Body & Fitness

Why are we so scared to talk about Menopause?

It’s called “the change”, but what hasn’t changed – much – is our willingness to talk openly about it.

Menopause. How comfortable are you saying the word out loud? To yourself, your partner, your workmates, your friends? If you haven’t been through it, do you know what is to come? If you have, did you discuss it with those around you?

The Australian Women’s Weekly approached a number of high-profile women to talk about menopause for this article; celebrity cook Allyson Gofton, television personality Suzanne Paul and businesswoman Theresa Gattung agreed to do so – but a number of women declined.

This was initially surprising. Menopause is, after all, a stage of life all women go through in varying degrees. Why are we happy to talk about periods, pregnancy and childbirth but not menopause?

There are some obvious reasons for wanting privacy. Talking about menopause means talking about the most intimate parts of our bodies and discussing symptoms that are not particularly sexy: such as hot flushes (also called hot flashes), night sweats and vaginal dryness. It also means chatting about the uncontrollable, undesirable emotions that can present themselves during menopause.

But what I had failed to grasp as a 37-year-old who, until now, had thought little about menopause, is that it also means acknowledging that you have matured as a woman – and that means accepting that you have aged. And in a society where ageism is still rife – where older women are still met with discrimination in the workplace and where beauty and sexuality is still so often measured by youthful ideals – it is regrettable, but understandable, that women choose to stay quiet about their experience.

During my research, I noticed menopause referred to at times as the “crone stage”, particularly when associating menopause with a wise stage of life. Look up the dictionary meaning of crone though and you’ll find “withered old woman” or “old ewe”.

Type “crone” into Google images and you’ll see numerous pictures of grey-haired, long-nosed, wrinkly, witch-like characters.

Hardly a desirable or relevant image in 2017, when it is common for a 50-year-old (the average age of menopause) to be in the throes of a thriving career with a busy social life and, with the upward trend of older pregnancies, children who may not have even reached their teenage years.

Theresa Gattung

Theresa, Suzanne and Allyson all have unique experiences of menopause, but what they share is a desire to lift the taboo on the subject.

Theresa, who is 55, says that taboo is directly related to the stigma around ageing – particularly in the workplace.

She says while ageism is an issue for men and women, women get it on two levels: personally, they are expected to look youthful, and professionally, they are concerned about “being put out to pasture”.

“It is hard enough to make your way as a woman in the workforce, so you don’t want your age to be held against you as well,” says Theresa.

“Menopause completely draws attention to them being in their 50s. They don’t want to do that, just like they probably wouldn’t want to talk about their sore knees, if sore knees were a function of 50-year-old women.”

Hot flushes in a business meeting, bouts of uncontrollable rage while trying to make the school lunches, or insomnia can make life a real challenge – but add to this a generation of women whose mothers rarely uttered the word, and it’s no wonder there is a stigma around the… cough, whisper… “change of life”.

Suzanne Paul

Suzanne had few people to talk to about her menopause symptoms because her social group is generally younger.

“My mother had already died and when she went through it, when I was in my late 20s, they didn’t used to talk about it. You think it is bad now, but it was dreadful then. It wasn’t even said out loud. Because we weren’t allowed to talk about it, I didn’t know what the symptoms were or how long they would last. So a lack of information didn’t help at all.”

Allyson, who had her second child, Olive-Rose, at 46 and is now 55, was socialising with younger mothers when her menopause symptoms started.

“I’m a good 10-15 years older than them, and it was not something I could talk about because it made me feel old, and the last thing I wanted to tell these young mothers was what’s ahead. As a result, it became a very personal time of life and it can be really lonely.”

Allyson’s mother had died, and she missed the presence of an older woman to guide her through menopause. She thought about buying books on the subject but likened purchasing the books from a young retail assistant to buying tampons as a teenager from a male checkout operator.

Eventually she turned to her Auckland-based doctor, Sara Weeks, who helped her understand her symptoms.

“The best thing she did was explain what was going on chemically in my body. Once it began to make sense I felt a lot better about it. I found that by talking to her I understood why I wasn’t coping.”

And if women aren’t talking much among themselves about menopause, you can bet men are not talking about it at all.

