This very clever skit on perimenopause popped in on one of my social media pages recently, shared by a friend who has been through it all and come out the other end. I admit that it is very funny and very cleverly done. It manages to gather most of the effects of perimenopause into one song.
But although I was sniggering along with it, part of me was thinking, this is actually so wrong on so many levels. It’s the ultimate female sell out to a way of thinking that equates perimenopause with the beginning of the end.
The discussion around menopause is firmly out in the open today, thank goodness. It’s not a discussion everyone finds comfortable. The young male waiter serving our table when I was out with a group of female friends not long ago was clearly uncomfortable with the snippets of conversation he was overhearing. Especially when one of my friends clocked that and said to him “be gentle on your Mum, she’s going through this too!”. My friend Sara goes out of her way to bring up the subject when there are men in the room on the basis that she thinks they need to know. But it seems to me that there are two issues that need addressing in the mainstream conversation.
Firstly, the approach that menopause is a ‘condition’ to be ‘cured’. I have my own feelings around the word ‘cure’, which I think is one of the most misused words in the English language (but that’s for another blog post). What I’ll stick to here is the fact that menopause is not a ‘condition’ to be ‘cured’ at all. I expand on this in a minute.
Secondly, the fact that because menopause marks the point in life when a women ceases being fertile, and therefore in western culture is no longer ‘youthful’ and ‘attractive’, there is an unexpressed desire to prevent it from happening. Or at least to pretend it hasn’t happened. Maybe even turn back time as far as possible, with lasers, toxin injections, GLP-1 jabs even if the clinical criteria are not met, extreme diets, and whatever else is the thing of the minute on social media.
If that’s your thing, then that’s entirely up to you, but I have a question for you: when and how do you say enough is enough? For myself, I’ve chosen Helen Mirren as my role model for the future, not Cher.
So to return to the medicalisation of menopause, let’s have a quick look at what menopause actually is.
A condition to be cured?
Menopause itself is defined as the moment at which a woman’s menses ceased. That is to say the last moment of the last day of her last ever menstrual cycle. This can only be identified retrospectively. There is no test that can actually pinpoint this moment when it happens. Generally, if you haven’t menstruated for 12 months, then you are deemed to have passed menopause. However, because the female body is not a machine, and things can still be going on that you are not aware of, it’s recommended to continue using contraception for another five years after menopause.
And no, that’s not just a myth. A friend of my Dad’s was 25 years younger than his youngest sibling from the same parents, and described this age disparity of pretty much a whole generation as ‘my parents discovered the hard way they could still have children!’.
My own experience is that I can go three or four months without menstruating and then I get another period. It’s annoying, especially when you get out the habit of being prepared with period paraphernalia in your handbag at all times.
Emotionally, the momentous physical upheaval of menopause coincides with significant external changes in life. This has corresponded, for me at least, with teenagers going through exams, and then one leaving for university. Waiting for the results can be even more stressful than the exams themselves.
When life changes such as empty nesting or ill health or relationship challenges or changing needs of elderly parents land at the same life stage, I can see that for many women understanding who they are compounds the physical symptoms. Seeking to put the brakes on and remain in a state that is familiar if not entirely comfortable becomes a way of hanging on in there.
The hormonal cycle
The reason for the unpredictability of the moment of menopause is the way female hormones work. Through the fertile years, a woman’s body produces a number of hormones in a cyclical manner. I’ll focus on oestrogen and progesterone here. Once she gets to her fourth to fifth decade of life, things start getting ready to slow down. This is not a linear decrease in hormone production over a number of decades.
At first, progesterone goes AWOL every now and then. Not every month at first, but it becomes more frequent. Progesterone’s role is to check oestrogen production and prepare the womb to receive a fertilised egg. After a while, with nothing to inhibit it, oestrogen goes wild. This is when you start to notice that your body is behaving differently. And when all the things the ladies in the youtube video are singing about start to creep in. Add stress into the mix, and that is like the touch paper to an bomb, which then detonates in a fiery mess.
There is no doubt that because oestrogen plays such a wide range of roles within the body that it’s decline can create chaos. There are oestrogren receptors in our bones, muscle, nervous system and pretty much every endocrine organ in the body. This is why excess or insufficiency of this one hormone has such a many and varied impact. But I don’t think that replacing it forever with a bio-identical synthetic substitute is a viable way to go.
This is the point at which western medicine jumps in. I’m not saying HRT is bad per se. It can help women with horrendous symptoms manage them by damping the effect of wildly fluctuating hormone levels. Some women can take if for years with no problem whatsoever. Some women can’t take it at all. For example cancer survivors who take certain drugs long term can’t take oestrogen because it’s counter indicated. For some women, the ‘cure’ produces unwanted symptoms – migraine being a common one.
How about a reframe?
So I doubled back down into my nutrition and coaching training to manage my menopause transition a different way. I have realised several things:
- Reframing my expectations has been extremely powerful. My standing joke is that my body might be 55, but in my head I’m 35. Trying to remain my 35 year old self is a hiding to nothing because my body is different. And so is my mind.
- Changing my mindset has made doing things differently more accessible.
- Aiming for balance in all things – food, movement, sleep, emotional space – has left me feeling healthier both physically and emotionally.
- ‘Cure’ is a very misleading word – managing and supporting make much more sense and are achievable.
Through my Qi Gong practice, which I started as a means of stress management but which has come to be something much more all-encompassing, I discovered recently that in Chinese medicine, perimenopause is not considered to be a condition in its own right. Instead it is thought of as a series of imbalances in energies affecting different organs. The period of perimenopause is seen as the winter – a time of incubation or gestation if you like – before the arrival of the spring of menopause itself, which is used to describe a new stage of life beyond motherhood. During that winter time of darkness and challenge, the body recalibrates and then there is a concept of a new woman bursting forth into her second spring or the beginning of a new phase of life.
Achieving balance through the different energy systems leads to a harmonious emergence into a new season of life as a? What? There is no real archetypal role model for this in western culture. In the Chinese world view, the archetype is the Elder, whose role and wisdom are valued. This is much more powerful in a concept in a society that traditionally places where elders have an important role, but that is a discussion for another day.
I find this approach both refreshing and exciting. My own description of menopause as a liminal time between one thing and the next (see my essay here) aligns with this concept. In fact, comparing perimenopause to a gestation period is a uniquely feminine comparison.
What comes after?
How much alters if we think of “the Change” as a period during which our bodies and minds are undergoing seismic changes, but from which we will emerge as strong, confident women standing in our own power? I have really struggled to find a positive archetypal role model for older women in western culture.
I’ve also used my own experience to inform my work with my clients. Using the body’s natural rhythms – circadian, menstrual – and the rhythms of the natural world – lunar, seasons – makes achieving an overall balance almost inevitable.
As well as working with clients one a one-to-one basis, I have woven these principles into a group programme, called Rooted, Resilient and Radiant, which allows me to work with more women, and adds an element of community, which in my experience makes the journey more enjoyable, and provides extra support through challenging times.
Rooted, Resilient and Radiant
You can find out more by clicking the link above, or book a complimentary call with me here. If you’d like to find out more, join my zoom call on Wednesday 19th November at 7pm, register here.