Research

Are You There, God? It’s Me, Menopause

Menopause is essentially puberty in reverse—but there’s a huge lack of education around the transition. Jennifer Gunter, M.D., explains what to expect when you’re no longer expecting a period.

By Dr. Jennifer Gunter

October 19, 2020
something major was going to happen to your body, but instead of accurate information you’ll receive a barrage of negative messaging and be slapped with depressing stereotypes?

That’s menopause for many women.

Menopausal women are expected to choose their player—witch, lady detective, 

snarky matriarch, or woman with an ever increasing number of cats—and cope in 

silence, as their value to a patriarchal society vanishes along with their oestrogen.

SYMPTOMS 

Symptoms are worthy of treatment if they’re bothersome. Just because it’s normal to experience hot flushes doesn’t mean you have to suffer through them.

A hot flush is a wave of heat that feels as if a furnace is cranked up, but on the inside

Hot flushes are often accompanied by palpitations and nausea. They can feel like an anxiety attack

For some women this cycle of intense heat and shivering can happen 30 or more times a day. This is also no sprint—the average course of hot flashes is seven years, but some women can suffer for 10 years or even longer

WHY YOU SHOULD GET CHECKED AND TREATMENTS AVAILABLE 

opens the door for many other medical conditions. Most notably cardiovascular disease (heart attack and stroke), osteoporosis (fragile bones), and dementia. So, when navigating therapies, women should consider their risks for these conditions and others and how they may be impacted by treatment.

menopausal hormone therapy (MHT), which is oestrogen and CBT (cognitive behavioural therapy) can be used to help with women's hot flushes 

It’s important to remember that MHT or other prescriptions are just one piece of the menopause puzzle. The three healthiest things a woman can do for her menopause transition (and her life postmenopause) are to quit smoking if she’s a smoker, get the recommended amount of exercise (at least 150 minutes a week of moderate physical activity), and eat a healthy balanced diet.

Perimenopause & Premature Menopause FAQs | NAMS

The gradual transition between the reproductive years and menopause (the cessation of menstrual periods) is called perimenopause (literally meaning “around menopause”). It is generally a transition that is many years long and can be associated with shorter menstrual intervals, irregular menses, night sweats, and other symptoms. In some women, these symptoms are troublesome enough to need medical intervention. 

Mental health and the menopause | DPT

The menopause can impact on a woman’s health both physically and psychologically, primarily due to the depletion of the hormone oestrogen in the body. In addition to hot flushes, the sweats and tiredness, heavy bleeding and vaginal dryness, some women also experience emotional and psychological symptoms such as anxiety, irritability, poor concentration and low self-esteem, which can often be mistaken for depression.

Helen hopes that other women experiencing similar symptoms such as low mood, anxiety and “brain fog” will not immediately think they too are “going mad”, but that these issues may be linked to hormonal changes in the body, and crucially, can be treated and will pass.

“I found it very difficult at times,” says Helen. “There were occasions I thought I was losing my mind. I was exhausted all the time and couldn’t order my thoughts and I had pain throughout my body and aches in my joints.

MENOPAUSE AT WORK 

With around 3.5 million women aged between 15 and 65 years currently in employment in the UK, women now represent nearly a half of the UK labour force. That surely makes menopause mainstream and as important as any other occupational health issue.

Working through the menopause

• Many women find they are little prepared for the onset of the menopause and are even less equipped to manage its symptoms at work. They tend not to disclose their symptoms to their manager
• The majority of women feel they need further advice and support
• Workplaces and working practices are not designed with menopausal women in mind
• Heavy and painful periods, hot flushes, mood swings, fatigue and poor concentration can pose significant and embarrassing problems for some women, resulting in lowered confidence
• Women are often uncomfortable disclosing their symptoms and problems to managers, particularly if they are young or male.
• Where women have to take time off work to deal with their symptoms many do not disclose the real reasons for their absence
• Some women say they have to work extremely hard to overcome their perceived shortcomings due to their menopause
• Others consider working part-time, despite the concern about the impact on their career. Some even think about leaving employment altogether.

Source: UNISON’s Health and Safety guide to the menopause

Wouldn’t it be great to see employers providing...

