It’s noticeable that menopause, which eventually affects half of the population but has always been cloaked in silence and shame, is being talked about more openly and more often. It would be a brave person who dares to suggest that it’s fashionable, a trend or a passing moment. Not if 13 million of us have our say it won’t be.
People immediately started praising and discussing Davina McCall: Sex, Myths and the Menopause when it aired on Channel 4 on 12 May. It took me a week to watch it because I knew it would stir up strong feelings, in my own right and thinking of the many women I know (or know of) who’ve had an unnecessarily difficult time accessing the support and medical care they need.
In the space of 45 minutes I shed tears, smiled, laughed and nodded enough to give myself neckache. I felt sadness and frustration but also pride and gratitude towards Davina McCall and all those who are speaking out and pressing for the changes that are desperately needed and would make a massive difference to so many women’s physical and mental health. It provided an up-to-date and accurate picture of the risks and benefits of HRT and the gaps in medical training for GPs on menopause care. It was honest and fun on sex with some tempting shopping ideas.
I’m not going to review the film because I urge you to watch it, especially if you’re a woman who’s not there yet. Because one thing that comes up again and again is women not knowing what to expect and not understanding what is happening to them. The average age of menopause in the UK is 51 but for some it comes much earlier, compounding not only the medical implications but also the difficulty in accessing care and being taken seriously. It is a natural process and of course not everyone has a hard time but those who do are often let down.
When Davina McCall started experiencing the symptoms of peri-menopause at 44, she was advised not to speak about it publicly as it’s ‘ageing and unsavoury’. She and many of us are deciding to stick that attitude where it belongs: in the past. Even as someone who makes a point of writing fiction about women over 40, it horrifies me to realise how many ageist and misogynistic messages I have internalised and this was one of them. Right up to my late 40s I shuddered at the mere mention of menopause and its deluge of negative associations: faded, invisible, ‘dried up’, past it, desexualised. Of course, these only reflect the values of wider society obsessed with youth, beauty and fertility, female sexuality as commodity. I retired the compliment ‘You don’t look 50 (or whatever)’ once I examined what that’s really saying.
When I began to get hot flushes and mood swings at 48, I had to pull my head out of the sand due to my family history of bone disease. Due to lack of diagnosis and treatment following early menopause, my mother lost half her height to multiple spinal fractures and spent her final years in agony. I’d had a ‘fragility’ (zero trauma) fracture at just 43 when I broke a rib coughing. The GP could see I was on a mission to proactively manage the risks associated with oestrogen depletion, putting me on HRT and ordering bone density scans etc. at my request.
Things went OK for a few years but I felt guilty when I saw other women talk publicly about menopause. Like many of us, I had a lot of other challenging stuff going on and it can be hard to identify what’s down to menopause and what’s just life. Menopausal symptoms are frequently misdiagnosed as depression but the time I broke down in front of the GP when I’d gone to request stronger HRT, she was right: I was depressed – about something long term that had come to a head – that’s what I needed help with. I’m not complaining about my own care because I’ve been lucky, but it helps that I’m well informed, privileged and am not intimidated by doctors, though I do respect them. It was heartrending seeing the women in the documentary who’d been driven to desperation and sometimes the brink of suicide through not getting appropriate care and treatment.
I never thought I’d approach those depths but last summer, at the height of the pandemic, illness unexpectedly catapulted me into ‘surgical menopause’ and ‘complex menopause’ care when I experienced a drastic androgen deficiency after parting company with my ovaries. That’s testosterone, to you and me. Especially me, as I am now dependent on the synthetic kind for such luxuries as the will to get out of bed, have any interest or pleasure in anything, or to sleep. It’s said repeatedly that if men had the menopause, there would be far more research and treatment available, something I can really relate to as there is no longer a female testosterone replacement product licensed in the UK. It’s not commercially viable, which leaves women like me (not many, but we matter) to mess around guessing at small doses of gel meant for men. Although the seven GPs I’ve spoken to have been helpful, my consultant is the only person I can turn to who’s qualified and experienced enough to monitor this treatment.
I have found it lonely and emotionally difficult the way many women find dealing with classic menopause issues they can’t talk about. It’s messed with my sense of self and made me feel freaky even though I’m only replacing something my body and mind need to function as a female human. Is this fun to talk about? No, but I’ve become a bit desensitised after talking to doctors about losing my hair, unwanted facial hair (you couldn’t make it up) and the quality of my orgasms (without the treatment there wouldn’t be any and what’s more, I wouldn’t care).
Am I embarrassed or ashamed to talk about menopause? No, and I don’t think anyone should be. And for those who don’t yet know it, I can tell you there are plenty of good things on the other side.
Now go watch the programme.