Menopause:

It’s called “the change”, but what hasn’t changed – much – is our will­ing­ness to talk openly about it. Ni­cola Russell looks at what holds us back and found three well-known Kiwi women who are happy to share their menopause ex­pe­ri­ences.

Australian Women’s Weekly NZ - - Contents -

three celebri­ties speak frankly about “the change”

Menopause. How com­fort­able are you say­ing the word out loud? To your­self, your part­ner, your work­mates, your friends? If you haven’t been through it, do you know what is to come? If you have, did you dis­cuss it with those around you?

The Aus­tralian Women’s Weekly ap­proached a num­ber of high-pro­file women to talk about menopause for this ar­ti­cle; celebrity cook Allyson Gofton, tele­vi­sion per­son­al­ity Suzanne Paul and busi­ness­woman Theresa Gat­tung agreed to do so – but a num­ber of women de­clined.

This was ini­tially sur­pris­ing. Menopause is, af­ter all, a stage of life all women go through in vary­ing de­grees. Why are we happy to talk about pe­ri­ods, preg­nancy and child­birth but not menopause?

There are some ob­vi­ous rea­sons for want­ing pri­vacy. Talk­ing about menopause means talk­ing about the most in­ti­mate parts of our bod­ies and dis­cussing symp­toms that are not par­tic­u­larly sexy: such as hot flushes (also called hot flashes), night sweats and vagi­nal dry­ness. It also means chat­ting about the un­con­trol­lable, un­de­sir­able emo­tions that can present them­selves dur­ing menopause.

But what I had failed to grasp as a 37-year-old who, un­til now, had thought lit­tle about menopause, is that it also means ac­knowl­edg­ing that you have ma­tured as a woman – and that means ac­cept­ing that you have aged. And in a so­ci­ety where ageism is still rife – where older women are still met with dis­crim­i­na­tion in the work­place and where beauty and sex­u­al­ity is still so of­ten mea­sured by youth­ful ideals

– it is re­gret­table, but un­der­stand­able, that women choose to stay quiet about their ex­pe­ri­ence.

Dur­ing my re­search, I no­ticed menopause re­ferred to at times as the “crone stage”, par­tic­u­larly when as­so­ci­at­ing menopause with a wise stage of life. Look up the dic­tio­nary mean­ing of crone though and you’ll find “with­ered old woman” or “old ewe”. Type “crone” into Google images and you’ll see nu­mer­ous pic­tures of

grey-haired, long-nosed, wrinkly, witch-like char­ac­ters. Hardly a de­sir­able or rel­e­vant im­age in 2017, when it is com­mon for a 50-year-old (the av­er­age age of menopause) to be in the throes of a thriv­ing ca­reer with a busy so­cial life and, with the up­ward trend of older preg­nan­cies, chil­dren who may not have even reached their teenage years.

Theresa, Suzanne and Allyson all have unique ex­pe­ri­ences of menopause, but what they share is a de­sire to lift the taboo on the sub­ject. Theresa, who is 55, says that taboo is di­rectly re­lated to the stigma around age­ing – par­tic­u­larly in the work­place.

She says while ageism is an is­sue for men and women, women get it on two lev­els: per­son­ally, they are ex­pected to look youth­ful, and pro­fes­sion­ally, they are con­cerned about “be­ing put out to pas­ture”.

“It is hard enough to make your way as a woman in the work­force, so you don’t want your age to be held against you as well,” says Theresa.

“Menopause com­pletely draws at­ten­tion to them be­ing in their 50s. They don’t want to do that, just like they prob­a­bly wouldn’t want to talk about their sore knees, if sore knees were a func­tion of 50-year-old women.”

Hot flushes in a busi­ness meet­ing, bouts of un­con­trol­lable rage while try­ing to make the school lunches, or in­som­nia can make life a real chal­lenge – but add to this a gen­er­a­tion of women whose moth­ers rarely ut­tered the word, and it’s no won­der there is a stigma around the… cough, whis­per… “change of life”.

Suzanne had few peo­ple to talk to about her menopause symp­toms be­cause her so­cial group is gen­er­ally younger. “My mother had al­ready died and when she went through it, when I was in my late 20s, they didn’t used to talk about it. You think it is bad now, but it was dread­ful then. It wasn’t even said out loud. Be­cause we weren’t al­lowed to talk about it, I didn’t know what the symp­toms were or how long they would last. So a lack of in­for­ma­tion didn’t help at all.”