“I got more empathy from my gynaecologist than my husband,” says Allyson, who would ring her husband’s best friend to come and take him out when she needed breathing space during menopause.

“I have a pretty average Kiwi male husband and by the time he got to 55, the thought that he might have to step out of his comfort zone because his wife is going through menopause was as alien to him as flying to the bloody moon. And I can’t say that is wrong, it is just the way they have been raised, they think that if they don’t say anything, it will go away. Hopefully, the next generation will age with a bit more understanding of these changes.”

Allyson Gofton

Suzanne says communicating with her husband about menopause helped her and her marriage.

“We are separated at the moment but we did get through my menopause because we talked about it. I just would keep saying to him, ‘It is nothing you have done or said.’ For years women haven’t talked about it so men have no idea why their wives are suddenly not the women they married.

“When you are going, ‘Oh my God, I just flew off the handle, shouted at my husband and threw a saucepan at his head,’ you just need to say, ‘Sorry about that, I am just having one of my moments. It’s not your fault, it is just the hormones.’

“The expression I would always say to my husband, and still say now if I have a bit of a meltdown, is: ‘I’m sorry, it’s me hormones, they are all up the swanny at the moment.’”

At a time when many women are used to being in control of their lives, the erratic, uncontrollable nature of menopause is perhaps more challenging than ever.

We can, if we wish, dye our hair, use appearance medicine or cosmetics to reduce the physical appearance of ageing, filter our own photos on social media and even schedule a caesarean, but when and how menopause presents is initially out of our control.

Menopause specialist Dr Anna Fenton says menopause can hit much earlier than we think, with about a third of women suffering perimenopause symptoms intermittently from their mid-30s.

“It would often require them talking to someone to work that out, because it might appear to them like ordinary PMS.”

But it is not only younger women who can take a while to twig. It took Suzanne Paul months before she realised she was menopausal, because her first hot flushes hit in summer.

“It isn’t as if your periods just stop one day and you think, ‘Oh, this is it then, I’m in the menopause.’ With age, your periods get a bit erratic anyway and unfortunately if the menopause starts in the summer – as it did with me – you just think, ‘Gosh, this is the hottest summer I can remember.’”

The Natural Glow celebrity realised that something was awry when her typically sunny mood turned increasingly dark.

“My mood swings were out of control. I have always been really easygoing but I was just flying off the handle at anything and crying at the drop of a hat. My mother had died around that time so I put a lot of those symptoms down to grief.

“When I did actually go to the doctor, I went because I thought I had a really bad depression. I said, ‘I am up and down, I’m having emotional outbursts and anger and I just feel overwhelmed – it is not like me. I think I have got the depression’.”

Allyson also suffered night sweats and hot flushes.

“After Olive-Rose was born I immediately suffered from awful night sweats. Each night I’d line up three to four changes of pyjamas on the floor beside the bed and in between night feeds for a brand new little girl, I’d fall out of bed and change clothes and fall back to sleep. It went on for over a year.

“It was [because of] tiredness from this and a slide backwards into that jolly depression that seems to rattle me every so often that I sought help from my doctor.”

Dr Fenton says it can be hard for women to tease out menopause from what’s going on in their lives.

“It is a time in a woman’s life where there can be some major things going on – the kids may be leaving home, their parents are getting older – so it is an awful collision of these major life events.”

She recommends going to a doctor and talking through the symptoms if you suspect it might be the case.

“The symptoms are pretty distinctive and there isn’t much else that would create a similar type of picture.”

Once diagnosed, the next step is deciding on treatment. Suzanne was so open about her condition, she found herself being bombarded by recommendations from friends and clients on natural remedies to take. In her signature fashion, she worked with a scientist and nutritionist to come up with her own supplement based on herbs that worked for her.

Allyson was also trying a multitude of remedies.

“I would just go into the girls at the chemist and say, ‘What have we got this week?’ It would be really useful to have an accurate medical opinion on whether those things work and why they work – and sometimes I think they worked for a short time and sometimes I didn’t.”

As Allyson also suffered from depression, her doctor upped her antidepressants to help her cope with menopause, which Dr Fenton says can produce the same changes in brain chemicals as a clinical depression.

