BREAKING THE M WORD TABOO How the conversation has changed about menopause
It’s something all women go through and thankfully the menopause is finally having a rebrand. Saska Graville examines the change in attitude
One of the many reasons it’s glorious to be a midlife woman right now is that we don’t have to put up with comedian Les Dawson’s 1970s take on the menopause. Dressed in drag with curlers in his hair, sagging bosoms and wrinkly tights, Dawson mouthed the words ‘the change’ as if it were a deep, dark secret not to be said out loud. Cue audience sniggering and a consensus that the menopause was the domain of tragicomic old ladies.
Fast forward to 2019 and we have a glowing Gwyneth Paltrow discussing her hormonal swings, sweats and moods. If ever there were a poster girl for the rebranding of what perimenopausal and menopausal women look like, Paltrow is surely it.
The actor and Goop founder is just one of several high-profile women who are changing the conversation around what has been, for far too long, a health taboo. Every single woman will experience the menopause and yet, until very recently, it has been a shorthand for ‘old’ and ‘past it’. This time of life has been something to be dreaded, endured and mocked – and certainly not discussed openly.
So with Paltrow, along with the likes of beauty entrepreneur Liz Earle and TV presenter Louise Minchin (who revealed recently the temperature has been lowered in the BBC Breakfast studio because of her hot flushes), raising the volume of menopause conversation, has the taboo
around the subject been well and truly broken? The honest answer is: not quite yet.
‘The conversation has started, but we have a long way to go,’ says Diane Danzebrink, founder of Menopause Support, who’s been a relentless campaigner for awareness and education after her own experience.
In 2012, a total hysterectomy at the age of 45 put Danzebrink straight into surgical menopause. Discharged without any information on the hormonal implications of her surgery and with a fear of HRT based on what she had heard about her mother’s experience 25 years earlier, Diane’s mental health deteriorated ‘into a very dark place’.
She eventually sought medical help. Prescribed (and educated about the benefits of) modern HRT by a doctor who identified oestrogen deficiency as the cause of Danzebrink’s anguish, she vowed to ensure that other women were menopause savvy in a way that she hadn’t been. ‘I’m incredulous that, in 2019, menopause isn’t taught in schools, GPS don’t get mandatory education and we don’t have any guidance in the workplace,’ says Diane.
Her campaigning at Westminster has helped drive a change in the curriculum requiring that the menopause will be taught in schools from 2020. It’s long overdue; I wish that I had been one of the schoolchildren (boys will be taught about it, too) to benefit from the education changes that Diane has helped to bring about.
My own understanding of the menopause began and ended with hot flushes. No one talked about the other symptoms that many of us will face. When severe anxiety and
brain fog struck me in my late 40s, I put them down to the pressures of a career change and new job. How wrong I was. I endured 12 months of stress – and lots of sobbing – before a blood test finally revealed I was perimenopausal, in the stage before the menopause. Had I known that my sudden loss of confidence and seeming inability to retain any facts or information were absolutely classic symptoms, I could have saved myself (and my partner) a lot of drama.
STORIES SHARED
Now I am trying to do something to bust the taboos around menopause and make women more able to deal with their symptoms and get on with their lives. I founded Mpowered Women last May, creating a community of doctors, wellbeing experts and brilliant women to power all of us through these years.
One of Mpowered’s goals is to promote menopause as a mainstream conversation, asking high-profile women to share their experiences. Easier said than done. ‘She’s not comfortable talking about that,’ is the response I’ve had from several celebrity agents.
This makes me admire all the more the women who have talked openly to us, chipping away at that taboo with their honesty. Designer Kelly Hoppen describes her ‘overheating and anxiety’, actor Patsy Kensit talks of ‘seriously losing my mind’ and TV presenter Trisha Goddard discusses her ‘dreadful chafing on my cross-country runs, thanks to vaginal dryness’ (God love Trisha, that is probably the biggest taboo of all).
The story that resonated the most with me was from chef Skye Gyngell. In an extraordinarily candid interview, she revealed for the first time that she had left both her marriage and her job because of ‘menopause insanity’. Skye walked away from the restaurant at Michelin-starred Petersham Nurseries in Richmond, Surrey, where she had been head chef. ‘I left the house that I’d lived in for 15 years, the man that I’d had a young child with, the job that I loved and had made my name at,’ she told me. ‘I had about enough money to pay the mortgage for three months. I literally jumped off the precipice without wings. It was menopause insanity, but I only see that in retrospect.’
TIME FOR CHANGE
To leave both your relationship and your job as a result of undiagnosed menopause symptoms may sound extreme, but it is the sort of story that Dr Louise Newson hears every day. She founded the Newson Health Menopause & Wellbeing Centre in Stratford-upon-avon, a private clinic that is often a last resort for women who have tried, and failed, to get help from their local GPS. ‘Most women are coming because they’re on their knees,’ says Dr Newson, citing wrongly prescribed antidepressants (‘these women aren’t depressed, they’re menopausal’) and a lack of informed GP advice on HRT as common patient experiences.
‘In a recent survey we undertook, 90% of my respondents told me that their menopausal symptoms were having a negative impact on their work,’ says Dr Newson. ‘And about half of respondents had taken time off work.’ Tellingly, only a tiny minority of those taking time off were prepared to declare menopausal symptoms as the cause, and only 14.5% of respondents had received any menopause support from their workplaces. Leaving their jobs is often preferable, Dr Newson discovered, to being honest with their employers.
Her solution? For more companies to adopt in-house menopause education, put practices in place to support their employees and direct them to the right care, ideally by holding in-house menopause clinics run by nurses or doctors with an interest in the menopause. ‘It’s not about simply giving these women a fan to cool down,’ she says, of the assumption in some offices that a blast of cool air will fix the problem.
So while the taboo around the M-word has been broken, we still have a way to go. It’s only when ‘menopause insanity’ is a thing of the past that the work will finally be done.
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Turn to page 118 to read the most up-to-date health advice on the menopause