Allyson, who had her sec­ond child, Olive-Rose, at 46 and is now 55, was so­cial­is­ing with younger moth­ers when her menopause symp­toms started.

“I’m a good 10-15 years older than them, and it was not some­thing I could talk about be­cause it made me feel old, and the last thing I wanted to tell th­ese young moth­ers was what’s ahead. As a re­sult, it be­came a very per­sonal time of life and it was re­ally lonely.”

Allyson’s mother had died, and she missed the pres­ence of an older woman to guide her through menopause. She thought about buy­ing books on the sub­ject but likened pur­chas­ing the books from a young re­tail as­sis­tant to buy­ing tam­pons as a teenager from a male check­out op­er­a­tor.

Even­tu­ally she turned to her Auck­land-based doc­tor, Sara Weeks, who helped her un­der­stand her symp­toms. “The best thing she did was ex­plain what was go­ing on chem­i­cally in my body. Once it be­gan to make sense I felt a lot bet­ter about it. I found that by talk­ing to her I un­der­stood why I wasn’t cop­ing.”

And if women aren’t talk­ing much among them­selves about menopause, you can bet men are not talk­ing about it at all. “I got more em­pa­thy from my gy­nae­col­o­gist than my hus­band,” says Allyson, who would ring her hus­band’s best friend to come and take him out when she needed breath­ing space dur­ing menopause.

“I have a pretty av­er­age Kiwi male hus­band and by the time he got to 55, the thought that he might have to step out of his com­fort zone be­cause his wife is go­ing through menopause was as alien to him as fly­ing to the bloody moon. And I can’t say that is wrong, it is just the way they have been raised, they think that if they don’t say any­thing, it will go away. Hope­fully, the next gen­er­a­tion will age with a bit more un­der­stand­ing of th­ese changes.”

Suzanne says com­mu­ni­cat­ing with her hus­band about menopause helped her and her mar­riage.

“We are sep­a­rated at the mo­ment but we did get through my menopause be­cause we talked about it. I just would keep say­ing to him, ‘It is noth­ing you have done or said.’ For years women haven’t talked about it so men have no idea why their wives are

sud­denly not the women they mar­ried.

“When you are go­ing, ‘Oh my God, I just flew off the han­dle, shouted at my hus­band and threw a saucepan at his head,’ you just need to say, ‘Sorry about that, I am just hav­ing one of my mo­ments. It’s not your fault, it is just the hor­mones.’

“The ex­pres­sion I would al­ways say to my hus­band, and still say now if I have a bit of a melt­down, is: ‘I’m sorry, it’s me hor­mones, they are all up the swanny at the mo­ment.’”

At a time when many women are used to be­ing in con­trol of their lives, the er­ratic, un­con­trol­lable na­ture of menopause is per­haps more chal­leng­ing than ever. We can, if we wish, dye our hair, use ap­pear­ance medicine or cos­met­ics to re­duce the phys­i­cal ap­pear­ance of age­ing, fil­ter our own pho­tos on so­cial me­dia and even sched­ule a cae­sarean, but when and how menopause presents is ini­tially out of our con­trol.

Menopause spe­cial­ist Dr Anna Fen­ton says menopause can hit much ear­lier than we think, with about a third of women suf­fer­ing per­i­menopause symp­toms in­ter­mit­tently from their mid-30s. “It would of­ten re­quire them talk­ing to some­one to work that out, be­cause it might ap­pear to them like or­di­nary PMS.”

But it is not only younger women who can take a while to twig. It took Suzanne Paul months be­fore she re­alised she was menopausal, be­cause her first hot flushes hit in sum­mer.

“It isn’t as if your pe­ri­ods just stop one day and you think, ‘Oh, this is it then, I’m in the menopause.’ With age, your pe­ri­ods get a bit er­ratic any­way and un­for­tu­nately if the menopause starts in the sum­mer – as it did with me – you just think, ‘Gosh, this is the hottest sum­mer I can re­mem­ber.’”

The Nat­u­ral Glow celebrity re­alised that some­thing was awry when her typ­i­cally sunny mood turned in­creas­ingly dark. “My mood swings were out of con­trol. I have al­ways been re­ally easy­go­ing but I was just fly­ing off the han­dle at any­thing and cry­ing at the drop of a hat. My mother had died around that time so I put a lot of those symp­toms down to grief.

