1/Burning Questions answered here
Welcome! I am thrilled that you are here. My goal with this blog is to answer questions, review products and books, and muse on the dumpster fire that peri/menopause can sometimes be. A quick word about inclusivity — all folks who are impacted by the biology of menopause need support through this transition and I hope they find it here. For convenience, I use the terms she/her-woman/women-female, but I recognize that they do not capture the diversity of identity in the peri/menopause crowd.
Feel free to send me questions, especially of the “is this normal?” type. I can’t promise I have all the answers (there are soooo many unanswered questions about women’s health) but if there is a good, stereotype-free, non-sexist answer to be had, I will deliver it (with sources).
The global menopause market is expected to reach $17.8 billion USD in 2024. That is your spending power. You can expect to be sold all manner of creams, shampoos, make-up, sweat-wicking pyjamas, water bottles, functional chocolates, and bedding designed to ease your transition and maybe serve up some feel-good feminism lite at the same time. I am hell-bent on finding items that actually work and support quality of life. I’ll keep you in the loop.
I am a voracious speed reader and read widely on health, sexuality, biohacking, fitness, mental health but also history and culture. I will share the fruits of my labour so that you can know all the things.
I may or may not share inflammatory opinions. Here is the first one: peri/menopause is an, unfortunately politicized, issue. There are significant disparities in menopausal care and despite this, there is still a cadre of people, including those at The Lancet, who believe it is “over-medicalized,” uneventful for most and easily addressed with cognitive-behavioural therapy (CBT). If you are reading this, you are probably, like me, not in this uneventful natural transition camp. And even if you are blessed with a smooth transition, the estrogen withdrawal of menopause is associated with a 20% loss of bone mass, increased risk for cardiovascular disease and 50-70% of us can expect to experience Genito-Urinary Syndrome of Menopause (GUSM), including vulvar and vaginal atrophy, sexual pain, urinary incontinence, etc. I do not see how CBT will address that.
Recently, in the UK, the Equality and Human Rights Commission has stated that employers need to make accommodations or risk being sued for disability discrimination. On one hand this is brilliant news because a shocking number of women abandon their careers because they cannot manage their symptoms in the workplace. If men were dropping out of the workforce willy-nilly, stepping off the partner track, or walking away from their life’s work, we most certainly would not take it at face value. All the historians, sociologists, psychologists, and researchers would be on the case. On the other hand, menopause is a disability?! And the solution is access to quiet rooms?! As Kate Muir muses in The Times article linked above, menopause is “a natural process in every woman’s life and legislation (however well intended) will not give us back our missing hormones. Only hormone replacement therapy will do that.”
I am not suggesting that every woman needs, wants or can have hormone therapy, but everyone deserves evidence-based data about it so that they can make an informed decision. The WHI study, the results of which were published in 2002, linked HRT with heart disease and cancer. It was hugely flawed and immensely influencial. More on this in another post, but the result was that a generation of Baby Boomers were denied or chose to refuse hormone replacement even if their quality of life had significantly diminished. And the influence persists, even though newer research (and older research pre-dating the WHI) indicates the opposite and many of the WHI statements have been rescinded. A 2022 NIH study, still in pre-print, analyzed the data of 7 million American women who were Medicare benificiaries from 2007-2019 and who used various forms of HRT. It found a 20% lower all-cause mortality rate as well as lower rates of cancer (breast, lung, endometrial, colorectal, ovarian) compared to women who did NOT use hormones. I want you to understand your hormones and different types of hormone therapies so that you are dealing in science and not opinion.
