'I went into instant menopause at 42. Here's what I want you to know.'

It feels like everyone is talking about peri and menopause, doesn’t it? It’s certainly in the zeitgeist. Zeitgeist or not, there are a lot of worried women.

I’m 43 and in menopause. I want to offer an alternative lens through which to ponder the historically rooted, ugly, fearful narrative that too often accompanies menopause.

In light of the significant advocacy of prominent women I’ll coin Peri Pioneers and Menopause Mentors (Mia Freedman being one of them), ‘peri’ and menopause now reside in our everyday lingo. 

Women are claiming space. Women’s health, hormones and fertility are claiming airtime. About time. However, there’s a tricky paradox here. 

For centuries, women’s health has lived in the shadows of a patriarchal medical system operating through a male lens.

Watch: Ask Mia Anything | Perimenopause. Story continues after video.

Yet as women’s health claims space in social consciousness, the abundance of commentary around peri and menopause has the potential to create collective anxiety. And it has. There is an anxious aura around menopause among women of all ages. Inevitably, this has fuelled a burgeoning ‘menopause industry’ of products, podcasts and potions. And profit. Call me cynical. I am.

Yes, increased knowledge and awareness around women’s health across the lifespan is significant progress. Revolutionary even. Yes, there is increased awareness of, advocacy and research on endometriosis, adenomyosis and PCOS. Yes, we’re talking about and normalising menopause.

And yet, countless women are falling through the gaps of the medical system due to the paucity of gender-specific research and funding. Too much unknown. Inevitably, this leads to misdiagnosis, medical gaslighting, unnecessary suffering and even death. Sound extreme? It’s not.

There is a macro level issue here: namely, medical misogyny.

In the UK, less than 3 per cent overall medical research funding is focused on woman-specific conditions and diseases (Public Health England, 2020). Furthermore, the British Medical Journal has identified the “ongoing problem of failing to incorporate gender-related data into evidence-based medicine” (BMJ, 2023). 

I don't need to tell you that the genders they are referring to are women, those who identify as women and the LGBTQI+ community.

To put it simply, this deeply entrenched and gendered research disparity is a human rights issue.

The gender data gap can and does have tragic implications. For example, the transformative work of Professor Jayashri Kulkarni (2023) highlights that the lack of research and awareness around significant hormonal transitions and the symptoms of menopause- even among doctors - can result in missed or misdiagnoses of psychiatric illnesses among women in this age group. These include major depression and bipolar disorder (BMJ, 2023).

Gaslighting and medical misogyny.

I am sick of women being gaslit about their own bodies. Told their pain is normal. Often for decades. It’s not.

Despite 12 surgeries for endometriosis and adenomyosis, having ovaries removed one by one and finally a hysterectomy, I still experience gaslighting by medical professionals. I know I am but one of millions.

Nothing heals the shame and grief of being repetitively doubted and fobbed off by medical professionals for decades. It is a lifelong legacy. Afraid of not being believed. Afraid of the implication ‘it’s in your head’. Afraid you can no longer be ‘the good patient’: smile, pay, walk away. Hide the wild hot rage and shame that accompanies being gaslit. Enough.

Collective anxiety vs individual experience: the paradox of commentary around menopause.

There is an unhelpful paradox here: on one hand, normalising menopause as a natural developmental stage in our lives has the potential to devalue the suffering many women endure. Yet the overwhelming circulation of information and misinformation doesn’t serve us either.

Unveiling the invisibility of women’s health and lifting it into public discourse is inherently positive. Yet there remains considerable anxiety, stigma and uncertainty around every hormonal change across our lifespan: periods, fertility, perimenopause and finally menopause.

One factor is The Unknown. There is so much ‘unknown’ around women’s health. This gendered knowledge gap is political. Clearly there would be less unknown – and therefore less suffering- if woman centred research and treatment was equally funded. Inevitably, the data gap is filled with anecdotes, contradictory opinions and misinformation. The sheer volume of information accessible to us via all forms of media can lead to overwhelm and collective anxiety.

What should be emphasised is that the experience of menopause, like all developmental transitions, is deeply individual.

Although menopause is a universal experience for women, it is not a unilateral one.

Albeit not ‘the norm’, I underwent surgical menopause at 42. Frankly, the potential symptoms of menopause were preferable to decades of pain and PMDD. And yes, I feared what menopause would look like and what would happen. In fact, not much did happen (apart from being permanently infertile, of course).

