No, I won’t stop banging on about the menopause. Here’s why


Frida Kahlo (1907-1954), The Flower of Life (1943/ 1944)
198 x 290 cm 
Oil on masonite
 Dolores Olmedo Collection, Mexico City

What to do when you’re paid to write a weekly column and you’re stuck for ideas? Simple: be professionally contrary. Choose a soft target and take the opposite view, the one you know is guaranteed to get you maximum howlback.

This is the case with a provocatively-titled piece that recently appeared in one of the national broadsheets. ‘Stop banging on about the menopause’, it pleads. Was it written by a man? I could perhaps understand if it was (it uses the term ‘menopause’ inaccurately, a mistake I’d assume a man would be more likely to make — unfairly, I’ll admit: certain men I’ve met genuinely want to understand the menopause in order to support their partners. To be more accurate, menopause refers to the bleed that does not come, while the perimenopause is the time leading up to and including the last bleed (although one cannot know the last bleed has passed until many months have passed (typically 12, although there can be wild variations on that). The perimenopause refers to the transition years that bring about the commonly-presumed symptoms)).

No, on reflection, it comes as no surprise at all to see that this piece was written by a woman. In a time when men are being told to talk about their physical and mental health more, it’s more likely women who are telling other women to shut up about theirs (take Suzanne Moore’s recent piece about a female midwifery lecturer who apparently told women not to discuss childbirth online). This is mainly to do with feminist differences — those who cringe at ‘the new feminist tendency to play the biology card’, for fear that it infantilises women and turns us into hysterical victims that will be cast into asylums or drowned as witches, and those of us who find talking and writing about our biology to be a way of understanding and owning it, particularly in a childish world where ignorance and misinformation, shame and fear, reign.

Janice Turner is of the former conviction, apparently preferring to think she’s one of the guys: men don’t ‘bang on’ about their own hormones, so why should women bang on about theirs? In this respect, women should aspire to be men. It’s clear, however, that some men (not necessarily young ones, either, as #metoo has revealed) don’t have to mention their hormones: testosterone does the banging for them (its levels decreasing slowly in men’s bodies throughout their lives, at a rate that’s bearable and hardly noticeable). Comparing men’s hormonal behaviour with women’s is as lazy and unhelpful as comparing periods with other bodily functions, such as defecating and ejaculating, something I’ve written about before: ‘If your ejaculation lasts as long as a period then knock yourself out. I'd pay to see it – and to meet these gods, each one of whom could populate the world with his sperm alone. And if only a period lasted as long as an actual ejaculation (3 seconds?) – or even a good shit (I myself have been known to shut myself away for – ooh! – half an hour?) – then I'd agree. But my period lasts 6 days. 6 days, people! Some men might be up for a 6-day ejaculation – who knows? – but even if science were to make it possible, it would probably kill them. Which for some might even be a price worth paying.’

The perimenopause, of course, is in another league entirely, lasting anything up to 10 years. Not that this stops Turner trying to believe her own cake-and-eat-it thinking — and even failing at that. Perimenopause, according to her, is something that should be endured in private, on account of it being, to use her word, ‘icky’. To illustrate this point, she starts her piece by conflating menopause with constipation (presumably because both involve the idea of something stopping). ‘Welcome to the Constipation Café,’ she says. ‘We’re here to support the silent millions suffering from this invisible yet debilitating condition. Come share your stories. Buy a T-shirt.’ Yet in the next sentence she contradicts herself: ‘I am not equating sluggish peristalsis with the menopause, whose symptoms — I know too well — can be sapping, life-wrecking, miserable.’ Which is rather strange, because she then goes on throughout her piece to compare the perimenopause with erectile dysfunction, premature ejaculation, haemorrhoids, thrush, herpes, incontinence and cancer.

