To say that modern medicine has moved at light speed has never been more true. More and more women are surviving childhood. And now, for some of us, the days of the proverbial “mature woman” could finally be coming to an end. Some older women have experienced the menopause. For many women, this journey is not a particularly abrupt one, but for those who are older it is a challenge. And what is described as the menopause has actually long been misunderstood.
It is a word that has sat there like a polarised construct. Because it is a word about menopause, we frequently feel reluctant to call these periods of mature life “menopause”. The confusion around what exactly is meant by the menopause has encouraged the tendency to categorise these periods in relation to both our menstrual cycles and infertility. Rarely do people think of it in terms of ageing or “decaying” bodies. Thus, the menopause gets labelled not as a biological function but as a disease or condition and one that is more prevalent in older women. It became an “HRT killer” and left many rightly fearing they had to enter a menopause of their own.
Thanks to a range of screening tools, often new and better available to women, we now know that the menopause is not a death sentence. Nor is it the end of life’s journey. It comes with different symptoms and, in some cases, different options of treatment. It can also happen to older women during other life stages: life gives you wrinkles and shakiness. The older you get, the longer you live. For many of us, this is the crux of the issue. For some women, the symptoms that accompany the menopause may feel like incontinence, insomnia, depression, and the loss of libido.
But others – by far the majority of women – experience completely benign symptoms that fade with time, such as sleep problems, anaemia, tiredness, emotional irritability, depression, a sudden burst of activity and even memory problems. This scenario that more often features in women over 50 – hence the “transition” tag – offers something to debate. Was that woman who raised the alarm really wrong to focus on the negative?
Many in the media that give voice to older women find themselves in an impossible position, finding it hard to explain such a wide range of symptoms from the menopause, or to present a clear picture of the options for addressing them. So they do what politicians in politics sometimes do: they use buzzwords. “HRT”, “hysterectomy” and “prostatectomy” are in the headline many times, or they get involved in the confusing and misleading debate around “antidepressants”. This has resulted in the suspicion that all medication used to alleviate symptoms is or may be harmful. Yet this is not the case. While the evidence shows that many people – especially older women – would benefit from taking antidepressants – given appropriate counselling – the reality is that most women will not need that medication.
Nowadays, the modern woman’s life is well “happier”. Yet the transitions from being a young woman to a woman of maturity are all at once more challenging and often more subtle. This is where the word “menopause” becomes a misnomer. Indeed, the reports about the younger women known as the “medically younger” women, the authors of whom have now identified this phenomenon, have raised concerns about misleading advertising around this term. Some argue that the term “menopause” has been and should continue to be used for something different – to highlight and celebrate the transition – in much the same way that we celebrate the American singer, jazz musician and jazz club owner Billie Holiday, or the artist Celia Cruz.
Of course, the transition to menopause can be just as challenging. The end of this life stage can be hard and scary. But we need not refer to it as anything more than that. “Menopause” is not needed. And it is important that it is not used as a term of fear, as the media, and politicians, sometimes seem to do.