The menopause is not an illness – and it certainly doesn’t need an expensive ‘cure’
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I sat in a waiting room the other day with that awful poster on the wall. It reads: ‘Real women don’t have hot flushes; they have power surges’.
Who and what is this for? Obviously, I am not a real woman, as I have never had a hot flush in my life, even though I have been through the menopause. Having seen friends start sweating and fanning themselves like maniacs, I envy no-one the experience and it certainly does need some sort of optimistic sheen put over it. Indeed, a new drug, Veoza, which is said to alleviate these night sweats, has been approved by the UK medicines regulator and is to be reviewed by Nice.
Some women do have dreadful menopausal symptoms and are debilitated by them. Some don’t. We are all different, which appears to be a constant surprise for the world of medicine, but there you are. The one thing that can be agreed on is, I suppose, that we are a mess, clearly deficient in something and in need of intervention. From menstruation to childbirth to menopause, the female body is a moving feast. Or, as the youth like to say, it’s “problematic”. What is problematic needs fixing, and fixing costs money.
Forewarned is forearmed and when my doctor told me I was perimenopausal – I had gone to complain about my insomnia – and that the perimenopause may go on for 10 years, I was flabbergasted. Female trouble indeed. Why had no one told me about this? “Are you having mood swings?’ the dear old doc asked me. No just the one mood. Rage.
So I did what I always do: I went away and read and quizzed everyone I knew and wrote about how little we talk about the menopause and how ill-informed so many of us are. That was in 2015 and it was clear that, if I wanted to write a book about it, I could have cashed in. My friend even came up with a title: Sweaty and Mental. Sweaty and Mental never saw the light of day because – guess what? That stage of life passed and I was out the other side as free as any old bird.
Yet it was clear there was money to be made in them there hummocks, because women do want to be informed. So much guff is spoken about it all and the taboo around menopause is really one around ageing. Because even beautiful, fit, celebrity women – however much they fill their faces and intermittently fast – find that, at some stage, their oestrogen levels have dropped.
For many women, this is a difficult life stage because they may already be frazzled with teenage kids and ageing parents. For some, it is a time of mourning because, if they are not resolved about not having children, their reproductive years are now well and truly over. For some, it is a kind of relief.
George Melly, at 70, on finding himself impotent, described it as, “Wonderful, like being unchained from a lunatic”. I know women who feel exactly like that and long for separate bedrooms, never mind beds, and I know women who feel the very opposite as all the worries about pregnancy have now gone and they feel more confident than ever.
Whatever your situation, you will be told by celebrity books to take HRT, and often the kind only obtainable from private doctors. Again, we need to make informed choices about this. HRT does not work for everyone. I ended up with profuse bleeding, if you really want to know. The scare stories about links to breast cancer are now downplayed and the advantages of helping ward off osteoporosis are real, but both GPs and private doctors need to get the dosage right.
Private clinics often offer compounded bioidentical HRT (made from the yam plant rather than horse urine, from which most HRT is made, and which seems so much nicer somehow) but these drugs are not subject to quality control. They seem better as they are prescribed individually after saliva and blood tests, but the issue is that they may be given at very high doses. Gynaecologists have warned that giving high doses of oestrogen and not using enough progestogen puts women at risk.
Alongside this, many celebs such as Davina McCall sing the praises of testosterone for libido. A friend of mine no longer fancied her husband so managed to get herself a testosterone prescription. “How’s it going?” I asked her. “Great!” she said. “I fancy every single man apart from my husband.”
Most high-profile women who write about the menopause – Mariella Frostrup, Meg Mathews, Davinia Taylor and, of course, Gwyneth Paltrow – are flogging something else as well as HRT. Davinia Taylor, who wrote Hack Your Hormones, has a range of supplements called Willpowders which, she says, help with cognitive function and memory. Meg Mathews, ex-wife of Noel Gallagher and now “a menopause campaigner”, apparently, has a book called The New Hot and her name is on a range of organic and vegan intimate-beauty products designed to make women “feel confident and empowered about their bodies”.
Mariella Frostrup has been vocal about the impact of the menopause on women in the workplace and has partnered with Always Discreet to promote pelvic floor exercises. Davina McCall has her videos and energy supporting drinks to sell. Gwyneth and her brand Goop sell a course of supplements called Madame Ovary. Of course they do!
Am I glad that the menopause is being spoken about more? Obviously. But why is the solution always more stuff to buy? How does this work out for those who cannot go private? Even the “natural” remedies – black cohosh, valerian, devils claw and red clover – will max out your credit card in the health food store.
Menopause care, you see, is a huge market, and start-ups know that. Since 2015 in the US alone, it is estimated $530 million has been invested in companies with backers such as Cameron Diaz and Drew Barrymore. All of this is for “sexual wellness”, biopharma and devices which will help alleviate menopausal symptoms.
Look, I am a “whatever gets you through the night” kinda gal, but all of this somehow misses the point. Perhaps women would not feel so terrible if ageing were not seen as sinful, as something that one must battle only inevitably to lose. Why frighten women into thinking that the menopause is the worst thing ever when it’s a good thing to have made it that far? Menopause is not a disease. It is part of a female body’s wondrous life cycle. Let’s attend to our minds as well as our bodies. Let’s talk about what we want to do for the rest of our lives.
I once met a friend’s 88-year-old aunt at a party. She was still going strong, with a G&T in one hand and a cigarette in the other. I asked her about “the change”. “Honey, I didn’t notice,” she said. “I was too busy living.”
