Kate Muir - Everything You Need to Know About the Menopause: (but were too afraid to ask)

I have huge respect for Kate. A forensic journalist and menopause warrior.Davina McCall

Everything You Need to Know About the Menopause (but were too afraid to ask)

Kate Muir

For three generations: Isabella, Ella and Molly

And once the storm is over, you wont remember how you made it through, how you managed to survive. You wont even be sure whether the storm is really over. But one thing is certain. When you come out of the storm, you wont be the same person who walked in. Thats what this storms all about.

Haruki Murakami, Kafka on the Shore

Imagine, for a delirious moment, that men got symptoms of the menopause.

A bloke walks into his doctors surgery. He starts grumbling:

My penis is getting all dry and wrinkly. Its agony having sex, but whats the point anyway? My libido just drained away when I hit 50. In fact, I dont know why I bother going to bed. I cant sleep more than an hour with these night sweats, and at work I get so many hot flushes I have to sneak into the gents to change my shirt. Armpits like puddles.

Have I mentioned the awful anxiety? I wake up before dawn with my pulse racing, feeling like Im having a heart attack. Suddenly Im too scared to drive on motorways. I lost the car in Sainsburys car park. Im feeling more and more worthless and depressed. Yesterday, I found ice cream melting in my manbag and my phone in the freezer. He pauses, now tearful. Worse still, Im getting a muffin top.

Would all this be brushed off as mens troubles, reduced to coffee mugs that say Im Still Hot It Just Comes in Flushes Now! and largely ignored by the medical establishment? Because thats what happens to womens troubles when many of us are sledgehammered by the menopause and fall apart at home and at work. Ninety per cent of women get symptoms from hot flushes, memory loss, anxiety, depression and vaginal dryness to fading libido, painful joints and constant insomnia but they are met with a shrug from society, or a handout of antidepressants from doctors. While not everyone will get the full trolley-load of symptoms, and some will escape with just a couple, the menopause is still woefully misunderstood by many people, including parts of the medical establishment. Women do not need to go through this any more. This is about hope and change, and not the Keep Calm and Carry On attitude that has served women so badly for so long around the menopause. Think of these pages as a capacious handbag of knowledge, stories and cutting-edge science that will help you understand precisely whats happening to your body and mind and help you to take charge.

This book is part of a newly emerging public conversation surrounding the menopause, through which we can support each other, our colleagues and our partners. Too often, the menopause is still a place of shame. We mention it discreetly as The Big M, in the way that a few years ago we used to refer to The Big C of cancer. Even the early feminist menopause books in the 90s euphemistically called it The Change (Germaine Greer) and The Silent Passage (Gail Sheehy). We need to name, shame, blame and reframe the menopause. Its a subject we barely have the vocabulary for: medically, menopause means the exact day twelve months after your periods stop it was minted by a Frenchman in 1821 from the Greek men (month) and pausis (pause). Like most people, Im using menopause in a wider way to mean that chaotic period of hormonal change that begins with the perimenopause and includes the rest of your life that follows, post-fertility. The older term The Grand Climacteric perhaps describes it better, and I fancy the idea of The Reboot myself, but lets stick with the menopause.

We need to reclaim the M-word for ourselves in every language. But what if, in some languages, no word for the menopause exists? As Dr Nighat Arif, a campaigning GP from Buckinghamshire who serves a large Pakistani community, told me: In Punjabi you might say no periods, and the word for periods is kapara rags or cloth. This reminds me of when I worked at The Times, where one of the male executives used to refer to female journalists on their periods as on the rag. Now were all off the rag, I suppose. Arif added: And theres a rarely used Urdu word, baanjh, loosely translated as dried up, woman who cant have children. I think I prefer menopause, which is a much kinder word. Dr Arif has taken to Instagram Live and even TikTok to reach a wider, younger audience of 150,000 followers with her message in Urdu, with the occasional untranslatable gynaecological word in English cropping up.

The menopause should be about metamorphosis, not misery. This book is about the coming medical revolution that will make most menopause symptoms history and about the parallel need for a cultural and personal reboot that celebrates, rather than denigrates, this moment of change. As the menopause movement grows and we reach tipping point, we need to be empowered with up-to-date knowledge of our bodies and our selves.

In the UK and USA, most of us will live for more than 30 years post-menopause, and well keep on working for much of that. We need to become much better informed about hormones and safe hormone replacement, and not let the medley of symptoms or the long-term health effects of the menopause bring us down. By 2025, 12 per cent of the worlds population will be menopausal and increasingly vocal. We will be one billion women. Hear us roar!

The sooner we understand everything about the menopause, and its dastardly little sister, the perimenopause, the better we will be primed. This knowledge is not just for older women, but every woman who believes in equality in the second half of life. And keeping a weather eye out in your thirties for the coming storm of the perimenopause in your forties just makes good sense.

We need to start by educating ourselves. I read a shelf-load of books during pregnancy, but in my forties I headed unknowingly into the perimenopause those pre-menopausal years of rollercoaster hormonal dips and humungous periods that arrive like unpredictable tsunamis. I thought the perimenopause was just the run-up to the menopause, and not a potentially treacherous passage in itself. I had no idea it would make me so furious. In the kitchen at various times during my deranged perimenopausal mood swings, I threw at the wall: 1) a butternut squash 2) Nigella Christmas 3) broccoli 4) a full butter dish and 5) blue poster paint. No one was injured. Indeed, the missiles actually released family tension, and at least the dog began to treat me with more respect. Yet despite these clear (if messy) warning signs of growing mental chaos, my full knowledge of the approaching menopause was this: Periods stop. Full stop. Not a problem. And whatever you do, dont touch hormone replacement therapy. I was so wrong, I wrote this book.

Id like to say that this investigation of the failure of the medical establishment and society to manage the menopause came out of my own journey, but to be honest my journey was a total car crash. Yet I feel that if so many other women have shared their stories with us for this book, I should, too. At 51, I went off the menopausal cliff in the manner of Thelma and Louise. Before then, I had a full-time job as a film critic, three teenage children, a husband, a dog and a mother with late-stage Alzheimers disease. I lost all of those some for a short while, some for ever as we shall see in later chapters. It was not all about biology psychology, morality and midlife chaos played their part too but I had absolutely no idea how important hormones were to physical and mental health. As the psychotherapist and writer Susie Orbach put it: The menopause arrives, seeking out our vulnerabilities like a guided missile, just as we need all our strength to cope with daily life.