• Greater awareness among managers of the menopause as a real occupational health issue
• Provision of a culture where women feel comfortable about discussing their symptoms and what impact that has on their working lives
• Options around flexible working hours and working arrangements to help manage symptoms
• Improved access to support –formal or informal
• Options to improve your work environment temperature and ventilation

SYMPTOMS 

- anxiety 

- brain fog

- cold flashes

- dryness

-fatigue

- heart palpitations 

- hot flashes 

- incontinence 

- insomnia 

- joint pain 

- mood swings 

- night sweats 

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REFINERY RESEARCH 

refinery29 YOUR VAGINA'S FINE 

> Central site for people with vaginas to go to for information and updated stories on vaginas, including a lot on their appearance and debunking false notions around how vaginas should look, smell and feel 

Dr Jen Gunter is Taking Down The Patriarchy, One Vagina At A Time

KATHLEEN NEWMAN-BREMANG

27 AUGUST 2019, 17:11

Absolutely. The patriarchy has conditioned you to believe that the uterus is toxic so that you have no value.

What about the biggest threat to our overall sexual health?

Misinformation and shame.

> Imagery is sensitive, intimate and with a feminine gaze 

> Lots of flower and fruit motifs, suggesting something natural and organic 

> Touches on topics which are misinforming women

> Looks to guide readers through these mis informative pieces of information 

> Editorial style, a strong output as suggested by Refinery themselves in the webinar for the output of this brief 

> Should follow their aesthetic and style to coincide with their target audience base 

> Illustrative

> Bold, colourful, strong use of shapes and gradients 

> Collages, photography and illustrations used 

> Images always illustratively developed, those left to the original formats normally as a promo for tv shows or celebrities in which they already have their own style chosen that refinery does not want to overbrand 

> Particularly like the bold illustrations used to depict stories on the refinery instagram 

> Keeping things fun, playful and bright will align it to their direction and appeal to their target audience

Primary and Secondary research should be done into understanding the symptoms of menopause, the way it can affect people’s lives, the lack of education on the topic and the effects this has on not just physical but mental health.

SHATTERBOX 

#Shatterbox is the Award Winning Female-Helmed Short Film Series from @refinery29✨ Season 3 with @levelforward Coming Soon 🎬

> More serious tone in film direction 

> Muted colours and tones 

> Opportunity for creating a short film in the brief 

29ROOMS

> Interactive, explorative spaces set up around the world that collab with artists and designers on creating an experience for people 

> Presents art, creates photo ops etc. 

> Also takes on the aesthetic of very bright, bold, colourful aesthetic 

> This section of refinery would be an opportunity to create an outcome centred around physical spaces, immersion and an almost gallery layout 

>> All Refinery's outputs and areas present this focus on empowering women in all creative areas, and providing an experience and uplifting moment to the viewer, whether it's through words in an article or film or through mini visuals on their instagram with inspiring quotes 

LIFE BEGINS AT 

This week on Refinery29, we’re filling your screens and consciousness with inspiring women over 50. Why? Because living in a culture obsessed with youth is exhausting for everyone. Ageing is a privilege, not something to dread. Welcome to Life Begins At...

> Pretty aesthetic, very stereotypically feminine 

> Not my normal style but very refinery29 

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PREVIOUS THE CASE FOR HER D&AD WINNERS 

> Educational and informative in a very accessible way 

> Simple illustrations and type, that are sensitive, fun and positive 

> Course that people can take online to learn about female pleasure, ensures that the project creates results and change rather than just informing 

> Places itself on platforms where young people find information, instagram and youtube (doesn't actually exist though) 

> Additional visuals for overall campaign in posters 

LADY LIBRARY 

(i) 

> Visibility Issue Teen Vogue 

> All winners had strong ideas and videos presenting these ideas using clips from films and tv shows 

> This strongly communicated their ideas on what the orgasm gap is, why it exists, and what the solution is 

> The presentation of the work was always in context of teen cogue and refinery pairing up and what each brand is doing for the outcome/solution

> Lots of apps and websites

> Lots of learning facts and getting 'pleasure diplomas' 

> Menopause best outcome would be an app, a website or general brand/account that provides people with the necessary information 

> Or a way of presenting this information on a woman's product or item that they would engage with 

> Would have to be a product that generally older women engage with 

> How do you engage with this target audience? They're on average 32 years old, and those learning about perimenopause and menopause would be around that age and older on average 

> They would engage with social media platforms and websites, but older generations would find print material more engaging 

> Having the outcome on all of these would ensure engagement with all the different ages within the target audience and subject matter 

