After four fabulous, fun and fruitful years I am stepping down from WOMGENE SIG and before bowing out was asked if I wanted to contribute to the recent menopause-themed newsletter. I wouldn’t say it was my specialist subject but I have as they say ‘gone through it ‘ so agreed to share some of my reflections. Or rather I had at the time of asking but media coverage appears to have reached total saturation point and I’ve struggled to come up with anything that hasn’t already been said by Lorraine (who she?) Davina or Mariella.
Once seen as a taboo issue, menopause is currently the hot topic . We now have a Menopause Taskforce and the ultimate government symbol of earnestness ,a Tsar. The Menopause Support and Services Bill which seeks to make NHS prescription Hormone Replacement Therapy (HRT) free of charge recently enjoyed a second successful reading and the Tsar is tasked to sort out the recent shortages which have left many women literally high and dry , sourcing from the black market or asking friends to buy the medicines abroad.
There is no doubt that the contributions made by celebrities like Frostrup and McCall have been important , the more voices raised the better, but there are good reasons why they should not be the definitive influencers on a topic long championed by grass roots campaigners.
Frostrups’s documentary for example, The Truth About The Menopause was billed as a frank , personal and intimate attempt to bring this great taboo out into the open. Trouble was her experience was unrepresentative, entirely divorced from women who didn’t have access to their own dedicated Harley Street gynaecologist and failed to address the challenges many women face seeking and accessing advice and support from NHS services. . More recently she demonstrated another blind spot when gynaecolgist Dr Jennifer Gunter author of The Vagina Bible and Menopause Manifesto. (@DrJenGunter) challenged her and others including Davina McCall, for appropriating the name of her book as the name of their website and lobbying group. Frostrup employed the classic DARVO manoeuvre (deny, attack, reverse victim offender) , doubled down, and is now claiming that the ensuing media attention resulted in Gunter’s book ‘flying’ up the charts, expressing bafflement as to what all the fuss was about and suggesting that all publicity is good publicity.
And then the inevitable backlash from a female journalist and novelist with a national newspaper column , India Knight, who decided to frame the focus on this issue as “mania” largely based on the fact that she herself had only experienced mild symptoms. Some sisters really do just do it for themselves. Honestly, feminism can be an absolute hoot sometimes.
if you want to really understand the diversity of experiences better to follow journalist @monaeltahawy ‘s advice and ensure that those talking are not just privileged white, cis gender women . Pledging to support the ‘Bloody Hell’ anthology which promises menopause stories from across the political and personal spectrum would be one way of doing this.
Anyway, rather than add to the menopause word mountain and in the spirit of sisterhood I want to share some things I’ve learned about what Alexandra Pope, Psychotherapist and menstrual health educator and co- founder of www.redschool.net describes as “ the amazing life changing powers of our cyclical nature as women”.
Rather than starting with the finale , I want to look over my shoulder and contemplate the beginning.
I’m talking periods.
The Greek ‘Menos’ meaning month and ‘pausis’ meaning to cease refers to the time when the monthly period stops or if you prefer , “A pause while you consider men” .😂( Margaret Atwood) There’s a long list of slang word and euphemisms used to describe menstruation, On The Rag, Carrie, Shark Week The Crimson Tide, The Curse none of which portray deep joy so when they end there is an oft expressed sense or expectation of liberation. If you have suffered with any one of a number of conditions that make periods difficult to manage like dysmenorrhoea, menorrhagia, endometriosis, Premenstrual Dysphoric Disorder (PMDD) , the ending of periods may well be experienced as a relief . For those undergoing forced menopause as a result of cancer or surgical treatment disruption to the menstrual cycle can be temporary with some treatments but permanent with others which can have devastating psychological consequences. Furthermore, as menopause tends to be framed around the experiences of cisgender women, the experience of the transgender and non binary community can be overlooked.
It’s complicated and deeply personal.
