Do our attitudes about Menopause affect our experience?

“ If hormone symptoms were solely due to hormonal changes then the menopausal experience would be more homogenous” Dr Sandra Thompson

Lately, there’s a growing push that not recommending hormone replacement therapy (HRT) for every woman going through menopause is somehow “unethical.” For some, HRT has been a game-changer, offering much-needed relief from symptoms that can feel all-consuming. But let’s pause for a second and unpack some things, especially since the narrative around HRT is so charged, and with all the pressures, it’s hard to know what’s truly best.

In places like the U.S. and UK, HRT use is highest. Interestingly, these are also countries where postmenopausal health issues, like heart disease and certain cancers, are rampant. Many countries with much lower HRT use also see fewer of these postmenopausal health challenges. This suggests a much bigger picture, with other factors—like culture, lifestyle, and the relentless drive for youth, fertility, and productivity—potentially impacting our health just as much, if not more.

So why the pressure to start HRT, and why is it presented as “essential” for surviving menopause? While some women experience significant symptom relief on HRT, it’s not a one-size-fits-all solution. Some women face unexpected side effects, like heavy bleeding, especially those starting in their late 50s. Many are left without answers or meaningful support as doctors simply recommend “staying on it indefinitely.” And it’s not just personal stories piling up; even experts are calling for better clinician education in managing menopause, as recent reviews in both Australia and the UK have highlighted.

Many women struggle with doctors who, despite best intentions, don’t have the latest training or insights on menopause management. This is improving, with medical schools just now adding menopause care, but the gap is still there. Without clear guidelines on doses and durations, and with frequent “adjustments” outside of the norm, it’s easy to feel confused and even skeptical.

Of course, pharmaceutical companies and private clinics profit massively from this confusion. Menopause is big business, with products and treatments heavily marketed to women. How do we separate what’s genuine from what’s just capitalizing on our insecurities?

Maybe there's something to learn from how women from different cultures experience this life phase. It's amazing to have choices and options. It's also essential to question whether it addresses the root causes of negative menopausal experiences. Re-evaluating our cultural perspectives and values might also be necessary.

Jennifer Chandler in her book ‘Menopause Around the World’ (2021) cited research that the culture and where you live affect your menopausal experiences. In the West, we view menopause as a disease, or more recently described as a deficiency. Our culture, where older is still not better, sets a tone of impending doom and I believe that even though we are talking more openly about menopause the fear has escalated rather than decreased.

Things are changing slowly and older women are being represented in popular culture but it is still a curated image, strong 60+ year olds doing pulls-ups (I couldn’t do it at 25 and still can’t) or glamourous grey locks etc. We need to be more willing to allow all versions of aging to be represented.

In societies where age has traditionally been more revered and older women are seen as wiser and valued, menopausal symptoms are often less bothersome. Japan is the poster child of menopause, where it is called ‘konenki’ and they report fewer of the common symptoms and have lower rates of post-menopausal comorbidities such as heart disease, osteoporosis, and breast cancer.

While in China menopause is a time of rebirth and about more than just our bodies; it's also an emotional, mental, and spiritual path. Chinese women have long reported less common symptoms and rarely experience embarrassment because of their symptoms.

Traditional Chinese Medicine has always advocated early preparation for perimenopause to prevent more difficult symptoms and experiences in later life cycles. It is also recognized that key lifestyle factors can make symptoms more challenging. In TCM these 4 key areas are the ones that require the most attention:

1. Overworking 

2. Emotional stress and trauma

3. Inconsistent positive dietary and supportive lifestyle habits like exercise, rest and meditation

4. Too many compensating habits like alcohol consumption, smoking, and a poor diet.

I know from conversations with women in Africa and India that although menopause doesn’t come symptom-free it is approached as a natural life stage that can bring liberation. In India being post-menopausal opens up access to certain spiritual practices when the stigma of feeling and being labeled as untouchables during periods is lifted.

Going forward my wish is that we address menopause through a holistic lens that goes beyond the body and surface symptoms to see that menopause doesn’t happen to us, it is part of us. That hormones don’t work in isolation. That our hormonal health is affected by our environment, our emotional well-being, our diet, physical activity, stress, sleep, and the cultural heritage we carry with us.

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Last weekend I joined several practitioners to talk about The Power of Menopause from a holistic standpoint including Ayurveda, curandismo rituals, and yoga.

If you missed this or did join but would like time to listen more deeply or take advantage of some of the offers then you can purchase a VIP ticket that provides you a year-long access through this link

https://www.powerofmenopause.online/vip-bonuses?sa=sa00243238249641542ed126bc398f6a0402dea61d