Breaking the Taboo of Menopause.

Older lady with many wrinkles representing good health in older age, post menopause

Why is menopause only being seen as a health concern now?
Was menopause even a problem 100 years ago?

It is not a sign of weakness!
Yet despite this I often have women state they are happy to ‘battle’ through the symptoms. Or they feel they are ‘coping OK’ with the night sweats. And when I query their reluctance to investigate options, many state that their mothers and grandmothers went through it, so they should be able to as well.
Menopause is and always has been a part of human history. It is a natural progression of life for any woman who makes it to middle age. So, what is the history behind the increased interest in menopause?

Age and Menopause

The simplest explanation is that there are now more women on Earth who have reached menopausal age than ever before. As our life expectancy increases, so does the chance of reaching menopause. To put this in perspective, the average age of menopause in Australia is 51. According to the Australian Bureau of Statistics average life expectancy in 1890 for women in Australia was 50. Thus, on average 50% of women never experienced menopause. With fewer experiences, there are even fewer stories to pass down to the next generation.

Attitude to women and their bodies also impacts the stories we hear about menopause.

Even if there were more stories to pass on, it is possible we would never have heard them. To talk about bodily functions, let alone women’s bodies was very taboo in 1890. By the 1950s the average life expectancy rose to over 70, but society still felt women should be in the home. At home meant less visibility and to be fair to the people of the time, this also meant less understanding of how dramatically menopause can change your brain function and ability to produce written and spoken work. If it is not seen it is hard to make changes. Attitudes towards women and sexuality started to change in the sixties and then in the 1980s, we were told we could do it all. So how do you remain a sexual being and manage to work and look like you are doing it all? You hide your shortcomings. So again, in the next generation, very few of us were told about the menopausal experiences of our mothers or grandmothers. I still have patients who are reluctant to ask their mothers about their menopausal experiences. Sometimes they do and the answer surprises them.
We still have a long way to go in terms of equality with men, and part of that process is educating both men and women and what is a normal part of life. Without talking about issues, it is very hard to pass on knowledge which in turn drives understanding and treatment. My hope is that the tide has now turned, and we can empower not only ourselves but also the following generations.

Medicine and Menopause

Adding to the complexities of the menopause is the history of medicine. A vacuum of silence and lack of data.
Modern medicine, where you visit the doctor and they tell you what to do and how to do it, until recently, has been governed by men. The lineage of women who used herbs and natural remedies to help women were more or less removed as witches, leading to a male-centric model of care. Literally all learning was and still often is based on the male experience with women considered as other. Or a man with female reproductive parts. With men in charge of health the spotlight was off women and research into women’s health was often pushed aside in favour of the population as a whole. Unfortunately, even these population studies often only contained men, which continually propagates men’s health as the standard. Leaving women to fit in with what is considered ‘normal’. Normal for men is a 24-hour hormonal cycle and a slow decline in hormones over decades. For a woman, it is a 28-day variable cycle with changes in physiology over this time that impact mood and well-being. This is followed by a sudden loss of hormones around 50, menopause. Medically the complex interplay of monthly hormones and the loss of this driving force in perimenopause has been ignored or minimised until recently. It was the reason women were often omitted from studies, it was too complex to measure! This attitude has impacted our sense of self and our place in society as women did not respond to life as men did. It is only now that we are truly beginning to understand once again, how much our hormones impact our well-being and life experiences. We carry the legacy of this attitude today. It will correct, we just need time.

The study that showed HRT was bad for women in menopause.

Yes, the WHI study into women’s health, (finally) set the idea of symptomatic menopausal relief back decades. Thankfully research has shown that many of the findings on HRT no longer hold true with new medications and an understanding of the mechanisms involved.
I discuss that here.

Stress and Menopause

Stress has always existed, and always will. The difference is that we are living on edge much of the time. Rushing here and there, looking after elderly parents and children at the same time as working and running a household. Something has to give. Often, it’s our bodies and our minds. The perception that diet and exercise alone are enough to counteract the effect of this, needs to change. Stress is not just what we put in our bodies but what we surround our bodies with.
To decrease stress in your life is to decrease inflammation in your body. Inflammation in your body is a major driver not only of disease but also aches and pains and mood disturbances. Those very things that come to the fore in perimenopause. Physiologically as we go through perimenopause and our hormones shift, we start to handle stress and inflammation differently. This is not a sign of weakness it is simply a biological effect. It is also where we have the opportunity to shift, to become an elder, and be wiser and more powerful, if we listen to our bodies.

We are busier than ever before, so when was the last time you stood on the ground and just breathed? Or lay and looked at the clouds and just imagined. No input from external sources, just quiet time with your brain and your breath. Sound scary? It can be. Sound like something you can’t do? Anyone can, even a child with ADHD. It just takes practice. Start small and work up, 1 minute at a time.
Decrease your busyness and mimic your ancestors, it can help.

The chemical soup we live in and the impact on menopause.

So far we’ve worked out that menopause has always been around, that stress can impact your symptoms, and that talking about menopause has been hushed for generations. Is anything else affecting the narrative? The simple answer is – yes. It is well known that we are carrying a much higher toxic burden than our predecessors. The sprays on our food, the plastics we use, and the pollution in the air are insidious. Individually they may not seem like a burden, but as a whole, they do impact our endocrine system.
This article by the Australian Menopause Society discusses how these chemicals work and the link between increased obesity and insulin resistance, both of which increase during perimenopause.

And lastly, and maybe most importantly in today’s society, our gut.

This is an ever-evolving space and with this comes new information and knowledge every year. What we do know is that the concentration of nutrients in the fresh food bought from supermarkets is lower than they were in the 1950s. Research suggests we need to consume around 600g of non-starchy vegetables a day to meet our optimal nutritional requirements. If we can meet these requirements, people often find the symptoms of menopause diminish quite significantly. This makes me suspect that the women in traditional societies, or those in many of the blue zones around the world, who do reach menopause, are protected by their diet and thus their gut health.

In Summary

Menopause is here to stay and is being experienced by more women than ever before. The symptoms of menopause are worsened by many factors in our modern lifestyle. Thankfully this means they can also be alleviated by changing our lifestyle, and if this is not enough, with the help of HRT.
As society changes, and women start to become equal in all aspects of life, we will see more research, more understanding, and more empowerment for this time of life. We still have a way to go, so be honest, talk about your issues, and be brave enough to change the narrative, not only of your own life, but of the women that follow behind you.