Women’s Healthcare
Raising awareness and support for pregnant victims of domestic violence
A survey of pregnant women subjected to domestic violence found that most said that fear, shame and concern about having their children taken away stopped them from asking maternity staff for help.
The survey was part of an independent evaluation of a pilot partnership between Women’s Aid, the national frontline support service for women subjected to domestic abuse and four national maternity hospitals. The pioneering project emerged from years of Women’s Aid work with maternity hospital staff and with survivors of domestic abuse.
Training and raising awareness for pregnant victims
The aim was to use a three-pronged approach to training: (1) awareness raising and outreach to increase practical support to pregnant victims of domestic abuse; (2) enhance understanding of coercive control among maternity staff; and (3) create disclosurefriendly environments in maternity hospitals and units across the country.
established in maternity hospitals as part of the project, provided ‘same-day’ support upon referral to 379 victims of domestic abuse.
Speaking of the need for such targeted support for pregnant women, Women’s Aid CEO, Sarah Benson, says: “Pregnant women who are subjected to domestic violence and abuse face a range of barriers to helpseeking and disclosure, during a vulnerable and high-risk period. Persistent abusive and controlling behaviours by their partners, including physical assault can be devastating for a woman in what should be a joyful time in her life. The harms of domestic abuse during the perinatal period in particular targeted assaults aimed at the abdomen, increase the risk of maternal and foetal morbidity and mortality. Essentially, both mother and baby are victims of domestic abuse during pregnancy.”
Specialist hospital-based campaigns
The pilot maternity project developed and delivered specialist training to nearly 350 maternity care staff in the participating hospitals: the Rotunda, the National Maternity Hospital, the Coombe Hospital and Cork University Maternity Hospital.
At the same time, regular specially designed hospital-based awareness campaigns increased visibility of the issue and built understanding of the harms of domestic abuse during pregnancy. The independent evaluators found that the model of training and increasing awareness of domestic abuse should be replicated and expanded across maternity settings and other areas of the health service.
Support services for pregnant victims
A dedicated one-to-one support service, which was
Suzanna Knight Head of Training and Development, Women’s Aid Ireland
Multidisciplinary approach improves the care pathway for cancer patients
As survival from breast cancer improves, a multidisciplinary approach is required to manage the many effects of cancer treatment.
In Ireland, over 3,000 patients are diagnosed with breast cancer annually. Advances in diagnosis and treatment have improved outcomes considerably, making breast cancer highly curable if diagnosed and treated at an early stage.
Breast cancer and survivorship needs
As outcomes from breast cancer have improved, the issues facing patients living through and after cancer treatment are increasingly evident, particularly other causes of mortality and damaging side effects of cancer treatment. This is an area that has been under-researched and under-resourced in the past. However, there is a growing appreciation of the importance of living well after cancer treatment; The HSE National Cancer Survivorship Needs Assessment (2019) identified understanding and managing the physical effects of cancer and its treatment as an unmet need for cancer survivors.
Increased cardiovascular risk in breast cancer patients
Female breast cancer survivors are reportedly more likely to die of cardiovascular disease than their age-matched counterparts. This relates not only to a higher prevalence of cardiovascular risk factors such as high cholesterol, overweight, high blood pressure and diabetes in the breast cancer population but is increased exponentially by potential toxic side effects of multimodal cancer treatment on the heart.
To date, the rates and patterns of cancerrelated heart disease have not been well defined in the Irish population. Identifying high-risk patients could enable personalised care pathways to reduce risk and manage treatment side effects more effectively.
Addressing risk through multidisciplinary study to improve care pathway
The UCARE (Understanding CARdiac Events in breast cancer) study, funded by the Irish Cancer Society and National Breast Cancer Research Institute, is pilot testing a multidisciplinary assessment and monitoring care pathway at University Hospital Galway for patients at risk of developing cardiac toxicity from cancer treatment.
Management of these patients requires a careful balance of adequate and appropriate cancer treatment while minimising cardiac risk, as there is evidence that early diagnosis and treatment can increase the potential for minimising or reversing cardiotoxic effects. The ultimate aim is to prevent heart disease in cancer patients by creating care pathways and improving communication about cardiac risks during treatment.
Reproductive technology gives options for women who want to delay parenthood
Freezing your eggs can preserve your fertility, according to a leading fertility consultant, explaining the step-by-step process for egg retrieval.
