Reframing Menopause - why are British women suffering so much?

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British women are at the top of the league for unpleasant menopause symptoms. That is according to a study published in Climacteric, the journal of the International Menopause Society (2010).

The study included 1000 British women aged 45 – 55 as well as similar groups in the US, Canada, Japan and China. British women fared worse in 14 out of 15 symptoms, the Chinese beating them only in the category of irritability.

·      Two out of three British women suffer from tiredness vs one in twenty Japanese women.

·      More than 50% of British women suffer from hot flushes vs one in eight Japanese women.

A more recent report (2017) published by the British Menopause Society in 2017 stated that over half of British menopausal women said it had a negative effect on their lives.

If women all over the world experience similar endocrinal changes around menopause we have to wonder why is it that their experiences are so different.

What is going wrong for British menopausal women?

The answer is likely to be multifactorial. For instance, the Japanese and Chinese diets are higher in natural oestrogens such as those found in soy products. But there is a major difference which may play a key role – the status of aging women in society

David Sturdee, former president of the International Menopause Society and gynaecologist, says ‘It seems likely that in countries where menopause is less of a problem there are good genes. But it’s also clear that these countries tend to be matriarchal societies where women are revered for their wisdom.’

In Britain and other western countries where women are prized for their beauty and desirability, far more than their wisdom or other attributes, menopause may feel like a kind of death. Women report feeling invisible, ignored as they age.

The academic and historian Mary Beard is no stranger to vitriol and has had to defend her position as an aging woman, an academic and a presenter. She explored some of these issues in her Radio 4 documentary Glad to be Grey. She says ‘It goes back to well-mown issues where the white-haired craggy male talking about politics on telly is fine, whereas the wrinkled, white-haired lady isn’t. With men, the signals of ageing suggest authority but with women they don’t.’

Add to this the lack of information available to women. Women are rarely told what to expect and may not realise that their symptoms are connected to perimenopause, which can last for anything between 2 – 14 years before they are considered to have completed menopause. Post-reproductive health is not given sufficient attention in medical school and this can lead to symptoms being missed or misdiagnosed. There are too many accounts of women being prescribed anti-depressants when a conversation about HRT or symptom management might be more appropriate.  And it is not only in GP surgeries where there is a lack of knowledge; partners and family members are ill prepared to know how to be supportive.

How do we put this right?

The fact that women are managing better in other parts of the world offers hope that it is possible to make things better for British women.

Here are a few suggestions:

1.     Educate. Women need better education about what to expect and the choices available to them in managing symptoms and we need to be able to find it easily whether through the health service, mainstream publications, the media or conversations with others.

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2.     Be open about it. I am heartened to hear more and more people talking about menopause and perimenopause. We need to ensure that talking about the change of life is natural and nothing to be ashamed of. More women will feel better informed and able access support when they need it.

3.     Change the narrative. We need a more expansive view of women’s roles and capabilities, better role models, better visibility - across all ages but especially with older women. We need to remember that menopause is a time of transition, a metamorphosis, enabling women to enter a phase of live which has much to offer. 

4.     Talking therapies. Midlife can be a stressful time for many women as they juggle physiological changes, careers, financial responsibilities, parenting, caring for elderly relatives, empty nests amongst many other things. On top of this perimenopause can bring up unresolved issues and emotions that have been ignored or repressed for many years. Having a professional to talk to can help to untangle the many strands and help women to manage their wellbeing effectively.

On a personal note I think we need to reflect on the stories we tell ourselves about perimenopause, menopause and aging:

  • do we dread aging

  • do we fear who we will be if we are not viewed as attractive and desirable

  • do we fear being overcome by menopausal symptoms

  • do we see aging as a gift, a time of possibility, a time for another transformation.

Let’s be choosy about the narratives we tell ourselves. We all face trials and there will be difficulties and challenges ahead but we can choose to how face them, to find ways through, let’s choose hope and possibility and be the amazing women we know we can be.