Ask any woman about menopause and you’ll likely hear a version of, “No one talks about menopause! I didn’t know what to expect.”
That’s why Good Housekeeping decided to crack open a figurative bottle of wine, convene an online sit-down and get the conversation going — and we’re so glad we did. What we learned from our nearly 1,500 respondents (59% of whom were post-menopausal) was interesting, eye-opening and, sometimes heartening.
Here’s what we found.
The stigma may be lifting.
For all the “no one talks about menopause” complaints, the topic may finally be starting to shed its shame-covered and frankly depressing aura. When asked which of three definitions of menopause was the correct one, three quarters of women ages 18-25 got it right — that menopause is the point at which you go one full year without a period. Compare that to only one third of women aged 75 and up — most got it wrong, despite the fact that they’ve been there and back.
“Historically, there has been stigma around speaking openly about menopause in the media and incorporating menopause into sexual health education, where the focus is mostly around reproduction/fertility,” says Leah Millheiser, M.D., an OB/GYN specializing in menopause and sexual health at Stanford Medicine. “So it is not surprising that the women in the older age group had the responses that they did. We have gotten better about educating the public over the past decade, but we still have a long way to go when it comes to normalizing the conversation around menopause.”
There are some clear, helpful books about menopause available, and if you don’t know something, or are taken by surprise by some random symptom, ask! If your OB/GYN doesn’t have in-depth knowledge (and many don’t), visit the North American Menopause Society’s website for the facts and to find a specialist. Friends and older relatives can also provide tips and tricks for dealing with any challenges, or just remind you that you will survive. Lastly, there are at least a half-dozen menopause startups, including Evernow, Midi and Alloy, that aim to educate, connect and in some cases, provide symptom solutions or targeted skincare. “I’m so glad it’s becoming more at the forefront of conversation,” said one respondent. “My mom’s generation never really talked about it, just suffered silently.”
But there’s still an info gap.
Menopause has a messaging problem:
- Only 54% of all respondents correctly IDed the definition of menopause, even though (if you are a person with a uterus and lucky to live long enough) you are guaranteed to experience it.
- A quarter thought it was when your periods became irregular, and 16% thought it was when you start to show symptoms, such as hot flashes.
- A fifth of those between 26 and 35 said they honestly didn’t know what menopause was, exactly!
“There seems to be a void of information about normal aging of the female body,” one woman noted. “Our culture is so focused on beauty and remaking ourselves it is hard to know what is just normal and what to expect.”
If you have bothersome symptoms, they likely started to show up during perimenopause, the years-long period leading up to menopause, which is also when your cycle becomes wonky. The period after that one-year-no-flow milestone is called post-menopause.
Women expect menopause and perimenopause to be worse than they are.
Only 20% of women who have been through perimenopause and 14% of post-menopausal women say that these transitions were worse than they had expected. Everyone else felt that these experiences were either not as bad as they thought they’d be, or just as they expected.
This makes sense: There’s a wide range of symptom experiences (some respondents said they struggle mightily with things like brain fog and vaginal dryness) while others find them manageable. “There is certainly heterogeneity when it comes to the experience of menopausal symptoms in women,” says Dr. Millheiser, who is also the chief medical officer of Evernow. A lot of women — some 60 to 80% — have vasomotor symptoms like hot flashes and night sweats, says Dr. Millheiser, but for some they’re not too severe.
And then there’s how much they bother you: “Women have different approaches when it comes to addressing menopausal symptoms. While some choose to ‘tough it out’ even if those symptoms are severe, others choose to seek treatment at the first sign of a hot flush, even when the symptoms are mild. It really comes down to how these symptoms impact quality of life. There is no need to suffer with the symptoms of menopause as there are both effective hormonal and nonhormonal treatments.”
There are downright good things about menopause.
The best thing, according to our readers whose periods had started to taper off or stop altogether? 70% said that not having to deal with a potential bloody mess every month and the feminine hygiene cornucopia (pads, tampons, period panties, menstrual cups) that we’re tied to for decades (15% were psyched not to have worry-and-pregnancy-free sex and 12% were thrilled to no longer have cramps). “It’s a beautiful time in our lives,” one reader said. “Give yourself a break, rest more and become more introspective of your own life.” Another survey-taker told us, “Life is somehow more liberating after menopause.”
But there are some truly crap things about menopause.
Some women talked about menopause symptoms like difficulty sleeping, depression and anxiety, exhaustion and hot flashes that lasted for years and were a blow to their bodies and minds. There were some less common symptoms, like skin itching and hair loss, but the one they wished was addressed more: vaginal changes, including dryness that may make sex uncomfortable. “I never expected to experience the alternating depression/anxiety and total loss of libido,” said one woman. Other women had gone through menopause early or because of medical issues, which left them grappling with bigger life and family issues.
Menopause, while not an illness itself, can be a challenge. Loss of libido around menopause and perimenopause, for example, is normal, if not universal, as hormone fluctuations can have an effect. “My marriage is committed and strong but my husband really struggles with my having no interest in being touched sexually. I am actually OK without it, but he’s not, and I think he feels I should try more to ‘fix’ it,’” one woman confided.
