Making menopause more inclusive : The context and the challenges

The conversation around menopause is changing, but there are still too many inequalities in women's care and treatment. Noon founder, Eleanor Mills, explains the issues we'll be confronting in our new inclusive menopause series

This series of articles has been commissioned by Eleanor Mills, Editor in Chief at Noon about the inequalities facing Queenagers in health care. This series of articles has been edited by her and reflect her editorial judgement. The articles have been paid for by Theramex.

Dear Queenagers

Hope you’ve had a good week. I feel uncharacteristically knackered today; it’s funny how we take feeling well and having energy so much for granted. Today I woke up feeling exhausted, maybe that is part and parcel of this time of life. I’ve got a prescription for oestrogen in gel form sitting on my dressing table eyeing me balefully. Maybe it’s time to take the HRT plunge.

I’ve been thinking about health in midlife this week because we are just about to launch a big series of articles on Noon about the health inequalities that are still so much a fact for so many women in midlife. I was lucky to have a doctor who noticed I have a Mirena coil which gives me progesterone and asked if I wanted oestrogen gel as well. Many women do not get that kind of care and the effects are tragic: one in ten women at this age according to The Menopause Charity leave their jobs because of untreated menopausal symptoms.

At menopause, our production of three hormones – oestrogen, progesterone and testosterone – takes a dive and the lack of them in our bodies can cause over forty different symptoms ranging from depression to anxiety, sleeplessness, to dry mouth, hot flushes to aches and pains and headaches. Too often still these symptoms are misdiagnosed, one in four women who goes to a GP at this point complaining about low mood is given anti-depressants, not HRT. It is only now becoming mandatory for GPs to be trained in the menopause, many doctors had no formal grounding in this change which hits ALL women.

Thanks to campaigning by the likes of the amazing MP Carolyn Harris (Labour, Swansea West) and other groups, that is now set to change and new doctors will be taught about menopause. But it will be almost a decade before the new generation of fully trained-up GPs come through into the system. In Swansea there is already a pilot programme where GP Practice based pharmacists are distributing menopause advice, this kind of innovative thinking, plus tech-enabled solutions could also be game changers.

We’ll be discussing all of this and more at our Noon World Menopause Day online panel debate on Monday October 17th at 6pm – I’ll be sharing the Zoom link closer to the time, but maybe put it in your diaries? The panel will be me, Carolyn Harris MP, Kate Muir (the producer of the Davina McCall documentary and author of Everything You Wanted to Know about Menopause (but were too scared to ask)), community menopause activist Anita Powell, Tina Backhouse General Manager of Theramex (who make HRT and are passionate about improving health outcomes for women and who are kindly supporting this debate and our series listen to her on this great podcast), journalist author and Noon Advisory Board member Yasmin Alibhai-Brown, Andrea Berchowitz, Founder Vira Health (amazing entrepreneur who is changing the world with FemTech check out her Ted Talk) and Jennifer Howze, Editorial Director of NetMums. I’d love to hear your views about menopause and what improvements you would like to see – email me at eleanor@inherspace.co.uk or let’s get a discussion going in the comments below this post.

I have interviewed Carolyn for an article in this series; she is an amazing Queenager herself, she became a mother young, worked as a barmaid and dinner lady before going back to study at university in midlife and becoming an MP in her fifties. If ever there was a great exemplar of So Much More to Come it is Carolyn. (I was particularly taken with how her pink hair matched her magenta wallpaper when we chatted on Zoom). We’ll be running the interview with her to celebrate World Menopause Day in mid-October and launching a Parliamentary Petition calling for some key changes within the NHS system which could massively help with shortages in HRT and make sure ALL women understand about menopause. Carolyn said to me: “I was talking to some shopworkers the other day about menopause treatment and they said to me: ‘Oh aren’t you posh having a menopause!’ It’s so important that we widen the debate!”

It’s not just about class either. As Noon’s Dr Nighat Arif puts it, “It’s so important that this isn’t seen as just a white, middle class issue.” Yasmin Alibhai-Brown, Britain’s first black Muslim journalist to win Columnist of the Year, has written an amazingly moving piece about the stunted lives of her aunties and elders because of their lack of awareness about what was happening to them during the change. That will be up on the site this week, so do check it out.