Egg freezing, or oocyte cryopreservation, is a reproductive technology that allows women to preserve their fertility by extracting and freezing eggs. This process offers women the option of delaying parenthood, often due to their career, personal circumstances or medical conditions such as endometriosis or cancer. It is also becoming a viable option for LGBTQIA+ individuals looking to start a family. Dr Zaib Awan, Fertility Consultant, explains: “Egg freezing empowers women by giving them control of their reproductive future.”
When is the best time to freeze your eggs?
“Age plays a big role in fertility. The best time to freeze your eggs is mid-20s to mid-30s when egg quality and quantity is at its peak,” Dr Awan says. “Lifestyle choices are extremely important. Prioritising a healthy lifestyle, good nutrition and supplementation can enhance fertility outcomes.”
The step-by-step process
1. Initial consultation: A detailed medical and fertility assessment, including blood tests and an ultrasound to evaluate ovarian reserve.
2. Ovarian stimulation: Hormone injections for 10–12 days to stimulate egg production, with monitoring via blood tests and ultrasounds.
3. Egg retrieval: A minor procedure under conscious sedation, which may cause mild discomfort, using ultrasound guidance to collect eggs from the ovaries.
4. Freezing and storage: Mature eggs are frozen and stored for future use. The legal storage limit is 10 years, extendable up to the age of 51.
“The patient will be fully informed throughout the whole process, with combined care from both the medical team and nursing staff,” assures Dr Awan.
Is egg freezing right for you?
“Egg freezing does not guarantee pregnancy, and success rates vary depending on age and number of eggs retrieved,” Dr Awan advises.
“Think of it as a backup plan, a proactive step that can provide peace of mind for women.” While costs vary by clinic, they typically range from €3,000 to €4,000, and financial aid options such as the drug payment scheme can help manage payments. “This empowering reproductive technology is allowing women to take control of their fertility,” she adds.
HSE fertility hubs offer assisted human reproduction services
Six regional fertility hubs have been established by the HSE. These hubs can now offer assisted human reproduction (AHR).
AGP can refer a couple to a regional fertility hub if they have been trying to conceive for a year (six months if a woman is aged over 35) or if there is a known health problem that affects fertility.
Access to assisted human reproduction
At the hub, patients can expect to receive a structured fertility review and examination. Clinical assessments are then made by the specialist public fertility teams, and the next appropriate steps are decided.
These steps may include medical or surgical treatments and management at hub level. Some couples will need onward referral to other specialities. For a certain cohort of patients, advanced fertility treatment such as in-vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) may be indicated.
Eligibility for publicly funded treatment
For public patients who are clinically indicated for AHR and meet the national access for publicly funded treatment, a referral is made by their respective public fertility hub. Patients are referred to a private provider of their choosing once they meet the relevant eligibility criteria. There are eight HSE-approved providers distributed across the country to ensure access nationally.
As part of the arrangements in place with private AHR clinics, once a referral has been made by a regional fertility hub team, an initial consultation should take place within six weeks.
Active treatment must start within six weeks of that consultation unless there are specific clinical reasons for this not to happen.
Professor Aoife Lowery Consultant Breast Surgeon and Director of Clinical Research Facility, University of Galway,
Cancer Society
WRITTEN BY Bethany Cooper
Fertility care referral increasing in Ireland HSE fertility hubs are now receiving on average between 500 to 550 referrals per month across all six hubs. From Sept 2023 to August 2024, 6,288 couples were referred to an HSE fertility hub. As of the end of 2024, just under 1,700 of these couples have been referred for AHR treatment since referrals for AHR began in 2023. The overall pregnancy success rate reported to date for couples referred is 38%, with these rates varying as expected across age groups.
Dr Cliona Murphy Clinical Director,
Sponsored by ReproMed
Thinking about freezing your eggs?
Dr Zaib Awan
Fertility Consultant in Galway
National Women and Infants Health Programme, HSE
Irish
Understanding your fertility options in 2025
In Ireland, as many as one in six people experience difficulties with fertility, making it a more common challenge than many might realise.
Fertility is a complex and deeply personal journey, influenced by physical health, emotional wellbeing and the unique circumstances of each individual or couple.
Personalised fertility care
At Merrion Fertility Clinic, we understand that the journey to parenthood is different for everyone. That’s why we are committed to providing compassionate, evidence-based care tailored to each person’s needs. Whether you are just beginning to explore fertility options or have been navigating this path for some time, we are here to support you every step of the way.