If we’re going to make inappropriate comparisons, why not just say ‘First World problems’ and have done with it? Fake concern for menopausal women in the Third World is a strange tactic used by certain individuals in an attempt to shut down dialogue about something that is for them uncomfortable and embarrassing. It’s not for me to say whether women who live in the Third World (a term that is becoming outdated) pay much heed to their menopausal symptoms (and as far as I know, no studies have been carried out). However, if Menstrual Man is anything to go by, menstruation certainly remains a taboo that continues to put many women’s lives at risk. 'The fact that people are afraid to talk about it is a big part of the problem of women's hygiene in rural India,' says Menstrual Man director Amit Virmani. 'Women use and re-use rags which are washed and dried furtively, because everything surrounding menstruation is considered spiritually unclean. The rags teem with bacteria, which cause infections.' Arunachalam Muruganantham, the eponymous subject of the Menstrual Man documentary, explained in a TED talk how he risked divorce and social exile in order to develop a machine for women to make their own sanitary towels, after seeing his wife carrying a cloth that he said he wouldn’t even use to clean his motorbike. In Nepal earlier this year, a 21-year-old menstruating woman was believed to have died from smoke inhalation after lighting a fire to keep warm in the outdoor hut she'd been banished to. Menstruation is taboo all over the world, and I can only imagine that the (peri)menopause is too. The trouble is that, by definition, taboos are never talked about.

While refraining from the ‘First World problems’ chestnut, Turner nevertheless recycles another tired old myth, the one about older women being ‘tough’ and ‘fearless’, like soap opera battleaxes bustling about in their aprons and hair curlers with their no-nonsense approach to life. What Turner really  means by 'tough' and 'fearless' is 'putting up and shutting up'. ‘Traditionally, women have not made a great fuss about menopause,’ says Germaine Greer, ‘banging on’ in her recently revised edition of The Change. ‘When older women were in charge of the birthplace they witnessed frequent agony and death among childbearing women, and had reason to congratulate themselves on having survived.’ It’s safe to say that some women may well have had relatively peaceful perimenopauses, yet others, self-medicating with their ‘little helpers’, will not. Although the word ‘menopause’ had been recorded in medical literature since 1816 (by CPL de Gardanne (Greer, p. 22)), it did not enter common parlance until at least 1967, when it became the chosen moniker of the man who ‘invented’ the condition in order to sell a remedy he discovered (Wulf H. Utian, whom Greer calls ‘The Grand Master in menopause’ (p.12)). Since then, things have evolved in parallel with modern living. ‘It is probable,’ Greer continues, ‘that menopausal symptoms are becoming objectively more serious as a result of pre-menopausal medical intervention, especially sterilisation and hysterectomy, and of the pressure to be young, fit and beautiful if you want to be loved, and of addiction and of environmental poisons.’

No wonder women are starting to bang on about menopause more — because it is making more of our lives a misery. Rather than running the risk of defining us, however, talking about it is the first step to relief from the hot mess in which we find ourselves. What exactly is it that I’m experiencing? How to make sense of something that is a non-event, that begins to happen without us at first knowing, only for us to realise in retrospect? (one can never know one has had one’s final period until months afterwards). How to treat the symptoms? Black cohosh, or pregnant mare’s urine? A coil, perhaps? How about injections in the bum to suppress the bleeding? 'If I were you,' said a doctor who appeared to view my body as a malfunctioning car or laptop, 'I’d want to fix it.' The options he talked me through — the coil, blood suppression pills, an ablation (even though my heavy periods were not the problem for me), and hysterectomy (in that order) — seemed to be the only ones available, and I left the surgery not only feeling as though we’d been speaking different languages, but also slightly sick.