The reality is that it’s difficult to delineate between the ‘expected’ highs and lows of life, and those caused or exacerbated by menopause. All life transitions inevitably bring both grief and opportunities for growth. Such is life for all of us- at every stage.

Peri or no peri, menopause or no menopause, life in our 40s and 50s is a time of reflection: what we haven't done, where we’re at and what we want. You may have grief around ageing parents, disillusionment at work or missed opportunities in life. All these small and great griefs exist alongside menopause. They are not necessarily caused by it.

I’m still single at 43. There is deep grief in that. And dating as a menopausal woman certainly has its moments- one of these being the occasional cringey conversation about the HRT stickers on my butt cheek. But that’s small stuff.

Image: Supplied

And yes, the reality of infertility at menopause is confronting. 

There is deep grief in this for many women. The sadness can be dagger-like. At times it’s viscerally painful to look at peachy skinned babies (and the snotty ones) at kinder pickup. However, perhaps I would have felt this way even if I was still fertile. Whether we want children or not, fertility has an end point for us all.

The reality is that this stage of life is simply full on, regardless of menopause. And the experience of menopause is intrinsically individual. 

For example, I haven’t had many hot flushes, yet the dominant imagery around menopause would suggest I’d be a hot, flustered mess.

What your friends experience may be vastly different to you. We just don’t know. I want women to know that menopause is not ‘the end’ for us. In many ways, it is a new era. And for many women, menopause is literally life-saving (for example, cancer survivors).

Contemporary menopause.

Our mothers and grandmothers didn't have access to the plethora of information we do. Many suffered silently and their treatment options, if any, were minimal. Tragically, a widely disseminated and now debunked study on Hormone Replacement Therapy (HRT) frightened millions of women in recent decades, causing them to cease or never utilise this potentially life enhancing treatment.

I’m not a doctor - nor buying into the ‘appearance economy’ – however treatments such as HRT are proven to have both physical and psychological benefits for many women. Having said that, every transition requires adjustment and I've been there. But I experienced far worse hormonal fluctuations for 30 years.

Irrespective of menopause, at this point in my 40s I fear less and want more.

Women’s health and hormones: narratives across the lifespan.

The primal fear of unplanned pregnancy drilled into us as younger women has been usurped. Instead, many women in their 20s and 30s now experience significant fertility anxiety in light of the realisation that we can’t in fact ‘have it all’.

This biological, political and socioeconomic reality creates a kind of contagion effect which places pressure on many women to undergo costly, invasive treatments such as egg freezing (arguably still in its infancy in terms of research).

We’re fortunate to live in an era of significant scientific and reproductive advances. However, treatments such as egg freezing remain a privileged option inaccessible to the majority of women.

Alongside younger women, women in their 40s and 50s are being confronted with a plethora of information and misinformation around peri & menopause. Put simply, the bundling of all women into a unilateral experience of menopause is frightening women.

The common theme here? Across our lifespan, we are told our bodies are unpredictable, messy and risky. And we start to believe it.

An elephant in the room.

I believe there is also an unhelpful menopausal elephant in the room- let’s call her Maggie. Maggie is too often absent from truly honest discussions around peri and menopause.

That is – if we’re deeply honest with ourselves, are many women worried about how peri menopause will affect how we look? We’re told all the time it will. But maybe it won’t.

What about genes, ethnicity, environment and countless other variables? No two of us are the same.

In a world which equates ‘likes’ with attractiveness and appearance as currency (e.g.- social media influencers, the exponential rates of cosmetic procedures), it’s understandable how deeply confronting this is for many women.

Whether you will or won’t experience noticeable positive or negative physical changes as a result of menopause is deeply individual. The relative lack of control we have naturally invokes fear of the unknown.

Listen to No Filter, On this episode, Dr Ginni Mansberg joins Mia to talk about the very unexpected things that start happening to your body as early as your late thirties and can continue for up to a decade. Post continues below.

Again, menopause is not a unilateral experience. You are still you. You and all the unique beauty, mess, uniqueness, challenges and fears travel with you through life. And through menopause.

Equally as there will be challenges walking through this transition, there will also be new doors to fling open- menopause or no menopause. And generally by now we give less f#cks, which can only be a good thing for a generation of women taught to please. Institutionalised to please, in fact. 

Reframing peri and menopause as an era of power, not pause, is our opportunity to redefine ageing. Take up space. Blow back fiercely in the face of gaslighting. Ask questions. Demand answers. As the cliche goes, you've got this. Believe it.

Feature Image: Supplied

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