In Britain, a new treatment has given women the opportunity to delay menopause. But does this risk demonising a natural part of the ageing process? By Cat Rodie.
Kayte Murphy, 46, thinks we need to have more conversations about menopause. And, as co-host of the popular podcast The Hot Flush, she is practising what she preaches. With 117,000 downloads and a thriving community of followers, Murphy spends an inordinate amount of time discussing “the change”.
She is vocal about the array of unpleasant symptoms – “there are 34 of them,” she notes – that come with perimenopause (also known as menopause transition) and menopause. Still, she sees it as a normal part of the ageing process. “We are meant to age, to wrinkle and to get grey hair,” she says. “Menopause is just part of life.”
While Murphy takes this view, others would like to turn back the clock. And, with the availability of a pioneering new treatment that delays menopause, it might not be long before women can opt out of menopause altogether.
So far the treatment is only available privately through ProFaM, a clinic in Birmingham, Britain. Essentially, the procedure tricks women’s biological clocks into thinking they are far younger than they actually are.
Women signing up for the treatment have a small portion of an ovary removed. The tissue is processed and bathed in cryoprotectant (biological antifreeze), then slowly taken down to minus 150 degrees and stored until the woman reaches menopause.
The tissue can then be thawed and transplanted back into her body, kickstarting the production of her menstrual hormones. Each sliver of ovarian tissue can be effective for up to 20 years, but in theory the process can be repeated indefinitely.
The procedure was originally developed to help cancer patients recover their fertility. Now, for those willing to pay the £6000 ($A10,800) fee, the same treatment is available for otherwise healthy women who want to avoid, or delay, menopause.
Professor Simon Fishel, ProFaM’s chief executive and founder, sparked controversy in Britain when he told The Telegraph the procedure will allow women to “nail a career” before thinking about having children. But it’s not just about prolonging fertility – for some women, menopause can be extremely debilitating.
“Sixty-five per cent of women seek medical help for their menopausal symptoms, which often needs review, [to] change different pharmacological therapies – surely it would do no harm to delay these issues,” Fishel told The Saturday Paper in an email.
He isn’t exaggerating. Last year, research commissioned by BBC Radio’s Woman’s Hour found that 44 per cent of women said menopause had a negative impact on their mental health and mood. Twenty-three per cent said it reduced their enjoyment of life and 25 per cent didn’t want to leave the house because of their symptoms.
As well as causing hot flushes and night sweats, sleep disorders and mood swings, menopause also increases the risk of cardiovascular disease, osteoporosis and greater cognitive dysfunction. “Surely [it’s] best to delay the onset of such debilitating conditions, for them, their family and society,” reasons Fishel, who is also one of the scientists who pioneered IVF.
It’s early days, but since being granted a licence for the procedure in July, ProFaM has already taken ovarian tissue from 11 women. “Hundreds more are booked for consultation and many more are inquiring,” says Fishel.
Fishel is optimistic that ovarian grafting could make a difference to a whole generation of women. “At some point we have to believe, and we are of the firm belief that the medical science is at the point where material benefits can accrue from this technology,” he adds.
In Australia, ovarian tissue grafting is used only for fertility preservation. “We offer it to women who are facing a cancer diagnosis,” explains Genia Rozen, a fertility specialist and a spokeswoman for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
“Treatments like chemotherapy can render women infertile. If they have ovarian tissue freezing prior to undergoing these therapies, they can have this tissue grafted back if their ovaries fail. They’ll potentially be able to conceive,” she says.
At the moment, the treatment is not available as a menopause treatment in Australia. Rozen thinks that is a good thing. “I think that [using the procedure to delay menopause] is problematic. Even if we accept that it’s a good technique, we don’t know about the safety of having functioning hormones later in life,” she says.
There are other risks. “I’d be concerned about removing a part of a healthy woman’s ovaries because we know that ovaries are often fragile. There are also risks from the surgeries themselves.”
Rozen acknowledges menopause can be a tumultuous time. However, she believes that, with the right treatment, women don’t have to suffer in silence. Rather than opting for a new and expensive procedure, she says, women would be better off pursuing the range of effective treatments available, “from the more complementary therapies to hormonal therapies. Menopause isn’t something that women have to bear … We have lots of successful hormone therapies to treat the symptoms.”
From a sociological perspective, there is another glaring issue with delaying or preventing menopause: does the treatment demonise menopause, a natural part of ageing? Rozen says it’s important to remember that not all women experience troubling symptoms. “Rather than saying that menopause is something to be avoided, we could be more supportive of women going through it.”
Although almost all cisgender women will experience menopause, there is still a degree of mystery surrounding it. The Woman’s Hour research – which is the most recent research into the experience of menopausal women – found that 67 per cent didn’t have a strong understanding of what “the change” actually entails.
Likewise, many women don’t even consult their GP when they start to experience symptoms. Upon the publication of their research, Woman’s Hour editor Karen Dalziel said, “Our findings suggest that women don’t have enough information about the menopause. Whilst some of the physical symptoms are well known, we’ve discovered how the menopause is affecting women’s mental health.”
She added, “Women seem reluctant to talk about it – either with doctors or with their employers, and so could be missing out on sources of support.”
According to Amanda Vincent, the former president of the Australasian Menopause Society, research shows that as well as having gaps in their knowledge, women are dissatisfied with the information they are given about menopause. On top of this, Vincent notes that stigma surrounding perimenopause and menopause can stop women asking for help.
“We need increased awareness and normalisation of menopause, with the realisation that this is a process that women go through,” she says, adding that some women experience menopause early because of surgery or cancer treatment.
Does the stigma that often surrounds menopause increase women’s willingness to undergo expensive treatments such as ovarian grafting? Kayte Murphy, who says she wouldn’t want to opt out of menopause, thinks so.
“I would rather see more research and support by both medical practitioners, community, family and workplaces into supporting women who are going through ‘the change’,” she says. “We need to look at how we can treat and support menopausal women with empathy, not by telling them they are not normal – they are completely normal.”
Through The Hot Flush, Murphy has played a significant role in reducing the stigma of menopause. Apart from recording the weekly podcast, Murphy and co-host Kim Berry hold regular meet-ups so that listeners can get together and talk about their experiences in person.
“It is a very empowering community, peppered with good humour, eye-rolls and helpful advice,” says Murphy. “The power of women sharing their raw, honest stories makes you feel like you are not alone. And that is probably the most powerful part of what we are trying to do.”
This article was first published in the print edition of The Saturday Paper on Sep 14, 2019 as " Menopause for thought".
A free press is one you pay for. In the short term, the economic fallout from coronavirus has taken about a third of our revenue. We will survive this crisis, but we need the support of readers. Now is the time to subscribe.