My experience falls somewhere in the middle. Aged 47 and without warning or fanfare my regular and entirely manageable periods just stopped. No gradual easing, no dramatic final flood. Just ‘laters’ , without even so much as a backward glance . I am 63 now so have adjusted to my bodies altered notes and rhythms but the absence of periods profoundly altered the ways in which I accessed and channelled my creativity and managed my emotions. These changes occurred at a time of acute family stress and transition compromising my coping abilities in sometimes startling ways and it is only more recently that I have been able to make sense of it all.
Pope’s work which aims to increase awareness of the menstrual cycle and to facilitate a conscious menopause has been hugely helpful in this process.. With millions of women saying they have missed a health appointment because they are too busy to take time off work or have avoided seeking help for their female health concerns because they were simply too embarrassed to broach the subject with their boss , sleepwalking , unconscious and unprepared into menopause is a real risk and one dear readers I ‘m afraid I took.
If I could turn the clock back these are the key things I would have done differently.
- 1. I would have appreciated the beauty, dignity, power and deeper meaning of my cyclical nature.
- 2. I would not have perceived my increased sensitivity at certain points in my cycle as something to be ashamed of and apologised for.
- 3. I would have trusted my instincts and intuition more.
- 4. I would have welcomed emotional disturbance as conveying important messages about what I needed and what I need to act on. It is no coincidence that any arguments about the imbalance in domestic or emotional labour in my house arose at certain points in my cycle.
- 5. I would have rested more
- 6. I would have said ‘no’ more.
- 7. I would risked judgement from others and asked myself more regularly, What is it you most want and need at this time?
- 8. I would have timetabled in more opportunities for solitude.
- 9. I wouldn’t have kept my anger on such a tight leash.
- 10. I would have cut my inner critic off at the knees.
Pope describes cycle awareness as a woman’s number one self-care and stress management system and It is only now, reflecting on that list that I can fully appreciate this. Back then, there didn’t feel like a long enough pause to evaluate. Instead, I found myself swept up and ambushed by wave after wave of unfamiliar symptoms most of which could be categorised under WET, DRY and HAIR. Hot sweats, cold sweats, night sweats , nose hair , chin hair, breast hair, big toe hair, thinning scalp hair, dry skin, itchy skin, flaky skin, sensitive skin, age spots, dry vagina, wet eyes, wet nose , increased peeing, restless legs, insomnia, joint pain . situation specific anxiety where there had been none before and a roll of defiant tummy fat capable of keeping a small toddler afloat.
I have since learned that women in India, China and Japan experience far fewer menopause symptoms than western women who commonly report hot flushes, night sweats, depression and insomnia. Scientists at Kings College argue that this could be due to women lumping together their experiences of growing older with the menopause. Definitely guilty of that, they do rather bleed into one another (sorry) .
On a good day I can vibe Pope’s contention that I have been through a huge journey of initiation and have finally graduated. Hurrah for me.
“The woman who has crossed the menopause having understood the power of her menstruating years is truly a woman to be reckoned with. She has been offered, through the dynamics of her own body, a way to travel in both inner and outer worlds. She has stoked a fire inside which is now brilliant , fierce and enduring. She can warm herself on it, be powered by it. A power that allows her to know and love herself and the world as one, and to act accordingly.” Alexandra Pope.
And on a bad day, I’m definitely with Cher.
Asked by Oprah , “How do you feel about getting older?” she replied with characteristic candour, “I think it sucks”. Everyone collapsed with laughter. “Yeah, but what about all the wisdom” …. (voice trails off)
“Fuck that “
Like I said, it’s complicated.
Menopause is as varied as the people who go through it and the way individuals approach and experience it differs across cultures. Singular and privileged accounts of the experience mean that you may not see yourself represented.
The list of resources at the end of this piece is an incomplete attempt to widen understanding of the diversity of experience and encourage greater awareness of individual and unique health needs.