EXISTING MENOPAUSE APPS 

> symptom tracking 

> professional contact 

> information 

> menopause + perimenopause respective apps for specific advice and content 

> none of the apps present the joyous scope around menopause and how it is something to celebrate however, as Dr Jen pointed out on the webinar

> Like refinery's Life Begins section on sharing stories about women over 50 doing remarkable things despite going through the menopause 

> Campaign that reframes menopause as a positive development 

> What about enriching the lives of women who are going through the menopause? eg. Grace and Frankie vibrator for older women 

> Caria options for info and helping with menopause =

1 manage symptoms,

2 improve fitness

- mobility and mental mindfulness challenges 

3 focus on mental health

- soundscapes to help with hot flashes, focus and sleeping 

4 learn more about menopause 

- basics, journey, signs, solutions 

- stories from other women 

- treatment reviews 

- supplement + alternative therapies reviews 

POSITIVES OF MENOPAUSE 

1 No more periods: It means no more fussing with tampons or pads, no more worry about leakage, and no more menstrual cramping 

"Some women are even limited to their homes on days when bleeding is heavy. For them, menopause can be incredibly liberating," says Cynthia Stuenkel, MD, endocrinologist, women's health expert, and clinical professor of medicine at University of California, San Diego, School of Medicine. "I've had patients tell me, 'I can wear white again!'"

2 No more PMS: physical and emotional symptoms, ranging from breast tenderness and headache pain to food cravings and irritability.

3 No pregnancy with Sex: Some women even find that, because they no longer have to worry about the unanticipated outcome of sex, they can actually enjoy it more once they reach menopause.

4 No more hormonal migraines: Women are affected by migraines three times more often than men, according to the National Headache Foundation. About 70 percent of these women have menstrual migraines, headaches that coincide with ovulation and menstruation.

5 Time to take Stock: American anthropologist Margaret Mead called it "menopausal zest" — the rush of energy, both physical and psychological, that some women feel after menopause. 

"It's important to take advantage of this wakeup call to say, 'Let's put our best foot forward as we move along,' " says Dr. Stuenkel. She advises menopausal women to ask themselves if they're headed in the direction they want to go, both professionally and personally, and whether the way they're spending their time is meaningful to them.

6 Greater Self-Assurance 

women to report feeling empowered, partly because of the biological changes that take place in menopause and partly because of the point in life at which menopause occurs. 

Dr. Richardson "At the same time, your children are growing older and you are freed to pursue your professional and personal ambitions." After 50-plus years of life experience, including the ups and downs of relationships, child-rearing, and careers, women are more likely to go after what they want with a greater sense of confidence that they can handle whatever comes their way.

7 Time to take risks 

Dr. Stuenkel. "But now I tell women, 'You have half of your life to live. Stop holding back because the party starts now.' If there's something you've been putting on hold, there's no time like the present to taste what life has to offer.

8 Focus on Caring for Yourself 

With children grown or on their way to independence and a career that's well established, women in menopause have more time to take care of themselves. "There is no better time for a health makeover," says Dr. Santoro. "Many women in menopause are receptive to making changes that will maintain or improve their health."

9 Bond with other Menopausal Women 

"Not only do women exchange coping strategies and sympathy and empathy, but sharing their stories gives women courage to face the world, knowing that they're in good company and that unwelcome symptoms will not last forever," says Dr. Richardson.

Lauren Bacall once said during midlife, “I am not a has-been, I’m a will-be.”

women of advanced age doing some amazing things:

• The 87-year-old who created her own book about deep water running.
• Ann Kahl, 86, who wears a shirt that says, “You’ve been passed by an 86-year-old” when she participates in running events.
• Samples of other feisty women and their achievements include travel to the North Pole at 84, topping the music charts at 97, practicing medicine at 103, running a marathon at 93, and publishing a book at 90.

OUTCOME SHOULD: 

1 tackle the lack of awareness of menopause (must provide info on menopause)

2 tackle issues surrounding it and social stigmas (positive celebration will automatically tackle the misconceptions and stigmas) 

3 get people of all ages educated (depends on platforms used: 

Menopause Imagery 

> All imagery utilises the notion of time running out, which is a negative presentation of menopause as it suggests losing something or nearing something which is empty

> Even sites which are using illustrations to illustrate positive articles about menopause use these time running out motifs, which suggests its so ingrained into society's perception of menopause 

> Destroying this idea completely as part of creating a more positive campaign