Scientific and medical advancements have improved fertility treatments over the years.
One of the most well-known fertility treatments is in vitro fertilisation (IVF). While the term is often used as an umbrella for various assisted reproductive technologies, IVF specifically refers to the process in which eggs and sperm are combined in a laboratory to allow fertilisation. The first baby conceived through IVF was born in 1978, marking a groundbreaking advancement in reproductive medicine. Since then, over 8 million children have been born worldwide following fertility treatments.
Fertility treatment options
Scientific and medical advancements have improved fertility treatments over the years. With our wealth of expertise, we additionally provide specialist services
Why women should discuss family history of cancer with their GP
Experts in the field of gynaecological oncology emphasise the importance of accurate family history, genetic testing and surgical advances in care to improve outcomes.
Subspecialising in Gynaecological Oncology
Experts in gynaecological oncology urge individuals to be proactive in discussing family history with their GP, as early identification of genetic risks can lead to improved outcomes.
Genetics influence gynaecological cancer risk
Dr Hazel O’Sullivan, Medical Oncologist at Cork University Hospital, explains: “Family history is one of the most important factors when assessing the risk of ovarian and endometrial cancer. While only about 5% of all cancers are inherited, the proportion is much higher for certain gynaecological cancers at approximately 10–15%.”
Dr O’Sullivan adds: “By identifying gene alterations, we can offer riskreducing surgery in some cases. For those already diagnosed, genetic profiling of the tumour can determine eligibility for targeted therapies, improving survival rates.
including fertility preservation, intracytoplasmic sperm injection (ICSI), pre-implantation genetic testing (PGT), donor gamete services and our male factor multidisciplinary infertility service. However, not all emerging fertility treatments are equally effective. At Merrion Fertility Clinic, we offer treatments supported by real-world evidence. We continually publish and present high-quality research in this area at an international level in collaboration with Ireland’s major academic institutions. As Ireland’s only not-for-profit fertility clinic, we are not driven by shareholder interests. This gives us the freedom to prioritise what is truly best for our patients, ensuring that every treatment we offer is backed by science and tailored to individual needs.
Comprehensive, supportive expertise Our commitment to patient care extends beyond fertility treatments. Through our link with the National Maternity Hospital, we can provide additional interventions, such as reproductive surgery when necessary. This connection allows us to offer a continuity of care, ensuring that patients receive comprehensive support throughout their fertility journey. Fertility challenges can feel isolating, but you are not alone. Support, guidance and medical expertise are available to help you navigate this path. At Merrion Fertility Clinic, we are dedicated to helping you make informed decisions and providing the highest standard of care on your journey to parenthood.
Advances in gynaecological cancer care
The landscape of gynaecological cancer is complex, each of the five distinct types comes with unique diagnostic challenges and treatment approaches. Ruaidhrí McVey, specialising in gynaecological oncology, highlights how the recent evolution of surgical techniques is facilitating treatment precision. “The ability to tailor surgery to the individual patient, balancing the need for radical treatment with preserving quality of life, is one of the biggest advances in recent years,” explains McVey.
“Minimally invasive procedures, such as robotic and laparoscopic surgery, allow for quicker recovery times, reduced complications and improved long-term outcomes for patients with uterine cancer. Many procedures can now be done on a daycase basis,” adds McVey.
Surgeons can now remove localised vulvar tumours while preserving healthy tissue, using special dyes
and near-infrared imaging to identify the sentinel lymph node. For more advanced ovarian cancers, extensive surgical interventions combined with contemporary heated intra-abdominal chemotherapy are also improving survival rates.
Symptom recognition and screening Awareness is critical, alongside recognition of symptoms such as abnormal bleeding, persistent bloating or swelling, abdominal pain, early satiety and altered bowel habits. “Vulvar pain, bleeding and ulcerations are not normal in postmenopausal women and should always be examined,” explains McVey.
“If you have abnormal bleeding or unexplained pelvic symptoms, you should be examined regardless of your smear history — which doesn’t check for ovarian or uterine cancer.”
McVey emphasises: “You are not alone, you will be listened to, and you will remain in control of your examination.”
Resource for gynaecological cancers
The online personalised platform thisisGO.ie is part funded by the Irish Cancer Society Women's Health Initiative and developed in University College Dublin teaching hospitals. thisisGO.ie is for women, families and healthcare professionals who have been impacted or work with gynaecological cancer, BRCA or Lynch syndrome. It has thousands of resources including articles, videos, clinical trials portal and podcasts.
