October 18, 2023
Today is World Menopause Day and it is a great time to run out of estrogen and f*cks
Happy World Menopause Day to the 51% of us who celebrate!* Yes, half the world’s population will go through menopause, so if menopause isn’t a public health issue, I don’t know what is. This is, in fact, why I’m doing my master’s thesis on menopause as a public health issue. That, and because I am a fat, sweaty, middle-aged woman who spends half my time reading about menopause anyway, so why not kill two ovaries with one stone?
Since I got my first period at age 8—yes, 8, a true story and not at all a fanciful tale— there’s nothing I’ve looked forward to more than the menopause, which I learned about from Season 2, Episode 1 of The Golden Girls ("End of the Curse"), where Blanche believes her life is over because she's past her prime.** Thank God, this ends! I remember thinking, and grimly began counting down the days.
Needless to say, I was not thrilled to flower into womanhood Judy Blume–style, and though Blume’s middle-aged fans have been clamoring for her to write Are You There God? It’s Me Menopause, after watching the Judy Blume documentary earlier this year I’m more inclined to agree with my friend Helga Hagley that “no one who smiles as much as Judy Blume does could possibly have had a normal menopause experience” and maybe someone else should write it.
Menopause, it probably won’t surprise you, remains understudied and poorly understood, even by healthcare providers—something that is just starting to change (although there is a 1990s-era Vegetarian Times floating about my house that I may as well have just lifted that entire sentence from; sigh). Recently, a survey of residents in family medicine, internal medicine, and obstetrics and gynecology showed that the next generation of US physicians felt unprepared to treat patients in menopause, with only 7% reporting confidence in addressing patient menopause concerns and 20% reporting having received no menopause training at all during residency. This is concerning: hormones affect our health in far-reaching ways, and hormonal changes associated with menopause are independently related to serious health risks including osteoporosis, cancer, and cardiovascular disease. Physicians can’t provide good healthcare to older women if they don’t understand how the menopausal body works.
Now, consider the fact that the ginormous Milliennial cohort—that’s 72 million people—is coasting into midlife. This means 36 million women, or roughly 11% of the United States population, will begin entering perimenopause—the often turbulent phase before menstruation ends—and then menopause over the next decade. Let me repeat that: a huge swath of US society is about to run out of estrogen and f*cks at the same time. This not only has significant healthcare policy ramifications, it has great potential to be transformative in many aspects of society, from the family to the workplace to government. I am personally tingling with anticipation over what happens to pay equity in the nonprofit sector when No More Ms. Nice Lady takes over.**
Despite these upcoming demographic shifts, menopause still remains pretty invisible in pop culture, and that needs to change too (that Golden Girls episode is nearly 40 years old). And where menopause is visible today, the focus is often on “staying hot over 50,” alongside the image of a thin white woman in yoga pants—a very narrow perspective that leaves out a great many people, including BIPOC women, trans and nonbinary people, disabled people, women who undergo early menopause due to illness or hysterectomy, or just those of us who have had our eyes on the menoprize precisely because we get to be free, “no longer a machine with parts, just a person,” in our elastic waist pants and Mrs. Roper caftans. For that last group, so far, there’s this:
And that seems like a good note to end a reproductive lifespan on.
Some further reading:
The Society for Women’s Health Research has a Menopause Preparedness Toolkit (I’ll particularly recommend the Preparing for a Healthier Midlife section)
Dr. Jen Gunter’s book The Menopause Manifesto (also her newsletter, The Vajenda)
The North American Menopause Society (located in Cleveland btw)
—CB
*Menopause doesn’t exist in America yet other than as a grift to sell sweaty, insomniac women tinctures and potions, so most of the good awareness stuff is from the UK. As of 2020, menopause is even part of the UK national curriculum! Can you imagine?
**If you’ve forgotten, the B-plot in this episode is that Dorothy and Rose inexplicably decide to raise minks in the garage, only to discover they’re too old to breed. Then at the end Blanche makes a move on the hot young veterinarian!
***Let’s harness the power of running out of estrogen and f*cks to make a better world. Who’s with me?