Why is menopause for Western women in developed countries so problematic?
For the past three years I’ve subscribed to Google Alerts for notification of press about menopause from all over the world, which turn up in my inbox every day. You may not be surprised to hear that the majority of articles are profoundly negative. And from talking to thousands of women directly about their experiences and looking at the research we have to date, I know it’s true that for most women today, menopause is a seriously challenging life passage. Here are seven reasons why:
- The retrospective diagnosis: When you have your last period you don’t know it is the last one. Menopause is the only major life passage that has a retrospective diagnosis of a long-term nature – we only know “officially” that we have gone through menopause 12 months after it has actually happened, i.e. that we really have had our last period. Many women have irregular periods for years before their last one, and spend years in uncertainty – not only about their fertility and whether or not they need to continue using contraception, but also psychologically, because a post-menopausal woman feels differently about herself and about life, due to cultural expectations and biological reality. Having a doctor monitor your hormone levels can give you some indication of when your last period might be, but this is far from foolproof and in most countries is not covered by state-subsidised healthcare and is expensive. Women with a strong sense of inner body awareness are more likely to be aware they have stopped menstruating for good, and there are certainly psychological as well as physical indicators (more on this in future posts).
- Contemporary society venerates youth: New things are prized over old ones. This greatly serves neoliberal capitalism because it makes us buy more stuff; it does not serve women, especially in a patriarchal context which privileges men and male needs.
- Social failure to honour the wisdom of age: Along the same vein and for the same reason, society fails to sufficiently honour age and experience. This especially impacts women — see above re the patriarchal context.
- Lack of role models: Although this is getting better in public life, especially in politics and the creative arts, we still lack role models of women who age gracefully and with self-compassion, and who use their postmenopausal years constructively and powerfully. For many women this is a time of continuing health and strength. We should be encouraged to find avenues to express and further develop our knowledge and experience, rather than aspiring to the dead end of conventional retirement, cruises and playing golf. (The benefit of having a positive attitude to the third stage of life also applies to men.)
- Insufficiency of medical research: There is a lot we still don’t know about menopause. Mainstream medicine only offers women HRT for menopausal symptoms. This single solution creates huge profits for pharmaceutical companies but puts women at risk of increased rates of reproductive cancers (breast, uterus and ovaries) and other problems. And for women who prefer gentler forms of medicine and who are sensitive to hormones, it’s neither appealing or a good choice (see last week’s blog).
- Living too fast: A lifestyle that saps the adrenal glands and raises cortisol levels predisposes us to difficult menopause. The adrenal glands are called into play at menopause as this is where the body learns to make hormones for this stage of life and beyond, instead of in the ovaries. So running ourselves ragged overworking, while being fuelled up on coffee and sugar, contributes to having a body that struggles to adapt at menopause.
- Working outside the home, and lack of workplace accommodation to menopause: Due to an absence of research and the historical privacy with which menopause was treated (a taboo subject as part of the menstrual taboo) we don’t know for sure that menopause for Western women is worse now than it used to be, but anecdotal evidence supports this as a strong likelihood. When women work primarily in the home they have more autonomy over their energy demands and output, especially if their children are grown up. So certainly for women who were homemakers, menopause could be more manageable. We are just now learning more about how women deal with menopause in the context of a busy career and the workplace, and I will be writing much more about this in the months to come.
(There will be more on the positive perspective on menopause in subsequent posts. Also, please note, I’m sketching out the parameters here in the limited space of a blog — I go into more detail in my workshops and individual sessions.)
Coming next time: More on the cultural context, how menopause experience is culturally constructed, and how we can learn from other cultures and positively reframe our experience.