We’ve Lost the Plot on Menopause

It’s been 23 years since I went through the menopausal transition, long before there was more than just one (flawed) study on the impact of hormone therapy. So treatment options were limited, and I wasn’t much interested anyway, as my symptoms—an occasional 30-second flash of feeling like I was run over by a truck—were pretty negligible. Which isn’t to say that I wasn’t uncomfortable, but my discomfort was due more to lack of information about my symptoms than it was due to the actual physical issues. I mean, without knowing that pre-menopausal and menopausal symptoms can feel very different to different women, I at first assumed the run-over-by-a-truck feeling was a precursor to… death, probably. I remember clearly sitting in a café one evening while visiting our son at college, suddenly being overcome with that run-over feeling, and being both shocked and relieved when I realized the symptom was menopausal.

Of course! It was a flash! The fact that I wasn’t hot didn’t matter: It was my body’s unique way of declaring that I was entering a new phase. Sure, at the time there was a trickle of information about “the change”—but not the flood saturating all kinds of mass media and social media today.

On the one hand, that flood is a very good thing. Finally, a health issue that affects half the population is getting its due as research-worthy. Obviously, a lot of good can come of that. But you know what also comes of that? A lot of marketing to a predictable and growing audience of vulnerable people searching for the best ways to care for themselves as they confront the various symptoms of menopause and the questions arising from fresh research. Along with the positive aspects of the attention being paid to perimenopause and menopause, there’s a dark side that preys on our need—fueled by the beauty and wellness industries—to be doing everything possible, everything right when making our choices about self-care. Which has led to what looks like a kind of frenzy among women uncertain about those choices and vulnerable to investing in the—mostly useless—products being marketed to them. (For some great insights into menopause marketing, read this.)

A couple of years ago I was asked as a beauty “influencer” to answer a few thoughtful questions about how I believed an ageist, youth-oriented culture affected women’s experience of menopause. A very famous actress was involved in a project; I was told she was interested in bringing menopause into the open. I answered the thoughtful questions thoughtfully, but not without suspicion. The public relations agency that sent the questions wouldn’t be clear about how my answers were going to be used; it was only after significant prodding that it was revealed that they were researching a new product line aimed at menopausal women (and sponsored by the famous actress). Their motivation, overall? Not especially bringing menopause into the open, but bringing you and your open wallet into the market.

How menopause affects you depends partially on genetics, so the intensity of your symptoms is to some degree predetermined. You might have the kind of hot flashes that leave you looking like you swam the English Channel in your pantsuit. Or, you might have my kind—the ones that involve no sweating but the feeling for exactly 30 seconds that you were just flattened by a garbage truck. If you have my brand of menopause, you might also have the type of mood swings that cause you to sob when your cleaning woman switches her day. Or the kind that require you to angrily power walk 10 miles up to the George Washington Bridge and back in a hurricane (me again).

What isn’t predetermined is how you cope with your symptoms. One way to cope is to throw your money at anything that pops up on your social media feed promising to help you sail through the transition. This strategy, as you probably can guess, will leave your confidence and your bank account dwindling, but not your hot flashes. Another way to cope is to have a frank discussion with your gynecologist about the best way to treat your symptoms and then to turn the media faucet to the OFF position. Because you’re perfectly well-equipped to cope with the change of life—better equipped, in fact, than when you were, say, an 11-year-old suddenly having terrible stomach cramps and (whaaat???) bleeding into your little flowered cotton underpants. Better equipped than when you’ve just pushed seven pounds of human out of your vagina and your breasts are fountains of milk (or not) and you realize you’re legally required to keep that human alive.

What I’m saying is this: Menopause isn’t unlike all the other transitions you’ve survived. Weird shit happens, and then it stops. (Though some of it lingers as a small percentage of women have hot flashes post-menopause.) Yes, there is some loss involved—of juiciness, agility, and hardest of all, sleep. But life goes on. Having experienced menopause almost a quarter of a century ago, I can tell you that there is a sense of well-being that follows, with a rich, poignant, happy/melancholy quality. For one thing, we older women are pretty much free-range chicks, roaming the landscape unencumbered by the watchful, often predatory gaze of men. (I really miss the gunning engine of desire. But I’m enjoying a more languorous, luxurious kind of intimacy than I knew in my youth.) And after a lifetime of caring for other people, I now am the first person I ask about what to do next.

For all the adjustments, whatever the gains and losses, it’s the poignancy I cherish. It’s a poignancy you can’t appreciate till you’ve reached an age when you can fully understand what a gift it is to be alive. The runway continues to shorten, as it does for all of us, and the landing is, if not in sight, at least palpable for those of a certain age. But we are here now, as you likely will be too one day, having endured and even thrived after more transitions—of many kinds—than you can even count.


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