“When I did ac­tu­ally go to the doc­tor, I went be­cause I thought I had a re­ally bad de­pres­sion. I said, ‘I am up and down, I’m hav­ing emo­tional out­bursts and anger and I just feel over­whelmed – it is not like me. I think I have got the de­pres­sion’.”

Allyson also suf­fered night sweats and hot flushes. “Af­ter Olive-Rose was born I im­me­di­ately suf­fered from aw­ful night sweats. Each night I’d line up three to four changes of py­ja­mas on the floor be­side the bed and in be­tween night feeds for a brand new lit­tle girl, I’d fall out of bed and change clothes and fall back to sleep. It went on for over a year.

“It was [be­cause of] tired­ness from this and a slide back­wards into that jolly de­pres­sion that seems to rat­tle me ev­ery so of­ten that I sought help from my doc­tor.”

Dr Fen­ton says it can be hard for women to tease out menopause from what’s go­ing on in their lives. “It is a time in a woman’s life where there can be some ma­jor things go­ing on – the kids may be leav­ing home, their par­ents are get­ting older – so it is an aw­ful col­li­sion of th­ese ma­jor life events.”

She rec­om­mends go­ing to a doc­tor and talk­ing through the symp­toms if you sus­pect it might be the case. “The symp­toms are pretty dis­tinc­tive and there isn’t much else that would cre­ate a sim­i­lar type of pic­ture.”

Once di­ag­nosed, the next step is de­cid­ing on treat­ment. Suzanne was so open about her con­di­tion, she found her­self be­ing bom­barded by rec­om­men­da­tions from friends and clients on nat­u­ral reme­dies to take. In her sig­na­ture fash­ion, she worked with a sci­en­tist and nu­tri­tion­ist to come up with her own sup­ple­ment based on herbs that worked for her.

Allyson was also try­ing a mul­ti­tude of reme­dies. “I would just go into the girls at the chemist and say, ‘What have we got this week?’ It would be re­ally use­ful to have an ac­cu­rate med­i­cal opin­ion on whether those things work and why they work – and some­times

It is a time when there can be an aw­ful col­li­sion of ma­jor life events.”

I think they worked for a short time and some­times I didn’t.”

As Allyson also suf­fered from de­pres­sion, her doc­tor upped her an­tide­pres­sants to help her cope with menopause, which Dr Fen­ton says can pro­duce the same changes in brain chem­i­cals as a clin­i­cal de­pres­sion.

Both Allyson and Suzanne made life­style ad­just­ments. Allyson cut down on caf­feine and al­co­hol, ex­er­cised reg­u­larly and got coun­selling.

Suzanne had a ma­jor diet over­haul – she be­came a pescatar­ian, and sig­nif­i­cantly re­duced wheat, dairy and pro­cessed foods, which caused bloat­ing. “That [bloat­ing] drove me up the wall. I have al­ways been very slim and able to wear nice fit­ted clothes, but all of a sud­den I would eat some­thing and within 10 min­utes my stom­ach had swelled so much I would look like I was eight months preg­nant.”

And she bought fans. Lots of them. “I have a fan that at­taches to my mo­bile phone, I have got one that goes into my com­puter and one at the end of the bed.”

Dr Fen­ton, who is New Zealand’s Im­me­di­ate Past Pres­i­dent of the Aus­tralasian Menopause So­ci­ety, says there is a wide range of treat­ments avail­able for women, but they can be shrouded in mis­in­for­ma­tion.

She says the HRT (Hor­mone Re­place­ment Ther­apy) furore in 2002 was a re­sult of un­ver­i­fied data be­ing re­leased to the me­dia. Once the data was ver­i­fied, it was found that the risks as­so­ci­ated with HRT were largely iso­lated to women over 65 and those tak­ing cer­tain com­bi­na­tions of hor­mones. Within a week, how­ever, 90 per cent of women had stopped tak­ing the treat­ment world­wide. “That is no ex­ag­ger­a­tion. It had a mas­sive ef­fect,” she says.

The stigma re­mains, and HRT has now been re­named MHT (Menopause Hor­mone Treat­ment) in an ef­fort to shift the as­so­ci­a­tions with can­cer.

