Connected as it is with ageing, it is not surprising that the menopause has a bad reputation. Even for women who have generally found their periods to be a nuisance, the cessation of the monthly cycle of egg production often comes as a shock. As well as the psychological impact of what used to euphemistically be called “the change”, the menopause brings with it symptoms for which a lot of women find themselves alarmingly unprepared – as many readers told us when we invited them to share their stories.
These symptoms include the heavy or irregular bleeding that often precedes the cessation of menstruation, hot flushes and night sweats, an increased risk of osteoporosis (brittle bones), disrupted sleep, anxiety, vaginal dryness and reduced sex drive. Given all this, and the fact that millions of women are going through the menopause at any one time (around 1 million women in the UK take hormone replacement therapy, although four in five do not medicate), it is remarkable the extent to which the taboo surrounding the menopause remains untouched. Even as other aspects of female reproductive health have become more widely discussed, the menopause has been stuck on the shelf.
So the efforts of two MPs, Labour’s Carolyn Harris and Conservative Rachel Maclean, to bring forward legislation on menopause policies at work are very welcome. Provisions such as flexible working or sick leave for women with symptoms might sound like common sense. But for many women, the experience of the menopause at work is one of discomfort exacerbated by prejudice. Even those at the highest levels are not immune. Dorothy Byrne, head of news and current affairs at Channel 4, recounted last week how she was once sent home after a meeting in which her (male) manager thought she looked feverish.
But the truth is that even doctors do not fully understand hot flushes, while HRT has never been free of controversy. Marketed in the 1970s as a way to combat the signs of ageing, it was later revealed to raise the risk of breast and ovarian cancers. Broadcaster Dame Jenni Murray, who was treated for breast cancer, was among those to speak out, and the numbers on HRT in the UK fell sharply. More recent guidelines state that, while women must be informed of the risks, the treatment should still be offered – with advocates pointing out that the cancer risk is minimal when compared with factors such as obesity.
New concerns have been added to the old ones, with a shortage of HRT causing difficulties and an alternative treatment known as compounded bioidentical HRT, which is unregulated but widely available, under increased scrutiny following an unprecedented warning from experts. Legal entitlements for menopausal employees would provide reassurance to these women and others, while the menopause activist Meg Mathews is surely right that a storyline in one of the big TV soaps is overdue. Reflecting on her own menopause, the comedian Jennifer Saunders referred to “the indefinable something that you don’t have any more”. But the loss can also feel like a liberation – and would be a far more palatable prospect were women offered the support from employers, and society more broadly, that they deserve.
