It's good to talk — but has there been any real change for menopausal women?

There’s even a stage production —  Menopause the Musical, and more recently Menopause the Musical 2.

We’ve come a long way in mainstreaming the M word. We are the first generation to speak openly about it, to normalise it the way we have normalised periods, pregnancy, birth — it has been the last female taboo to be declassified and brought into the open.

Our mothers spoke euphemistically about menopause, while our grandmothers didn’t speak of it at all; until now, it has always been about the cessation of our fertility, rather than a radical body-mind experience as transformative as puberty or pregnancy.

In patriarchal society, menopausal women lost their value as sexual beings; our magic power — to incubate and pop out new humans at regular intervals — was no more, rendering us redundant. When our periods stopped, so did we. We’d had, to paraphrase Amy Schumer, our last fuckable day. This has long been the narrative — hags, old bags, has-beens.

Things used to be considerably worse for menopausal women. What had been regarded throughout history as a natural process was rebranded by the Victorians as a disease. Specifically, a mental illness. In February 1865, an article appeared in the Journal of Mental Science, outlining a condition known as Climacteric Insanity. This only affected women in midlife. Its author, Dr Francis Skae, a medical officer in an insane asylum in Birmingham, noted how it was only women in their 40s and 50s who developed this condition, its symptoms including “depression of spirits, restlessness, sleeplessness, inattention to ordinary domestic affairs, fear of undefined evil, profound melancholia, delusions”. And my favourite: “They constantly express themselves as weary of life.”

He added that these symptoms were “so uniform, characteristic and peculiar as to render [climacteric insanity] easily recognisable.” The cure? Locking women up in madhouses, surgically removing their ovaries, and stuffing them full of narcotics.

It wasn’t until the discovery of hormones in 1902 and oestrogen in 1929 that doctors — always men — realised menopause was not a mental illness to be ‘cured’ by oophorectomies and incarceration, but a natural stage in women’s lives.

Menopause, writes Jill Shaw Ruddock in The Second Half Of Your Life, is “a new, hormonally induced desire to finally put our needs first, cultivate dormant passions and reconnect with the world in a different way”. Terrific.

Yet despite the fact we are talking about it, and despite the widespread commodification of menopause, as corporations invent product after menopause product you didn’t know you needed, we still have considerable ground to cover in terms of systemic change. 

Talk is cheap, and products profitable, but has life really changed for women in the thick of it — apart from installing a few fans in the office, do women in menopause need more support and understanding?

And what about the people we live with? Shouldn’t someone fill them in — in advance — about what to expect, rather than wondering why your missus/mum/auntie seems to be semi-homicidal a lot of the time?

Recent research from Boots the chemist showed 84% of women would like more support during menopause and perimenopause. Over one third thought there was a lack of information around menopause, which means that our primary sources of knowledge come from private sources such as Davina and Mariella, rather than in school or via public health information.

More awareness and public discussion, more help from the medical profession, more support from employers, more access to counselling and HRT, all featured in the wish lists of the women surveyed.

In response, Boots have provided menopause training to 1,400 staff in Ireland and the UK, as well as launching the inevitable range of menopause products to zhuzh our desiccated skin, hair and vaginas. It’s a start.

“The research highlights that Irish women need robust and reliable support as they experience the substantial impact of menopause on their physical and psychological health,” says Caoimhe McAuley, Boots’ director of pharmacy, saying the company wants to normalise menopause and share expert advice in an accessible, everyday manner.

For genuine systemic change, we need far more mainstream education, and not just aimed at midlife women. Education is more effective — although less profitable — than all the products in the world. Jo Fuller, founder of The Merry Menopause online community and host of The Merry Menopause Bookclub Podcast, agrees.

“Yes, for me education is top of the list, but education at a much earlier age,” she says. “Many of us reach our late 30s or early 40s, still having regular periods but when things start to change — our mood, our energy, our sleep — we don’t always realise that this is the start of our perimenopause. We are waiting for the hot flushes in our 50s, which we may or may not get, and by which time our symptoms may have had a huge and negative impact on our mental and physical health.”

What we can forget in our stampede to manage menopause without losing our minds is that we are fundamentally designed to experience it. It’s not a malfunction, as the Victorians thought.

“It’s a natural hormonal re-calibration that is part of the lived experience of those who menstruate,” says Jo Fuller. “But the way we experience it in today’s world is different to the generations before us. Biologically it is the same — the decline in production of the sex hormones oestrogen, progesterone and testosterone — but the way we live today has an impact on our stress levels, which exacerbates many of the symptoms we experience.”

Which means there’s a lot more to it than slapping on a HRT patch — while HRT is a crucial tool for millions of women, how we live our lives greatly impacts how we experience menopause, for better or worse.

“We need to be taught about the science of menopause and the impact that our lifestyle choices will have on our hormonal health as we age,” says Fuller. “Screen time, diet, stressful jobs and relationships will all play out in our menopause experience.

“For many of us, our symptoms are a wake-up call to make changes that will benefit us in our life post-menopause. Menopause doesn’t want to throw us under a bus, it wants to wake us up to the changes that we need to make to support us as we age.”

At any given time, 35% of the female population is either menopausal or post menopausal. This is when we enter the age of wisdom — the crone zone. Our nurturing of others, other than perhaps recreationally as grandparents, is done; we are now in a phase that is the opposite of nesting.

We are flying free, to the next stage of our lives, until decrepitude eventually slows us down. It’s like a second puberty, but with wisdom and confidence instead of angst and spots. It’s an incredibly exciting time.