Those of you who have been reading this newsletter for a while will know that I am passionate about reframing this debate. It is HUGELY important that all women get the care that they need which includes doctors recognising menopausal symptoms and treating us properly, and that we ALL have the right information. And I feel passionately that access to that treatment and information shouldn’t only be for women who can afford private medicine; the whole situation around testosterone, which is almost impossible to get on the NHS, really needs fixing.  I am also a great fan of companies taking menopause seriously and having the right policies and support in place.

BUT and it is quite a big but – I don’t want to be branded ‘menopausal’. I don’t want my hormonal state to define me, just as my teenage daughters wouldn’t want to be branded ‘menstrual’. (And I doubt many midlife men would like to be told they were in “the Viagra years”…) I also don’t need a sick pink ‘menopause’ vest (yes I’m talking about you Primark), or any other range of clothing with a hot-pink moniker, or a menopause saucepan and I don’t want brands to market to me as menopausal as if nothing else in my life matters.

I’m not the only one! When we did our Noon research earlier this year we discovered that 78% of women aged 45-60 DON’T want to be branded as menopausal or be seen as walking hot flushes. The whole point of feminism was for women NOT to be defined by their biology. It would be ironic as just as our hormones die down, we get a testosterone surge and many of us have more freedom and energy to devote to our lives, our careers and ourselves, that society writes us off once again as a walking bag female biology, or brain-fog hotness (and not in a good way).

Everything we are doing here at Noon, the whole point of being a Queenager is to change the story we tell about the later stages of women’s lives to one which is more optimistic, more reflective of everything we can be, and that is more fit for purpose. Menopause is one of the things that affects us at this point, for sure, but it is not the only thing that we are or we have in our lives. One in four women have a terrible time and can feel so depressed they can be suicidal; of course they need to be supported properly. But many women with a bit of help, some HRT if they can take it (I know those with breast cancer and other conditions can’t) and the right actions can get through all of this just fine. I worry a bit that the noise around menopause can once again feed into a gendered-ageist script, can become just another way to dismiss older women and put them down. We’ve had years of having eyebrows raised about whether we are about to have babies, or whether we are grumpy because we are on our period – we don’t need that to extend into midlife too.  I know many of you are concerned about that too.

So yes, let’s campaign for the health rights which we deserve and for the right treatment and protections at work, but let’s also make the case for all the other things we brilliant Queenagers are and can be. All the wonderful things that we have going in our lives, the wisdom we bring, the experience we have and the fun we can have! Queenagers deserve joy, fun, happiness – all the good stuff. That is what Noon is all about.

On that note – the best thing I did last week was to join a workshop on later life sexuality – it was probably one of the most intimate, exciting and important conversations I have ever had. Women talking about coming into their sexual prime in their fifties, having better sex than ever before. There were some with menopause related issues, a bit of chat about vaginal dryness (the more we all talk about that the better to stop the stigma!) but also a totally unheard narrative about connection, and physicality, feeling comfortable in our bodies and with our partners, and being sexually freer and more orgasmic than ever before.

So yes, we’ll be leading the charge on World Menopause Day – but let’s not let that define us! We are coming into our prime. Becoming the women we deserve to be. That is what really matters.

I’d so love to hear what you all think!

Much love and watch out for those articles I mentioned, I’ll send out the links to them on Noon when they drop.

Eleanor

And big thanks to Theramex for being a company that is really trying to support women and spread information about all of this to the largest possible audience. We really appreciate your help.

By Eleanor Mills

If you are fired up by watching this and would like to sign the Noon petition, backed by everyone on the panel, to make menopause a QOF then click here

Theramex is a leading global pharmaceutical company dedicated to supporting women’s health needs at every stage of their lives. We have a reputation for delivering  patient focused treatments and driving value for our partners.

Our exclusive commitment to women’s health and fertility reflects our passion to address unmet needs by women and their healthcare providers.

We offer a wide range of treatment options for women, addressing her specific needs, from both a medical as well as a lifestyle perspective.

Across our four therapy areas we offer therapy choices to both prescribers and our patients, women, who often take an active part in making a decision on their health care as they progress through the different stages of life.

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