Both Allyson and Suzanne made lifestyle adjustments. Allyson cut down on caffeine and alcohol, exercised regularly and got counselling.

Suzanne had a major diet overhaul – she became a pescatarian, and significantly reduced wheat, dairy and processed foods, which caused bloating.

“That [bloating] drove me up the wall. I have always been very slim and able to wear nice fitted clothes, but all of a sudden I would eat something and within 10 minutes my stomach had swelled so much I would look like I was eight months pregnant.”

And she bought fans. Lots of them.

“I have a fan that attaches to my mobile phone, I have got one that goes into my computer and one at the end of the bed.”

Dr Fenton, who is New Zealand’s Immediate Past President of the Australasian Menopause Society, says there is a wide range of treatments available for women, but they can be shrouded in misinformation.

She says the HRT (Hormone Replacement Therapy) furore in 2002 was a result of unverified data being released to the media. Once the data was verified, it was found that the risks associated with HRT were largely isolated to women over 65 and those taking certain combinations of hormones. Within a week, however, 90 per cent of women had stopped taking the treatment worldwide.

“That is no exaggeration. It had a massive effect,” she says.

The stigma remains, and HRT has now been renamed MHT (Menopause Hormone Treatment) in an effort to shift the associations with cancer.

“We have got a huge range of options that women can use to manage the symptoms – from complementary therapies through to things we can prescribe, and so I think one of the key messages is making women aware that they do have some options, this is not something they just put up with, that they can get some help.”

And she says women are doing themselves a disservice by putting up with severe symptoms.

“I think one of the critical things that changed our approach in the last year at least is finding that women putting up with very severe flushing and sweating are actually not doing their health any great service, because it turns out the symptoms are actually markers for risk of dementia and stroke. Studies have shown that severe flushes are associated with small areas of permanent scarring within the brain.”

What helped both Suzanne and Allyson through menopause was talking about it. While Allyson took a more private route and spoke exclusively to her doctor, Suzanne talked openly about her symptoms to both men and women.

“I tell you what, I just tell everybody – if I am having a hot flash, I don’t care who I am talking to. I just say to them, ‘Oh crikey, I am having a hot flash, here we go!’ Especially in my job when I’m trying to sell somebody something, I’d rather just get it out there than have them thinking, ‘Is there something wrong with her? She has suddenly gone all red in the face and sweaty.’

“I tell all young women about it, because then they will be better prepared than I was.”

And she kept a sense of humour.

“I became a stand-up comedian for the year and the basis of my act was menopause, and all the young people, even the men, thought it was hilarious.”

Theresa was one of the lucky ones, for whom menopause had few symptoms.

“My periods became more and more erratic and further apart and then they just stopped. I probably had a few weeks of hot flushes and that was it. I had no sleep disturbances, I felt no different, I took no supplements. I just sailed through it. I know that is not a lot of women’s experience so I think I am really fortunate.”

She’d like menopause to be seen as a celebration of a new phase.

“Fifty is so young – they just elected a 70-year-old president of the US! Fifty can be the halfway mark, so celebrating it and generally getting over our societal issues about ageism would hugely help.

“In traditional society, menopause is the new stage of women being honoured for their wisdom and the knowledge gained in the previous decades, so it shouldn’t be a fearful thing. It should be a celebration of the next stage of life. It has a lot of upsides – sex without worrying about getting pregnant, not worrying about tampons and sanitary products… it’s fantastic!”

Allyson agrees: “I don’t have to care about periods any more – love that!”

Suzanne is looking to women like Jane Fonda for inspiration.

“I read a few of her books and she was all about looking at it in a different way – that life was more like a circle, not an incline where you went up and up and then dropped off, which is how women used to look at it.”

She is trying to lead by example.

“I have just gone 60 and I am still me, I am still vibrant and taking on new challenges and living an exciting life.

“I like the confidence that you get with being this age – you don’t put up with the nonsense that you used to and you know what you want from life. Rather than thinking it is all over I am more like, ‘Oh my God, I don’t think I have much time left – I better get all these things done!’ For instance, in June I am escorting a cycling tour around Cambodia. I am training for it now. I think it is important that young girls see that life is not all about just having a nice figure and tight skin.”

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