"I didn't sleep for years," is how one cancer survivor described going through the menopause, while excluded from Hormone Replacement Therapy (HRT).
Other survivors around the country echo similar horror stories of losing their hair, constantly having to change their clothes due to hot flushes and even being afraid to leave the house.
These women cannot take HRT because of their history of cancer and feel "left behind" by this year’s free roll-out.
Now they are calling for a "game-changing" drug to be included under the drug payment scheme and medical card.
This non-hormonal medication is called Veoza and treats the vasomotor symptoms of menopause (hot flushes, night sweats).
It has been available in Irish pharmacies since last year, but at a cost of around €80 a month for the women who say they desperately need it.
Annie May Brennan from An Rinn in Co Waterford is one of these women.
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She had breast cancer three years ago which meant she had to stop taking HRT.
It had been keeping her "absolutely dreadful" menopause symptoms at bay and coming off it was "yet another fight", she said.
"I started suffering very badly, I lost my hair and everything. I’ll never forget the way I was sweating; it was unnatural."
Ms Brennan started Veoza in February - something she says has saved her life.
Her pharmacy bill has risen to over €150, but she said this cost is nothing compared to dealing with the menopause.
Women 'backed into corner', says consultant
The Clinical Lead of the Complex Menopause Clinic in the National Maternity Hospital in Dublin said around 60 of her patients are using Veoza.
Dr Deirdre Lundy said 80% of the women she treats have had breast cancer.
She said Veoza is "great" for treating hot flushes, but added that its cost has to be a "huge part of the conversation".
Dr Lundy said women are "backed into a corner" because of this high cost.
She added that Veoza was not tested on women who have or had breast cancer.
However, Dr Lundy said it is up to each woman to choose what is best for them.
"There should be individualisation of care," she said.
Dr Deirdre Lundy said they want to give patients "as much choice as possible".
"When it comes to Veoza, one of the things that limits choice is money," she said.
"For the people who have used it and found it enormously beneficial, many of them would have said 'I'll find other things I can live without.'
"Some of them have come off it because they literally can't afford it. That's a hard decision for them to make."
Drug 'especially valuable' for cancer survivors
Pharmacist Mafalda Mendes from Allcare Pharmacy in Donnybrook said Veoza can be "especially valuable" for women like Ms Brennan.
Ms Mendes said that women who have gone through breast cancer and were estrogen positive cannot avail of HRT, as it contains the hormone.
"The sweat would be dripping down my back, my head."
She said Veoza "should be covered" under the drugs payment scheme.
"For some special patients, who cannot take normal HRT - this drug makes sense."
Sharon Johnston also had to be taken off HRT after being diagnosed with the BRCA gene in 2023, which increases her risk of ovarian, cervical and breast cancer.
The removal of her ovaries and fallopian tubes and a double mastectomy followed.
The last few difficult years have been made worse by "absolutely horrendous" menopause symptoms, she said.
"I wasn't sleeping," she said. "It was absolutely horrendous."
The Dublin woman said she would suggest going for a meal with her husband, before having to cancel due to hot flushes.
"The sweat would be dripping down my back, my head," she said.
"I would wake up during the night, and I'd have to change my pyjamas. I'd have to shower.
"My bed clothes would be soaking."
"My life was very, very hard," she admitted.
Ms Johnston said it was getting to the stage where she could not leave the house.
She said since starting Veoza, she has been able to cope with the other health obstacles facing her.
"No one should have to go through this," she said.
"No human being should be going through the issues that women have to go through in relation to the menopause."
Free HRT should have been first step in larger rollout, says expert
The founder of Menopause Hub clinics around Ireland said that Veoza is part of a "toolkit for menopause" that can help women.
Loretta Dignam said the introduction of free HRT should have been the first step in a larger rollout.
"Anybody who’s looking for menopause treatment, should be able to avail of that," she said.
"A woman who can't take Hormone Replacement Therapy should not be discriminated against."
TDs from different parties have been raising this issue with the Minister for Health, including Fianna Fáil TD Aindrias Moynihan.
He has been contacted by women around the country who are feeling the pinch to their pocket - "a group of people who were knowingly being left behind with free HRT".
"You're dealing with the people who have already fought and struggled with cancer and here they have another fight before them," said the Cork North West TD.
"The night sweats were the worst of it where you literally can't sleep."
His Parliamentary Assistant, Colette Madden, was diagnosed with "high-risk estrogen-fed" breast cancer in 2016.
She went into "full-blown" menopause during her second round of chemotherapy at the age of 45.
"The night sweats were the worst of it where you literally can’t sleep," she said.
"I didn’t sleep for years," she said.
Ms Madden said she has "slept every night" since starting her new treatment.
'A kick in the teeth'
However, she described its price-tag as a "kick in the teeth".
"It’s one less holiday in the year," she said. "Or not upgrading your car when it really needs to be.
She worries about the number of women who have been left completely in the dark, faced with the same battle she had.
"There are people with medical cards who don’t have the additional €80," said Ms Madden.
When asked about Veoza, the Department of Health said the HSE has legal responsibility for the pricing and reimbursement of medicines.
"Once reimbursed, a medicine may be included in the national drug schemes, such as the drug payment scheme or the medical card," it said.
This assesses the clinical effectiveness and cost effectiveness of Veoza.
This application is "currently under review" with the HSE saying it "strives to assess pricing and reimbursement applications as efficiently as possible".
The HSE said decisions on which medicines are reimbursed by the taxpayer are made on "objective, scientific and economic grounds" in order to deliver "the best value in relation to each medicine and ultimately medicines to Irish citizens".
Final decision won't be until 2026
The National Clinical Lead for the National Centre for Pharmacoeconomics (NCPE) said the final decision could take until early 2026, as it is a long process.
"It won't be any earlier than that," said Professor Michael Barry.
He said for Veoza to be reimbursed and available under the drug schemes, the manufacturer (Astellas) must submit a pricing and reimbursement application to the HSE, which it has done.
The NCPE reviewed a rapid review submission from the company and recommended a more detailed review.
Professor Barry said while it had requested a full Health Technology Assessment from the company on 8 April, 2024, it only received this from the company on 20 August, 2025.
"The big delay here that I'm seeing here is this delay in the company getting the information to us," he said.
The drug will be considered by the HSE Drugs Group who will then make a recommendation to the HSE Senior Leadership Team.
It will then decide whether the drug will be reimbursed or not.
Astellas said in a statement that it is a committed to achieving public reimbursement of Veoza in Ireland "as quickly as possible" to "enable more women to benefit from this treatment option".
It said the NCPE’s latest request was "complex and took significant time and resource to provide".
