I was on a stage giving a keynote when I realised I was flooding. For the uninitiated, that means that the heavy, unpredictable periods I was enduring during perimenopause had overwhelmed my sanitary protection – a super tampon and a maxi pad – at the worst possible moment.
Blood was flowing down my legs. Fortunately, I was wearing black pants and the conference was in an RSL with the kind of carpet designed to disguise stains. Or so I reassured myself.
Anyway, what could I do? I couldn’t flee the stage. I just had to plough on until my session was over and I could escape to the ladies and clean myself up.
If you are under the age of 40, you may think that my experience is extreme and unusual, but you would be wrong. When I put a call out on Twitter for menopause war stories, I was overwhelmed. Stories like mine were common and so was the humiliation of the sudden hot flush.
Comedian Jean Kittson was speaking to an audience of young men when a ferocious hot flush turned her silk blouse black with sweat. She has since written a book on the subject titled You’re Still Hot to Me. The Joys of Menopause.
But it isn’t just public humiliation that menopausal women have to put up with. I heard stories of dry vaginas, aching joints, relentless sleeplessness, mood swings, anxiety, brain fog, horrendously heavy periods and persistent hot flushes that drench the sufferer, her clothes and – if she is sleeping – her bedding in sweat.
As women told their stories over social media, I had a sense of a pent-up misery that too many women had kept secret for too many years.
It isn’t as if menopause is rare. It happens to 100 per cent of half the population if they live long enough and, according to experts, one-third of women will experience seriously debilitating symptoms.
Perimenopause can start in your 40s and continue into your 50s. One woman, Bronwen, told me she had been perimenopausal for 14 years. She was catapulted into menopause aged 43 when surgery to treat her endometriosis left her with one-third of an ovary. Many younger women will find themselves experiencing early menopause as a result of treatments for a variety of medical conditions, including chemotherapy for cancer. It is bad enough to go through cancer and the misery of chemo without then being hit with a whole new set of awful symptoms once you are in remission, yet such is the lot of many women.
Given that menopause is a natural phenomenon that will be experienced by every woman who reaches a certain age – an age, often, when they are at their most productive and the demands of their lives at their most intense – surely there are all sorts of treatments available? Unfortunately, according to Dr Sheila O’Neill, former president of the Australasian Menopause Society, medical research into menopause has been in the doldrums for 20 years, with the pharmaceutical industry relegating it to the too-hard basket. From the 1960s, hormone replacement therapy (HRT) was regarded as a boon for menopausal women, reaching the peak of its popularity in the 1990s. Then, O’Neill tells me, in 2002 the Women’s Health Initiative Study linked HRT to a greater risk of breast cancer.
“This completely upended treatment of menopause,” says O’Neill. “Over 50 per cent of Australian women on HRT stopped taking it.” Though the WHI study was debunked in 2012, faith in HRT – among both doctors and their patients – never recovered. “Menopausal women with distressing symptoms were just left stranded,” says O’Neill.
It does not help that menopause is often seen as at best a joke and at worst a taboo condition that sends women crazy. Kittson points out that the diagnosis of “climacteric insanity” – climacteric being the medical term for the period when ovarian activity starts to decline, to the end of it altogether – was only struck off in the 1970s.
No wonder most women keep quiet about what is happening to them, especially in the workplace. According to Kittson, menopause represents the perfect nexus of ageism and sexism and many women are afraid that even talking about it will stigmatise them at work and truncate their careers. Kittson also says that for many women at this stage in life the juggle is too great, and since you can’t drop the responsibilities to your kids or to your ageing parents, many decide to quit work, further predisposing women to poverty as they age.
Fortunately, there are signs that this epidemic of silent suffering is coming to an end. Many of the women who contacted me spoke positively about programs in their workplaces aimed at educating colleagues about menopause and how to support women going through it.
Marian Baird, professor of Gender and Employment Relations at the University of Sydney, says that now “there is quite a bit happening around menopause, mostly in progressive organisations in the private sector”. She speculates that this is because more women of menopausal age are in the workplace and in leadership positions. She also credits the rise in concern about wellbeing in the workplace in general: “There have even been stories about it in HR Monthly.”
Natalie Moore and Lisa Saunders are the co-owners of Own Your Health Collective and agree there is an appetite for information about how menopause affects workers. Like Baird, they see this as a result of women in their 40s and 50s being the fastest-growing demographic in the workforce. Moore and Saunders point out that Covid-19 has also played its part. Not just by increasing the demand for workers but also, they feel, because the stress of Covid lockdowns, particularly on women, may have contributed to more women going into perimenopause, or at least having less bandwidth to deal with it.
Dr Sonia Davison, endocrinologist at the non-profit organisation Jean Hailes for Women’s Health, agrees that Covid has influenced the conversation. “People are more open about their health,” she says, “and quality of life has become more important.” However, Davison also blames Covid for returning menopause research to the backburner. “Universities were really screwed during the pandemic and women’s health research is not as important to governments as big killers like stroke and heart disease.”
Nevertheless, many in the private sector are seeing the opportunity. Media personality Shelly Horton and celebrity general practitioner Dr Ginni Mansberg, both perimenopausal themselves, have developed an online educational tool aimed at employers called “Don’t Sweat It” because they saw how much women needed support in the workplace.
Mel Kettle, an author and leadership communications expert, is also noticing new enthusiasm in organisations for workshops about menopause. She is finding that talking about women’s experiences openly in mixed groups is enabling people to share deeper private trauma. She cites a man who revealed his wife had lost a baby and how he had felt unable to talk about his grief to colleagues. “What else can we talk about to relieve silent burdens?” she wonders.
While menopause is a painful and prolonged experience for many women, I want to offer reassurance to anyone reading this who is carrying a fan – like Bronwen – or who never leaves the house without super tampons and maxi pads. For me, that experience in the RSL is now a distant memory and I have been enjoying the sunny uplands of postmenopause for more than a decade. Once you are through this, you never look back. Your body becomes your own again in a way that you haven’t experienced since you were a kid.
This article was first published in the print edition of The Saturday Paper on August 20, 2022 as "The hot topic".
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