We treat menopause like it’s an enemy to be defeated. Surely there’s a better way?
Come the age of 45 any ailment, big or small, can be blamed on the big M. When it comes down to it, though, isn’t menopause just ageing?
If there’s anything that we’re told women “don’t talk about enough”, it’s menopause. But as far as I can see we don’t stop talking about it – on podcasts, in the media and on socials, in Naomi Watts’ new book … there’s a sort of one-note chorus about how awful it is, and how it’s something that needs to be fought against with every seed, leaf and synthetic biochemical compound at our disposal. I have a weary wish that everyone would just shut up for five minutes so we can have a chance to assess what is really going on here.
Over the past five years, as we Gen-Xers have aged into our forties and fifties, the revolution that happened in our youth (where we declared that horror of female puberty and the onset of our periods was something we could be open about and find solutions to, or at least take comfort in the knowledge that we were not alone in our suffering) has now come for the hushery over the “change of life” of our mothers’ era. In 2025 there’s barely an open bottle of rosé in the country that isn’t within arm’s length of someone complaining about their dry vagina. Come the age of 45 any ailment, big or small, can be blamed on the big M. Or if you still feel too sexually attractive to tar yourself with the menopause brush (on the threshold of, but not yet past, your last f. kable day), you can still take cover under the umbrella category of “perimenopause”. This is defined by a cluster of familiar symptoms, which can appear while a woman is still in her thirties; it offers the same benefits as full-blown menopause – i.e., it offers a total explanation for everything that ails you – but sounds less like you have a vagina full of moths.
And yet there’s something about the new conversation that’s troubling. A sense of anxieties raised and fuelled rather than quelled. A feeling of more work to be done, when surely most of us crave rest. The source of my own disquiet is not so much the talk of symptoms but the talk of cures. When it comes down to it, isn’t menopause just ageing? Is it truly possible to hold back that tide? Are the promises of rejuvenation plausible – and if so, how long can they possibly last?
Going through menopause is a universal experience for all women who live long enough; according to a recent study 70-80 per cent of all women will be affected by symptoms, and a quarter will describe their symptoms as severe. Half of all women say the menopause impacts their home life and 36 per cent say it impacts their social lives. This must be taken seriously. Hormone replacement therapy (HRT) reportedly has a beneficial impact on many of those symptoms, such as hot flushes and fatigue, and there is good evidence that it can improve bone density and reduce the risk of cardiovascular disease. The worst menopause symptoms last for around seven years on average, and HRT is generally thought to be beneficial for many women during this period.
But it’s not just women suffering in this way for whom HRT is now recommended – if not by doctors, then by the blooming field of “menopause influencers”, and at wine nights around the country.
After a concerted period of online “awareness raising”, undoubtedly welcomed by the manufacturers of HRT, a typical conversation with a women’s healthcare specialist will invariably broach the subject of menopause or perimenopause symptoms – which are so common that I can’t imagine finding a single woman who hasn’t experienced at least one: Are you irritable with your teenage children? Is your partner increasingly getting on your nerves? Are you tired? A little anxious? Is your skin starting to look like a lizard’s or a wet plastic bag? Answering yes to any of these questions frames menopause or perimenopause as a problem that requires intervention. We can’t just get away with feeling old, coming to terms with it, and asking people to leave us alone. We now have to put ourselves through a biochemical process of rejuvenation and general betterment in the hope that we can hold off decline and death.
It seems that the practical definition of the problem is being 45 or older. Your experience of perimenopause/menopause cannot be confirmed via a lab test; it’s diagnosed when you tell your doctor you’re feeling “symptoms”. In this sense, it’s a self-ID situation rather than anything recognisably medical – and hormones will probably be prescribed. The effect of these hormones, medially speaking, is to make you more beautiful, more agreeable, more f. kable, and more alive. Gone are old-fashioned concerns about side effects and the risk of cancers. (The concerns, that is – not the risks themselves, which increase the longer you’re on hormones.) The consensus for now is that the elixir of youth can be applied on your upper arm via a skin patch – the earlier the better. Girl power!
Women are no strangers to the promises – and benefits – of medical transhumanism. Birth control has been singularly transformative in the lives of womankind. I also suspect that the influence of the transgender movement has bolstered confidence in the transhumanist promise of HRT – and the importance of this kind of self-actualisation. In a culture where self-identified trans adults have won access to HRT, it is less plausible to argue that women should experience the suffering of getting older in our very sexed way. Both are matters of identity – gender on the one hand, and youthful vitality on the other. And both rely on the very same hormones to be realised. Medical risks lose their potency when identity is involved, because the risk of not being “me” is the worst risk of all in a culture where self-actualisation is the most vaunted thing of all. And whose true self isn’t young? In the midst of these pressures to never leave the green fields of youth, from both within and without, how can a woman want anything else but to slap on a patch?
Yet when you’re sitting opposite a doctor with an encouraging demeanour and her pen poised over a prescription pad, many questions arise – none of which the doctor can answer. Some are quite beyond medicine. Is there an off-ramp for all this stuff we start taking? At what point do we give up the fight? Is it moral any more to just get old, or is it now medically recommended that we chase youth forever? When, finally, can we just have a good lie down?
