Growing up, it was referred to as ‘The Change’. If an older woman was angry, she risked being accused of going through The Change. If she complained of being warmer than those around her, it would be attributed to The Change. However, details of The Change were usually pretty cloudy.
When I think of menopause, I think hot flushes and mood swings. I think of invisibility, and ridicule, because the vast majority of the time this stage of life is omitted from public discourse. With the exception of Samantha in the Sex and the City 2 battling hot flushes and eating copious amounts of hummus in place of her confiscated HRT (Hormone Replacement Therapy) I can’t readily name a character who experiences menopause, and even then, Samantha’s suffering is viewed through a comedic lens.
As a parent to a young daughter I gave a lot of thought to periods and how to have that conversation with her, but haven’t once considered talking about the end of periods - which made me realise that I managed to reach my mid-thirties without having a single informed conversation about it.
The menstruation cycle is a natural, biological phenomenon yet as a culture, topics such as periods are still considered taboo, with many reluctant to talk about it. For people who menstruate, menopause is an inevitability and yet this stage is still shrouded in shame and mystery. Whilst we are taught about periods in schools and the notion of menstruation is present within public consciousness via ads for sanitary products, many people (including myself) received no formal education surrounding the topic of perimenopause and menopause.
A GP I spoke with told me that in order to be considered within menopause, one’s periods must be absent for a full 12 months. The NHS website defines menopause as the point where periods cease, stating that “is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman's oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is 51.” Perimenopause is a term I only recently discovered. Whilst the term ‘perimenopausal’ is mentioned in relation to other topics, there is no explicit information pertaining to this perimenopause on the NHS website.
Most know that periods begin and end, but know nothing of the potentially crushing symptoms related to the transition phase - such as, anxiety and depression or the fact that symptoms can start years before actual menopause takes place. Perimenopause can begin as early as 10 years preceding menopause and the symptoms range from anxiety to sleeping difficulties and heart palpitations. In fact, website megsmenopause.com lists at least 34 known symptoms. Founder of the website, Meg Mathews differentiates between the physical and mental symptoms, highlighting depression, brain fog and panic disorder as common. The BBC News website features a short video titled ‘What we wish we’d known about the menopause’ in which one woman explains that the mental health impacts were unknown to her, and that for her the symptoms left her “…feeling depressed, getting anxious, having panic attacks” which begs the question, why aren’t people made aware of this?
Caroline Criado Perez’s bestselling book Invisible Women exposes the myriad ways that the world is built with men as the default. In the chapter ‘The Drugs Don’t Work’, Perez discusses the male-centric nature of the medical world and how this male-default stance goes back ‘…at least to the Ancient Greeks, who kicked off a trend of seeing women’s bodies as a ‘mutilated male’ body. The female was the male ‘turned outside in’. Ovaries were female testicles (they were not given their own name until the seventeenth century) and the uterus was the female scrotum…The male body was an ideal the female body failed to live up to.”
Perez also introduces us to the gender data gap, “a gap in our knowledge that is at the root of perpetual, systemic discrimination against women, and that has created a pervasive but invisible bias with profound effect on women’s lives.” This gap in knowledge results in females being misdiagnosed when presenting symptoms because male symptoms are the default and even presents issues with treatment since female human and animal cells barely featuring in clinical trials for medication. This goes some way towards helping us to understand why for so long there has been so little awareness around a biological phenomenon that traditionally only happens to women.
It appears to be only relatively recently that the conversation surrounding menopause is being brought forward with documentaries such as The Truth About Menopause with Mariella Frostrup airing in 2018. One positive shift on the horizon is that from September, menopause will be added to the UK school curriculum for the first time. Another encouraging development is the presence of individuals such as Dr Anita Mitra, author of The Gynae Geek and Dr Louise Newson, founder of menopausedoctor.co.uk promoting conversations and awareness in this area on social media, thus helping to normalise the discourse.
Hopefully this will provoke more discussions around menopause and perimenopause with our peers and family members so that this stage of and the individuals who experience it are no longer felt to be invisible.
Credit main picture: womanlog.com
Written by Yasmina Floyer