“We have got a huge range of op­tions that women can use to man­age the symp­toms – from com­ple­men­tary ther­a­pies through to things we can pre­scribe, and so I think one of the key mes­sages is mak­ing women aware that they do have some op­tions, this is not some­thing they just put up with, that they can get some help.”

And she says women are do­ing them­selves a dis­ser­vice by putting up with se­vere symp­toms.

“I think one of the crit­i­cal things that changed our ap­proach in the last year at least is find­ing that women putting up with very se­vere flush­ing and sweat­ing are ac­tu­ally not do­ing their health any great ser­vice, be­cause it turns out the symp­toms are ac­tu­ally mark­ers for risk of de­men­tia and stroke. Stud­ies have shown that se­vere flushes are as­so­ci­ated with small ar­eas of per­ma­nent scar­ring within the brain.”

What helped both Suzanne and Allyson through menopause was talk­ing about it. While Allyson took a more pri­vate route and spoke ex­clu­sively to her doc­tor, Suzanne talked openly about her symp­toms to both men and women.

“I tell you what, I just tell ev­ery­body – if I am hav­ing a hot flash, I don’t care who I am talk­ing to. I just say to them, ‘Oh crikey, I am hav­ing a hot flash, here we go!’ Es­pe­cially in my job when I’m try­ing to sell some­body some­thing, I’d rather just get it out there than have them think­ing, ‘Is there some­thing wrong with her? She has sud­denly gone all red in the face and sweaty.’

“I tell all young women about it, be­cause then they will be bet­ter pre­pared than I was.”

And she kept a sense of hu­mour. “I be­came a stand-up co­me­dian for the year and the ba­sis of my act was menopause, and all the young peo­ple, even the men, thought it was hi­lar­i­ous.”

Theresa was one of the lucky ones, for whom menopause had few symp­toms. “My pe­ri­ods be­came more and more er­ratic and fur­ther apart and then they just stopped. I prob­a­bly had a few weeks of hot flushes and that was it. I had no sleep dis­tur­bances, I felt no dif­fer­ent, I took no sup­ple­ments. I just sailed through it. I know that is not a lot of women’s ex­pe­ri­ence so I think I am re­ally for­tu­nate.”

She’d like menopause to be seen as a cel­e­bra­tion of a new phase. “Fifty is so young – they just elected a 70-year-old pres­i­dent of the US! Fifty can be the half­way mark, so cel­e­brat­ing it and gen­er­ally get­ting over our so­ci­etal is­sues about ageism would hugely help.

“In tra­di­tional so­ci­ety, menopause is the new stage of women be­ing hon­oured for their wis­dom and the knowl­edge gained in the pre­vi­ous decades, so it shouldn’t be a fear­ful thing. It should be a cel­e­bra­tion of the next stage of life. It has a lot of up­sides – sex with­out wor­ry­ing about get­ting preg­nant, not wor­ry­ing about tam­pons and san­i­tary prod­ucts… it’s fan­tas­tic!”

Allyson agrees: “I don’t have to care about pe­ri­ods any more – love that!”

Suzanne is look­ing to women like Jane Fonda for in­spi­ra­tion. “I read a few of her books and she was all about look­ing at it in a dif­fer­ent way – that life was more like a cir­cle, not an in­cline where you went up and up and then dropped off, which is how women used to look at it.”

She is try­ing to lead by ex­am­ple. “I have just gone 60 and I am still me, I am still vi­brant and tak­ing on new chal­lenges and liv­ing an ex­cit­ing life.

“I like the con­fi­dence that you get with be­ing this age – you don’t put up with the non­sense that you used to and you know what you want from life. Rather than think­ing it is all over I am more like, ‘Oh my God, I don’t think I have much time left – I bet­ter get all th­ese things done!’ For in­stance, in

June I am es­cort­ing a cy­cling tour around Cam­bo­dia. I am train­ing for it now. I think it is im­por­tant that young girls see that life is not all about just hav­ing a nice fig­ure and tight skin.”

It should be a cel­e­bra­tion of the next stage of life. It has a lot of up­sides… it’s fan­tas­tic!

ABOVE FROM TOP: Suzanne Paul, Allyson Gofton and Theresa Gat­tung all be­lieve the stigma of menopause and its as­so­ci­a­tion with age­ing needs to be lifted.

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