At that stage I didn’t know whether my perimenopause had begun (I still don’t), or whether my PMS had become much worse. After doing my own research and finding another doctor, I was later diagnosed with premenstrual dysphoric disorder (PMDD), an extreme form of PMS that is similar to bipolar disorder but cycles every month, in line with hormonal changes. So bad have my depressive episodes become, for about a week last January I was obsessed with the idea of having a hysterectomy (of which kind, I wasn’t sure), which I was starting to believe could be the answer to my prayers. It was only as a result of ‘banging on’ about my condition to a woman — a local witch, no less — that I thought again. Cautioning against the operation, she reminded me that for some women, such as those with cancer or endometriosis, hysterectomy will be the only option. And some women who have had hysterectomies may well swear by the experience and recommend it wholeheartedly. Others, however, will not. Far from solving all my problems, I may merely be swapping one set for another: not only does having something taken out leave space for everything else to rearrange itself, if my perimenopause hadn’t started already, a hysterectomy would certainly bring it on. The witch then said something that had previously never occurred to me. “Think about how your uterus affects your orgasms,” said she. “Imagine how less rich and powerful they’d feel without your womb.”

Oh my. No one else had pointed this obvious truth out to me, and no one else was ever likely to. But it did make me think about my womb in a different way. Instead of believing it to be my enemy, a source of torment and something to gouge out of my body with a rusty spoon and melon baller, I’ve started to look upon it more kindly. Frida Kahlo’s painting Flower of Life (above), in which the uterus is presented as a kind of goddess, part-human in form yet endowed with cosmic energy, resonates on a psychic, spiritual level. And it’s this aspect which, for me at least, is missing from conventional medical advice and the women’s section on the shelves of Holland and Barrett (if only it were as simple as taking this supplement, or that). The menopause — and endocrine system in general — is so misunderstood, so obscured in ignorance, mystery and confusion (blood tests tell us little, if nothing, while the thyroid gland is often scapegoated) that it’s no surprise that some women are seeking treatments and experiences in places other than modern medical establishments, which are fixated on compartmentalising the body at the expense of the visible and invisible whole. ‘[T}he fact remains:” says Jessa Crispin, in her balanced and reasoned response to the criticism aimed at Gwyneth Paltrow’s Goop enterprise, ‘we women do not feel well, and we are legitimately sceptical that the traditional medical industry can or will help us.’

Germaine Greer, The Change, p. 8.
While Janice Turner may find that ‘[a] few excellent health articles, sympathetic doctors, access to medical treatment’ and a chat about symptoms ‘only with [her] very closest mates, preferably laughing over wine’ does it for her, others, including myself, are looking further afield. It’s easy to scoff at practitioners of alternative therapies, yet in the days before male professionals took over, medical practice was traditionally a female preserve of community midwives, hedgewytches and wise women. Even the mention of such individuals these days provokes derision and disdain, yet as Germaine Greer says in The Change, ‘There is no point in growing old unless you can be a witch and accumulate spiritual power that has been denied you as a woman. Witches are descended from the sibyls and the female saints; their lineage is noble and no woman need be ashamed to call herself a witch.’ (p.8). Not that this will stop the trolling that witches have always endured, and which any witch should expect (witness the online ridicule of participants of this year’s Womanfest in Somerset. Evidently, the idea of women getting together to inspire and encourage each other remains threatening to some). Middle-aged women have no rite of passage to prepare us for the menopause and beyond, unless we make it ourselves. For some this may well involve having a hysterectomy, running a marathon, finally divorcing the husband, taking a lover or doing the festival circuit. I choose to embrace my inner witch, who I know has been asking to reveal herself all my life.

Typical of women whose perimenopause was presumably relatively uneventful, Janice Turner appears to think that those of us who ‘bang on’ about it must be exaggerating for the sake of attention. Yet it was only after talking to other women that I was able to join the dots and seek alternatives to the ‘first line’ treatments typically offered by doctors, and create my own bespoke treatment ‘package’: 5-HTP, iron, vitamin B12, and body-identical hormones. Yoga, massages and reflexology also feature, while one of the best things I’ve ever done was write about my experience. ‘Banging on’ about the menopause is no more part of an obsession with baring souls and breaking taboos than telling people to ‘stop banging on’ is censorship. Ignorance is the water we swim in. If women are banging on, it’s so they don’t drown.

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