The menopause used to be ominously referred to as “the change” – an entire life stage relegated to a euphemism. And, although it directly affects half the population, it has remained a stubbornly taboo topic.
Now the shroud of secrecy has finally started to lift. High-profile women are discussing their experiences – or even just acknowledging them. Accepting an award on a freezing night in New York, Emma Thompson joked in her acceptance speech: “It’s such a cold night and it’s the only time I’ve actively been grateful for menopause.”
In the past year, parliament has set aside time to debate NHS menopause services and menopause in the workplace for the first time. Menopause cafes have sprung up around the country and Menopause: The Musical has embarked on a nationwide tour.
At the Guardian, we wanted to help drive this change forward. Our editor-in-chief, Katharine Viner, said: “The menopause affects half the population, but it’s a largely neglected issue, both in the media and when it comes to scientific research. We wanted to interrogate the menopause in more depth, give voice to those who have experienced it and explore suggestions for how to make it more manageable for women, in the workplace and beyond.”
We assembled a small team of reporters from our health, science and investigations desks. We also wanted to hear from readers, and asked them to get in touch to share their experiences. Responses came in thick and fast – several hundred in total.
“Many women told us that they felt there wasn’t enough information or discussion about the menopause and welcomed the Guardian’s reporting on it,” said Caroline Bannock, the Guardian’s communities editor.
Women said that the lack of discussion about the menopause meant that they had been unprepared for the experience. Some initially struggled to figure out what was causing their symptoms until a doctor or family member suggested an explanation that should have been obvious.
“I consider myself a woman of the world and I didn’t know what being perimenopausal was,” Meg Mathews, the former music PR, told us. Since experiencing the menopause, Mathews has become a prominent campaigner on the subject.
There was also frustration about the apparently contradictory advice from experts on hormone replacement therapy (HRT). Gynaecologists have tended to highlight the benefits of HRT, while cancer epidemiologists have pointed to the increased risk of breast cancer. Women have been left trying to figure out how to balance the risks and benefits in their own lives.
Many women who got in touch described a wider range of symptoms besides the typical hot flushes that the menopause brings, such as mood swings, depression, brain fog and forgetfulness. But there seemed to be a lack of clear evidence or advice about how these symptoms should be managed.
There were also positive stories and ones that defied menopausal stereotypes: one woman experienced a sudden libido boost (“I like to think it was my body’s last hurrah”) and embarked on an affair, and another described the “post-menopausal zest” she felt on the other side. Another described how a GP had made her cry with his kindness, saying “I was never dismissed or belittled”, a reminder of how much just being listened to can make a difference.
Sarah Boseley and Hilary Osborne covered an ongoing campaign by MPs for workplace policies to protect women going through the menopause: some argue that legislation is needed to bring about reform in this area. The report also revealed the toll that the menopause can take in the workplace, according to a recent survey in which 94% of those attending a menopause clinic said they felt their work had suffered as a result of their symptoms.
The Labour MP Carolyn Harris argued that the menopause should be put on a footing with the kinds of extra support women get during pregnancy: “I firmly believe there should be legislation to make sure every workplace has a menopause policy, just like they have a maternity policy.”
It became clear that NHS treatment and advice was patchy across the country, with women in some areas getting access to specialist clinics and others simply being recommended HRT. During our reporting, it emerged that even HRT supplies were running out, leaving thousands of women without treatment.
Amelia Hill revealed concerns about some bioidentical HRT products, marketed as being “more natural”, which experts say are unsafe, expensive and could increase the risk of developing cancer. These drugs are unregulated but widely available, with some women buying products through online pharmacies.
While researching the biology of the menopause, it became clear that the neglect of the subject has extended into the types of research being funded. So much of the basic biology of the menopause is yet to be understood. It is not yet possible to predict when it will occur and who will have symptoms and who won’t. Even the role of HRT – whether it delays or masks the menopause – has not been clearly resolved. Progress is being made, though, with the prospect of a new class of drugs on the horizon and trials showing the benefits of cognitive behavioural therapy and exercise to help manage hot flushes.
The response to our coverage has been overwhelmingly positive and reinforced our belief that there are important stories about the menopause that we should continue to pursue. Younger women want to know what to expect. Women going through the menopause want to know the evidence on treatment and to get the right support in the workplace. Breaking the taboos around the menopause is the only way to ensure that society supports women through this life milestone rather than leaving them to deal with it alone.
