Menopause is the cessation of the menstruation cycle and the end of the reproductive years for people with uteruses. It affects anyone with female sexual organs, including transgender men and gender-nonconforming people who have chosen not to get certain hormone therapies or gender-affirming surgeries. Specifically, menopause occurs about 12 months after one’s last period. The process towards menopause, often known as perimenopause or the menopause transition, can last several years and be highly disruptive, as egg-producing sacs in the ovaries plummet and oestrogen levels in the body drop. Symptoms usually begin in the mid to late 40s and can include hot flashes, insomnia, depression, dry skin, a decline in bone health, pain during sex, and erratic menstrual bleeding. As with all health issues, these symptoms and stages vary greatly among those who menstruate.
Women’s health research has historically been underfunded and menopause is no exception. This has caused much confusion and uncertainty (and sometimes, dismissal) by not only those going through menopause but also the health professionals treating them, including gynaecologists. Even the studies that have taken place have often used a limited sample group and/or have not been inclusive of women and individuals of different backgrounds. In addition, findings from these studies have sometimes been conveyed unclearly, leading to misinterpretation, misinformation, and fear. As a result, many menopausal patients who could have and can benefit greatly from effective drug or hormonal therapies declined them or were advised against such treatments by their doctors.
Menopause, like menstruation, has long been a taboo topic – discussed privately among women, but rarely in public. Even though women comprise 50% of the world’s population, patriarchal systems run predominantly by cisgender men have traditionally not permitted any acknowledgement of this significant period of one’s life (no pun intended), even as women increasingly enter the workforce. Much like the way they must conceal their tampons and pads in the workplace while menstruating, people experiencing menopausal systems often have to hide their symptoms, even when they are painfully debilitating.
A recent study published by the Mayo Clinic estimated that menopause costs $1.8 million in lost working time per year due to missed work or cutting back hours. Some faced symptoms that were so draining that they left the workforce completely, by resigning or being laid off. While there have been some legal actions in the United Kingdom that have ruled menopause as a qualifying disability to be protected against unfair treatment in the workplace, some opponents argue that this will only increase the stigma or perception that menopause is an abnormal occurrence.
Menopause, like many health issues, has socio-economic dimensions that disproportionately impact those who do not have access to affordable healthcare and/or the time to navigate complex medical systems. In the United States for example, treatments for menopause systems may result in prohibitively expensive out of pocket costs, particularly if one is uninsured. The recent Mayo Study on menopause also found that $25 billion in medical costs can be attributed to menopause. In addition to often having to work outside of the home, many of these people are also managing caregiving responsibilities for children, grandchildren, and/or ageing parents during this time.
The taboo around menstruation and menopause is universal – cutting across continents, cultures, races, and ethnicities. However, menopause is having a moment, driven largely by ageing Baby Boomers and Generation Xers. Known as the menopause “Gold Rush”, investors, including celebrities like Gwyneth Paltrow (founder of lifestyle brand GOOP) , are pouring money into telehealth services and nutritional supplements focused on women experiencing menopause. Most of these products are being marketed towards those who have a high disposable income – that is, those who tend to be wealthy and white.
If this trend of investment continues, menopause, which has existed for at least 40 million years in our primate ancestors, could potentially get the much-needed attention it needs. While this could be the essential turning point that could finally bring menopause out of the darkness, drive more research into menopause and women’s reproductive health issues, and support for people who are experiencing menopausal symptoms, there is a long way to go.
In order to truly impact those who experience menopause, research and support will have to be inclusive of class, race, ethnicity, sexuality, and gender. Resources will need to be language specific and culturally appropriate, meaning they are accessible for and tailored to diverse groups of people experiencing menopause. And it will need to be driven by a belief that people experiencing menopause are human beings, not commodities that pharmaceutical, managed healthcare plans, and beauty companies can exploit.