While there may be a sex-drive mismatch, says Dr. Millheiser, it’s not on you to “fix,” she says. “It is normal for a woman’s libido to decrease during the menopause transition and beyond. This is related to multiple factors: declining testosterone levels, pain during intercourse caused by vaginal atrophy (due to low estrogen levels), changes in relationship, a partner’s sexual dysfunction, body image issues related to weight gain or fat redistribution to the abdominal area and life stressors,” says Dr. Millheiser. And while older men may have erectile problems, they’re less likely to have a lower libido. “This is an issue affecting the couple and all factors that contribute to her lowered libido should be addressed,” she says. Start with an honest talk, and if relieving your stressors as a couple doesn’t help, talk to your doctor about whether it’s truly a hormonal problem that can be treated. Hormone therapy can help, as can topical estrogen to help ease vaginal symptoms.
Romantic partners are a mixed bag.
Of the respondents who are paired up, 47% said their partner was “very supportive.” “When I get irritable he reminds me that we are a team and there is no need to take it out on him and I am getting better at that,” said one. Only 5% reported their partner being more distant or negative. The rest were clueless about what to say, just plain hadn’t noticed, or something else. “It depends on how I am feeling or my mood — he will either be supportive or distant. Maybe he’s going through male menopause, lol.”
As with all things in relationships, it’s complicated, and if you’ve been together awhile, you know better than us how to get what you need from your person. Pass your partner this pro tip from Dr. Millheiser: “The best approach is for a partner to just listen,” she says. Someone going through menopause or perimenopause “doesn’t necessarily need a solution from her partner, just empathy,” she says. One reader counsels honesty. “I would also tell women not to be afraid or embarrassed to tell your partner you need lubrication for sex now. A good partner will be supportive (and still eager to have sex with you).” That is, if you want to.
Either way, let yourself adjust to how you’re feeling, and push back against any sexist or agist “humor” that comes your way at home or in the workplace. “This is a time for women to unite and band together! Don’t let the men in your life make fun, ignore or tease you about what is happening to you. We can joke about it, but it is a real thing and it can be years of symptoms,” said one.
You may have fewer effs to give.
Whether its menopause itself or just spending lots of time on this planet and seeing all manner of nonsense, a significant chunk of our readers said they had learned to incorporate some amount of “This sounds like a YOU problem, not a ME problem,” in their daily lives. 33% reported running out of patience for things they used to tolerate, while 27% said they were often more “blunt” and less “nice.” (9% admitted to fantasizing about running away!) Overall, hot flushes, brain fog and exhaustion were the three most cited changes.
Most women do not see menopausal women as “old.”
We offered a list of adjectives to describe a person in menopause, including positive descriptors (liberated, wise) and ones that some people might think are negative (hot-tempered, impatient). Interestingly, just 35% said they saw menopausal women as “old,” but they felt that almost 80% of other people would perceive a person in menopause as old. “Women should NOT be discounted as old or invisible just because we are in this season of our lives!” said one.
Can we talk about the word “old” for a sec? Yeah, menopause happens when a person is older than they were at puberty. Fact. Beyond that, it’s what you layer onto the word. “This perception historically comes from the media personifying the menopausal woman as unsexy, not feminine, no longer valued in the workplace. These a blatantly false and inaccurate depictions of menopausal women,” says Dr. Millheiser. In fact, she says, since so many of us feel desirable, competent and on more top of our game in midlife, “We need to continue seeing portrayals menopausal and postmenopausal women as strong, vibrant, tough, sexy in TV, movies, commercials, magazines, etc. The conversation needs to start there,” she adds.
Our readers agree. “Relax,” one reader advised. “All in all it’s not awful or something to spark terror — I’m actually more relaxed, accepting and content with all aspects of my life. It is, however, a new stage and there are frequent reminders that are marks of the start of the end part of my life. No one can turn back the clock, but I wish we could change perceptions, so menopause was something to celebrate and not regret. How about a cincuentiana, like a quinceañera for 50-year-olds?”
Menopause is a milestone, one that’s worthy of respect and one that, like most transitions, will have some feeling of loss involved. “I think many of us really struggle with a sense of not being ‘important’ now,” said one woman. “If we’ve had children, they are probably grown and living their own lives. We’re not needed and sometimes our advice or company or help isn’t wanted. I feel fortunate to have wonderful relationships with my own kids, and they do ask for my help and advice, but even so there are days when I feel insubstantial.”
But it’s just another life phase, one that shouldn’t be secret or shameful, or diminishing. “I never based my womanhood on a period. Why?! I’m much more than what happens once a month. Everybody’s body changes, male or female, so let’s just not make this more than it needs to be. If you need help, get it, but let’s stop looking at menopause as a bad thing or the end of ‘us’.”
The bottom line? We think this reader put it best: “Read as much about it as you can. It was a relief to me to know that the hair falling out is a common symptom, as well as the brain fog. You might think you are having a weird symptom or that you’re alone but nothing could be farther from the truth. Whatever you’re experiencing, someone else is too. Additionally, try not to mourn for the way you used to be, but try to look forward to what is still ahead in your life.”
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