monday when something struck me on the Sunday — I felt pregnant.
Now, as I had been on treatment for endometriosis — a 99.9% effective contraceptive — I knew there was no way this could be true. And yet that niggling suspicion stayed with me all day until later, the night before the operation, I decided to do a pregnancy test.
It was positive. Despite the evidence in front of my own eyes, I still didn’t believe it as I was convinced it couldn’t have happened. So, at 9am the following morning, I was waiting by my consultant’s office. He was surprised to see me as my theatre was scheduled for the afternoon. He was even more surprised with what I had to tell him.
That niggle is now my 12-year-old son, Teo — or ‘my miracle’ as I like to think of him. He wasn’t meant to be here but he made it against all the odds.
I had a difficult pregnancy and Teo ended up arriving early and was rushed to the Special Care Baby Unit (SCBU) with a pneumothorax (pocket of air between the lung and chest wall). Two weeks later we brought him home fit and well and ready to take on the world, as he has done ever since.
The ‘H word’ — hysterectomy — was mentioned pretty soon afterwards and I knew I needed to have it and to get a date booked.
I did plenty of research into the subject and even joined an online forum for early hysterectomy called ‘hyster sisters’.
I was petrified. And to make matters worse, my consultant had just retired and I needed to find a new pair of safe hands whom I trusted to do the operation.
I eventually found a consultant and the date was booked. Teo was only four-months-old at the time. I was worried about how I would cope with a young baby after surgery but I was mostly worried about the dreaded menopause and HRT.
I spoke to two women, one who had a full hysterectomy and went on HRT right away, and one who kept her ovaries and didn’t need HRT.
In the end I decided to leave it up to the surgeon and I told him just to fix what needed to be fixed. So he removed my womb and one ovary; the other ovary looked okay so he left it. This meant I didn’t need treatment immediately.
However, I was in agony for six months and kept getting cysts on the one remaining ovary so it was time for it to go.
I was 32 at this stage and now needed full HRT treatment. To be honest, if I had known how well that would leave me feeling, then I would have taken that option in the beginning.
For the truth is that I have never looked back. Because of my age my GP recommended hormone patches. Quickly, these became my new best friends.
I appreciate what Chris Evert says about how the menopause changes you, it is a huge shift for a woman. But I was very lucky — my hormone treatment really worked and I felt like a new woman.
All of the problems I had suffered for years were gone and the treatment prevented too many side-effects of the menopause. I think I slipped gently through it and out the other side in about six months.
I still felt hormonal for about two years after — every few weeks I had the effects of a period without actually experiencing one, but I could live with that.
I was just so delighted to get my life back again and be pain-free and not facing the prospect of more operations.
I also agree with the former tennis champ that the menopause remains a topic which is not readily discussed. Unless you go looking, there isn’t much information or support.
I was lucky as I have a good group of friends who rallied round me after the operation and took it in turns to look after me.
They were also there if I felt like a cry or a rant and a rave.
I’m off the patches now and delighted that, at 45, I don’t have the big M to cope with. I’ve been there, done that and got the t-shirt.”
The menopause is a natural part of ageing and usually occurs between ages of 45-55 as a woman’s oestrogen levels decrease.
In the UK the average age for a woman to reach the menopause is 51 but for one in 100 it can occur before the age of 40.
In many of these cases there is no clear cause but it can be due to factors such as surgery to remove the ovaries, some breast cancer treatments, chemotherapy or radiotherapy or an underlying condition such as Down’s Syndrome or Addison’s disease, a rare disorder of the adrenal glands.
Symptoms, which can be quite severe in some cases, include hot flushes, night sweats, vaginal dryness, difficulty sleeping, low mood or anxiety and reduced libido.
Treatments include Hormone Replacement Therapy (HRT), although concerns have been expressed about its long term use; cognitive behavioural therapy, eating a healthy and balanced diet and exercising regularly.