Menopause: Why we need to normalize the natural process

Menopause is a natural event for women, yet the narrative surrounding it has been skewed. Just mention the term and many have a list of preconceived ideas of what it entails. In reality, the definition of menopause is a point in a woman’s life 12 months after her final period. The menopause age for most women is between 45 and 55, and the average duration is anywhere from 7 to 14 years. The body reduces fewer “female hormones”, or estrogen and progesterone, during this time.

Despite being a normal life stage, social and cultural attitudes towards menopause affect how it is approached and managed. This Pacific Prime China article looks at why we need to normalize the natural process of menopause for women’s health.

Changing the narrative of menopause for women

In a recent British Medical Journal (BMJ) analysis piece, women’s health professionals from Australia, the UK, and the US talked about the stigma surrounding menopause and highlighted the importance of normalizing it. A 2021 global survey found that 16-40% of menopausal women experience moderate to severe symptoms including:

• Fatigue
• Hot flushes
• Sleep difficulties
• Muscle and joint aches

Hormone replacement therapy (HRT) has become a common treatment to help with such symptoms. By using medication, HRT replaces the hormones the body loses during menopause, thereby easing the symptoms. The therapy has proven effective in easing menopause symptoms in several studies, and many believe the benefits outweigh the risks (e.g. increasing the likelihood of breast cancer).

Despite its effectiveness, treatments like HRT are arguably only advised for women with troublesome symptoms. Martha Hickey, Royal Women’s Hospital obstetrician, and her co-authors point out that increased anxiety and apprehension about menopause can be caused by medicalization. Additionally, menopause medicalization could overlook the broad range of experiences that are associated with menopause, and highlight its negative aspects and the need for treatment instead.

Even though women with severe symptoms like night sweats and hot flushes often benefit from such therapies, the majority of women view menopause as a natural life stage and cope with it accordingly.

It’s not just about maintaining health, but youthful looks too

Experts have cautioned against HRT use for some time now. Elizabeth Siegel Watkins, a history of health sciences professor, touched on the topic in her 2007 book: The Estrogen Elixir: A History of Hormone Replacement in America. She explained that menopause medicalization started when estrogen was produced, marketed, and prescribed “in the first decades of the twentieth century”.

Estrogen was first introduced in the US in the 1940s and 50s as a short-term treatment for menopausal symptoms. Hormone therapy witnessed a significant boom between 1960-75 after menopause was redefined as a low estrogen disease. The way menopause treatment is viewed shows where science currently stands, as well as society’s attitudes towards middle-aged women.

According to Watkins, hormone therapy is suggested as a blanket solution to middle-aged women’s troubles. Not only does it claim to help women’s menopausal symptoms but maintains their youthful looks, positive demeanor, and more.

Holding onto one’s youth through hormone therapy

While saying that low estrogen causes women to become “insecure, inadequate, and ultimately careless” might’ve been acceptable in the 1950s, the wording hasn’t aged well. Even so, the connection between hormone therapies like HRT and hoping to preserve a woman’s youth lingers. The experts in the BMJ analysis point out that the idea that we can reverse or delay aging through HRT is reinforced in our society – from information and medical literature to media and more.

This begs the question: Why do these connections still exist? Essentially, marketing menopause is good for business. There’s a lot of profit to be made from a medication that half the humankind “should” be taking.

Changing our narrative of menopause

So how do go about changing the cultural narrative of menopause? Hickey and her co-authors suggest promoting its positive aspects and educating women on ways to manage challenging symptoms, thereby empowering them. Instead of dreading menopause and the thought of hot flushes and lethargy, discussing the positive aspects of menopause (and sharing this information far and wide) is key. These include:

• No more PMS (pre-menstrual syndrome)
• No more worries about getting pregnant
• No more hormonal headaches
• A new stage of sexuality
• More time for activities

Menopause marks the end of a stage in a woman’s life cycle, but it also marks the beginning of a new one. During this time, women can reflect on their lives so far and redefine who they want to be moving forward. The idea that women become difficult, unbearable, moody, etc. with menopause is by no means definitive. Instead, it can be a time to reassess one’s health, change the routine, and approach life in a new way. It’s only natural.

Further reading: 5 health tips for women

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