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Menopause is not a Disease

When women pass beyond their age of fertility into menopause, the alterations in body chemistry can produce profound and sometimes uncomfortable changes in their bodies and even their brains. However, it may be wrong to rush to a judgment that she is now ‘sick’ and to seek medical intervention. There are many ways to cope with menopause without resorting to aggressive interventions. In general, the passage of time itself is one of the greatest healers, and along with that some gentle aids can make the transition more comfortable.

Change is a sign of life.

Change happens throughout a person’s lifetime. It may bring with it times when you may long for the “good old days” where you had grown used to your body before the phase of change had set in. That’s why adolescence is a period when previously placid, friendly and affectionate children can turn into angry and aggressive teenagers seeing drinking, drug use and risky sexual activities as ways to dampen down their suddenly unfamiliar selves. The triggers for this phase are surges in hormones. Thankfully, once they have emerged from the tumultuous years and hormones level-off, their bodies will have adjusted to the new environment, and they will emerge as more stable and ‘normal’ adults.

A reverse cycle of hormone change takes place when women have passed their peak breeding years. The levels of estrogen start to drop when she passes into menopause. This again disrupts the patterns she grew used to for twenty or thirty years. It can produce a whole range of alterations in how her body and mind are working, and the changes can make her feel that something is wrong, so she is ‘sick.’.

Women should expect menopause and not fear it.

In the June 2022 issue of the British Medical Journal, a group of specialists in women’s medicine from Australia, the UK and the USA, led by Dr. Martha Hickey of the Department of Obstetrics and Gynaecology at the Royal Women’s Hospital, Victoria, Australia, published an article that sets out to change the way that doctors and women regard menopause. 

The title is “Normalising menopause” and it makes a couple of solid arguments, backed by research and statistics, that:

  • Negative beliefs and expectations of menopause may increase the likelihood of distressing symptoms
  • Women who view menopause as an expected and positive life transition are less likely to experience distress
  • Reducing gender-based ageism, eliminating stigma and providing balanced information about menopause may instill confidence and better equip women to navigate this normal life stage.

Why is menopause regarded as a burden, not a blessing?

In western culture, the prevalent language describing menopause is of loss, failure and decline, reinforcing a negative self-image in older women. It amplifies concerns about health and aging in a culture that prioritizes youth.

Negative views about reproductive aging in women have predominated in medical discussion for centuries. Once the link between menopause and estrogen levels was recognized in the 1950s, menopause was commonly labelled an ‘estrogen deficiency disease’ whose physical ‘symptoms’ needed to be treated with hormone replacement therapy (HRT). 

Unfortunately, as the BMJ article reports, a typical prevailing view was the one disseminated in one of the most widely referenced books on this subject, “Feminine Forever”, published in 1966 by the gynecologist Robert Winston. He recommended HRT for all menopausal women to treat their ‘serious, painful and often crippling disease’ so as to avoid the ‘untold misery of alcoholism, drug addiction, divorce and broken homes caused by these unstable, oestrogen-starved women.’ (Maybe it shouldn’t come as a surprise that the book was sponsored by manufacturers of HRT looking to promote their message about ‘menopausal decay.’)

The authors of the BMJ article quote the results of a systematic review of standardized questionnaires used to measure menopausal symptoms. It found that these questionnaires only asked about negative symptoms. As a result, there was no way women could report positive experiences of menopause. 

Later studies that allowed more positive outcomes reported that menopause can be viewed as bringing positive as well as negative experiences. As a result of midlife changes, women cited freedom from menstruation and need for contraception, and relief from premenstrual symptoms as distinctly positive and desirable changes.

A change in attitudes to menopause is overdue.

The medical fraternity, women themselves and society in general have for a long time been in need of an overhaul when it comes to attitudes towards menopause. Thankfully, as articles like the one we have quoted from here show, the doctors are starting to recognize that they need to do their part to turn around both their own approach and the expectations and experiences of their patients. Society is also waking up to how much work needs to be done in this area. A sign of this is the formation of global organizations like the Global Menopause Inclusion Collective. It is a collaboration of menopause activists, advocates, experienced experts, researchers, individuals and professionals interested in advancing equality, equity, diversity and inclusion in the menopause movement. It states its mission as being to “create a global forum for peers, trainers and thought leaders in menopausal inclusion…and (to) dismantle existing menopause stereotypes”.

Now, hopefully, women will themselves take control of their bodies and their minds, and treat menopause not as a disease to treated, but as a normal state to be managed. The ways she can handle it are wide and varied, and the choices she makes can be her own.

 

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