What Even is the Menopause Anyway?

It’s high time we started talking about it, says author Vicky Allan

The menopause. It’s a word frequently avoided, whispered, euphemised. Taboo clings to it. And the result is that many of us, including some doctors, don’t understand it that well. For many women, it comes as a sudden shock, arriving unexpectedly, even when it hits in the normal age range of 45-55. Certainly, when it thundered its way into my life in my midforties, I was thrown – surely I was too young? My brother had just died and I was consumed by grief: perhaps this was shock causing a blip in my periods which would surely come back? But then the other symptoms started to arrive, and, in a nutshell, they were more than just hot flushes. I am not alone in having felt that way. The book I co-authored with Kaye

Adams, Still Hot!, is filled with stories not just from women, but also nonbinary people, who repeat again and again, that they felt that no one had prepared them for this, no one had educated them. Though we were taught about our first change, puberty, by our parents and our schools; the menopause, “the change” at the other end, has been clouded by silence. Even though there is a rising wave of people now talking about it - documentaries like Davina McCall’s recent, or Kirsty Wark’s pioneering The Menopause And Me - and the menopause has been added to the curriculum in England (though not yet here in Scotland), there’s still a feeling that the topic remains vaguely taboo. The menopause is defined as that time in your life when your periods have been stopped for a year. But when you’re discussing it, you can’t not talk about the perimenopause: the phase leading up to the stoppage, when your hormones have gone haywire and often your periods are all over the place. That phase alone can be as long as ten years. The symptoms of both menopause and perimenopause are mostly similar, though the only one that gets much profile is the hot flush. Louise Minchin told us she liked to play menopause bingo with her friends – perhaps you’d like a try. I certainly have ticked off a few myself: joint pain, disrupted sleep, itchy skin, gum problems, dizzy spells, decreased libido, anxiety. What’s causing all this is that key hormones, oestrogen and progesterone, and also testosterone, which have kept so many of your bodily systems in balance, are either fluctuating or falling off a cliff.

The stories that have hit me most are the ones that touch on some of the biggest taboos, and among these are sex post-menopause and the vagina. It was almost a relief to hear sex expert Tracey Cox’s admission that even she, highly sexed as she once was, has felt her libido drop through the floor.

Jane Lewis, a former horse rider, told us how the pain of vaginal atrophy left her so low she felt suicidal. “The burning,” she said, “was like sitting on a bonfire andif you bent over you felt like you were going to split open.” Vaginal atrophy is believed to affect at least 70 per cent, or perhaps more, of menopausal women.

During perimenopause and menopause, your body attempts to adjust to these changed hormone levels. There are ways of handling these changes, and one of them is HRT, once disparaged following research linking it to cancer, which has since been found to have been over-hyped. Increasingly, experts are advocating that on balance, the health benefits outweigh the risks.

But there are also other things you can do to help yourself through this phase: weight-bearing exercise to keep up your bone density, and avoidance of caffeine, sugar and alcohol. One of the things I most wish I’d known at the start of my own menopause was that stress makes it so much harder for your body to adjust to shifting reproductive hormone levels. Lowering stress levels is, of course, easier said than done – especially given the menopause comes for many of us at a time in life when we have a lot going on.

Many women are reaching the peaks of their careers, perhaps they have teenage children, perhaps they are grieving an empty nest, they may have elderly parents to look after. Divorce, bereavement, the grief of childlessness – all these things have an impact on how we experience it. But we need the conversation that celebrates women at this time in life, because many are doing extraordinary things, and going on life-changing journeys as their oestrogen fades away and fertility ends.

I like to think of the menopause as a transition, certainly it is for many women a time in their lives of reckoning. One of my favourite chats was with author Sharon Blackie, who spoke of women developing what she called “hagitude” at this time of life. “Menopause,” she observed, “is about going inside. It’s really about taking the time to go inside and figure out what on earth this is all for.”

The menopause isn’t easy – for some of us it is excruciatingly hard and can seem relentless – but it’s not the end. It has the potential to be the beginning of a rewarding new phase. It can be the opportunity to find a new you.

WE NEED THE CONVERSATION THAT CELEBRATES WOMEN AT THIS TIME IN LIFE, BECAUSE MANY ARE DOING EXTRAORDINARY THINGS AND GOING ON LIFE-CHANGING JOURNEYS AS THEIR OESTROGEN FADES AWAY AND FERTILITY ENDS”

HOW MANY SYMPTOMS DO YOU HAVE?

1. Hot flushes 2. Night sweats 3. Irregular periods 4. Mood swings 5. Vaginal dryness 6. Decreased libido 7. Headaches 8. Breast soreness 9. Burning mouth 10. Joint pain 11. Digestive problems 12. Electric shocks 13. Muscle tension 14. Gum problems 15. Tingling extremities 16. Itchy skin 17. Fatigue 18. Anxiety 19. Disrupted sleep 20. Hair loss 21. Memory lapses 22. Difficulty concentrating 23. Weight gain 24. Dizzy spells 25. Bloating 26. Stress incontinence 27. Brittle nails 28. Allergies 29. Irregular heartbeat 30. Body odour 31. Irritability 32. Depression 33. Panic disorder 34. Osteoporosis

Still Hot! 42 Brilliantly Honest Menopause Stories by Vicky Allan and Kaye Adams is out now, published by Black and White, £9.99