Our Society Has a Menopause Problem and We Need To Talk About It

The glaring lack of support for menopausal women means they must advocate for themselves, but there’s good news

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“It is a well-known fact…that after women have lost their genital function” they become “quarrelsome, vexatious and overbearing.”

~ Sigmund Freud, neurologist

Hair loss, chronic migraine headaches, psoriasis, brain fog, and chills.

For the past four years, I’ve been dealing with these symptoms, not knowing they could be related to menopause.

I initially thought my lack of knowledge was because I went to school in the ’80s. To my dismay, I found out that even now, most women under 40 in the United States are not taught about menopause at schools.

And most doctors aren’t educated enough about menopause to help guide women during this period of significant life transition, leaving women to fend for themselves.

Perimenopause typically begins in your 40s, while menopause starts on average around 51 and can last for five to ten years.

The average life expectancy for women is 81, which means women are spending about a third of their lives in menopause.

Why are we, as a society, not doing more to help menopausal women?

The day I went menopause mad

In many ways, I know I’m lucky to be a 51-year-old woman in 2024.

In the 19th century, I would have been diagnosed with “climacteric insanity” and “hysteria” and locked up in an asylum for my menopause symptoms.

My mom never told me about menopause, and I’m pretty sure her mom didn’t either.

Before I hit the big 5-0, my only knowledge of menopause came from TV shows — a middle-aged woman drenched in sweat, fanning herself, or having a temper tantrum while the audience laughs.

I thought when the time came, all I had to do was buy a hand-held electric fan. I didn’t know my massive hair loss was linked to perimenopause.

I was 47 when I consulted my gynecologist about it. He recommended taking biotin, a B vitamin — it didn’t help, obviously.

As my symptoms progressed, I would frequently wake up in the middle of the night, unable to go back to sleep. I was dizzy and had heart palpitations.

This persisted for a few years.

One early morning, I woke up feeling like my heart was on the floor, and a dark cloud rested over my head. I was angry for no reason and wanted to punch a wall.

This caught me off guard. What the hell was happening?

I sat on the sofa, clenching my hair as my face flooded with tears. It wasn’t until I did some research that I realized that this was perimenopause.

That realization brought relief but also frustration. Why hadn’t I been better prepared for this? Why didn’t I know more about what to expect?

Luckily, I was well-informed about the safety of hormone replacement therapy (HRT), thanks to this Medium article by Kelly Eden | Essayist | Writing Coach.

Before that, I thought HRT was not safe, and so did a lot of women (and doctors). In 2002, a study was published that associated HRT with an increased risk of breast cancer, heart disease, stroke, and blood clots.

This led many doctors to not prescribe it, but later on, this fact was re-evaluated.

HRT has been shown to be the most effective treatment for relieving menopausal hot flashes, night sweats, vaginal dryness, and recurrent urinary tract infections.

It was heaven-sent for me.

The moment I rubbed the HRT gel on my arm, the fog lifted. It was what I needed to live a functional life.

Work bitch!

I was surprised to read there are at least 34 symptoms of menopause as well as “red flag symptoms” like breast lumps, nipple discharge, and nipple changes.

Even with HRT, I’m still experiencing a host of other symptoms that my gynecologist says I can’t do much about, like brain fog.

I enter a room and then forget the reason I went in. I thought it was early onset dementia since my dad had that.

It’s affecting my work. Writing this article took me about three weeks. Words slip out of my mind, and I can’t retrieve them.

I’m fortunate to work from home.

I can’t imagine what it’s like for women who have to work despite hot flushes and sleep difficulties, which are two of the most common symptoms of menopause.

You’d think the government would make it mandatory for menopausal women to get time off work. But no, there is no federal law mandating employers to make accommodations for menopausal symptoms.

It doesn’t qualify as a disability either, even when the symptoms significantly impact a person’s job performance.

In the U.S., most CEOs are hired at the age of 54.

This means middle-aged women are stepping into high-level leadership roles, reaping the rewards of decades of hard work and dedication — all while going through unpleasant menopausal symptoms that employers may or may not support.

Many women are reluctant to talk about their symptoms because of the stigma attached to them. They worry it could hurt their chances for a promotion or that they will be seen as less capable.

Their hunches are accurate.

In a number of studies, workers and college students were asked about their impressions of potential co-workers, including a menopausal woman.

They described her as “less confident and less emotionally stable” than the non-menopausal women.

Uneducated doctors

Oprah Winfrey talked candidly in an interview about how, in her late 40s, she was having severe heart palpitations. She went to every doctor, and no one mentioned peri/menopause.

Every night, she wrote in her journal, " I don't know if I’ll make it through the morning.”

The heart doctor gave her an angiogram and ended up putting her on a heart medication she didn’t need.

I have my own story.

Before getting HRT, I was suffering from chronic migraine headaches (another symptom of peri/menopause). It got so bad I consulted my GP.

He asked if I was experiencing any stress. I do appreciate him trying to offer solutions, but I was 49. Shouldn’t perimenopause be on his radar?

You’d think your gynecologist would know better, but again, no.

Mine failed to associate my massive hair loss with perimenopause and prescribe HRT pompto. No, he waited until my symptoms were so bad, I begged for help.

But it’s not entirely his fault.

Medical schools or residency programs don’t teach aspiring doctors about menopause, and if they do, the courses aren’t mandatory.

Same when training gynecologists. Residents aren’t prepared well enough to manage menopausal patients.

No wonder the majority of women over 40 say they’ve never talked about menopause with their doctors. Like me, most women get information about menopause from websites and friends.

That means while a woman is in the throes of menopause symptoms, she’s having to play doctor and diagnose herself.

Yep, we live in a world made for men where doctors don’t know jack shit about women’s bodies.

Male bodies are the default for almost anything, including thermostats for office air conditioners (yep, that’s why we grab our sweaters) and crash test dummies.

It’s the same for medical research. In the United States, it wasn’t until 1993 that it became mandatory for women to be included in clinical research — that’s only 31 years ago.

That’s why women tend to get diagnosed much later than men for over 700 diseases, sometimes waiting up to 10 years. We’re more likely to die from heart attacks and have bad reactions to meds.

We’re also more likely to get dismissed by doctors for our pain and symptoms and more likely to be ignored in the ER.

Women are often thought to have a higher tolerance for pain because we have periods and give birth, and these misconstrued stereotypes can lead doctors to dismiss or underestimate the severity of our pain.

Just great, isn’t it?

Now what?

I’m writing this because I don’t want women to be in the dark.

I want them to know they’re not alone. I’m there with you. Millions of other women are, too. And I want you to get the advice and treatment you deserve.

Ms. Magazine says, “Menopause is fueling a movement,” and it’s true.

Influential women like Oprah Winfrey and Michelle Obama, along with hundreds of clinicians, are using their voices to change the way in which menopausal women are cared for.

The White House also recently launched an initiative to funnel more research money into studying how menopause affects women’s health.

Don’t ever take no for an answer. Advocate for yourself. Talk about menopause.

“There is no greater power in the world than the zest of a postmenopausal woman.” ~ Margaret Mead, cultural anthropologist

This story was first published in Bitchy on July 11, 2024