Professor David Crosby Clinical Director, Merrion Fertility Clinic
Ruaidhrí McVey Gynaecologist
Dr Hazel O’Sullivan Medical Oncologist with a Special Interest in Cancer Genetics, Cork University Hospital
Sponsored by Merrion Fertility Clinic
Sponsored by GSK
WRITTEN BY Bethany Cooper
AIrish gym chain promotes health and longevity for women of all ages
Irish gym chain discusses the benefits of strength training and exercise for women of all ages, with measurable benefits to body composition, bone density, metabolic rate, hormone regulation and more.
ccording to research from the University of Exeter, resistance training can help alleviate some of the physical issues which arise during and after menopause. Sandra Dunne, Managing Director of Gym Plus, explains how she hopes to foster an environment in which women of all ages can feel comfortable and safe to exercise. “We want our gyms to be accessible and welcoming in order to reach that wider demographic,” she says. “I think it is important to ask, what sort of 70-year-old do you want to be?”
An inclusive gym community Gym Plus is dedicated to
empowering women without judgment, creating a community where women can engage in tailored fitness programmes, strength training or instructor-led classes with confidence. They can also access the swimming pool and spa area for low-impact exercise and stress relief, ensuring the long-term success of their personal fitness journey.
“Tracking your progress keeps you motivated, ensures results and helps you adjust your training effectively,” explains Dunne. “At Gym Plus, every member gets a tailored training programme alongside access to medical-grade InBody scales to track body composition, muscle mass, bone density and more.”
The growing impact of social media on women’s health today
Social media enhances communication and connection but may pose potential risks to women’s health. Thankfully, strategies exist to promote safer usage and a healthier social media environment.
Social media use has become an integral part of everyday life. Not only is it a key form of entertainment, for many it has become their first source of information for news updates, to seek advice and inspiration.
Body confidence and self-image
Constant exposure to curated images of beauty and success can negatively affect self-esteem. Women are often subjected to unrealistic standards, as many images and posts can be photoshopped, edited or enhanced, setting unattainable expectations. This can foster feelings of inadequacy, especially among young women and contribute to body confidence and self-image issues. For this reason, it’s important for women of all ages to avoid comparing themselves to images that they see on social media. Instead, focus on your own health goals, which can include incorporating a healthy, balanced diet and exercise into your daily regime.
Being aware of misinformation
According to the most recent CSO Household Consumer Behaviour Report, over two-thirds (68%) of internet users
Group workouts can provide motivation, accountability and a sense of community, making it easier to stay consistent. She adds: “We are interested in people staying with us long term. We want to foster an environment which supports women’s long-term health goals.”
Training and advice focused on women Dunne explains that the focus should be on health span, not just life span, enabling women to achieve a longer period of vitality and wellbeing through consistent and intentional exercise. They are supported by a team of highly skilled in-house fitness professionals whose focus is on guidance, personalised support and approachability.
“We spend a lot of time and money to train our staff, who are all registered fitness professionals, to support our members effectively,” she says. “There is a lot of interest within our teams in supporting the communities we serve, and we regularly send our staff on specialised training courses, including menopause coaching.”
Dunne advises: “It is important to build habits early, mark it clearly in your calendar when you will visit the gym, and don’t set expectations that are too high. Take the support on offer, and don’t be afraid to ask for help. Our gyms are always staffed, and everybody is happy to support you.”
are now going online seeking health-related information. While search engines can be a major source, social media misinformation and unqualified influencers can also have a negative impact on women’s health by promoting unverified or harmful health advice.
For instance, celebrities and influencers — often with large followings — may advertise weight loss products, unregulated supplements or fad diets or provide health advice without scientific backing.
Safe social media usage
To encourage healthier digital habits and foster a more supportive online environment for women, it is important to set boundaries around social media use. This may involve limiting our time spent on these platforms and unfollowing accounts that promote unrealistic beauty standards.
We can also become more conscious of the curated nature of social media and avoid self-comparison. Most importantly, when it comes to health-related issues and for your safety, it is essential to only seek advice from qualified health professionals.
Sandra Dunne Managing Director, Gym Plus
Laurann O’Reilly Public Health and Corporate Nutritionist, Nutrition By Laurann
WRITTEN BY
Bethany Cooper