Alice Smellie, co-author of Cracking the Menopause, shares how you can provide practical & emotional help to those going through this life change
If you think that the menopause is nothing to do with you, think again. What became very clear when researching and writing our book Cracking the Menopause, is that it affects everyone, not just women, but men, partners, children, colleagues and friends.
The average age to start the menopause is 51, but this is just one moment 12 months after your last period. The years after are postmenopause and the years before are called perimenopause, which usually starts in the early to mid-40s when ovaries start to slow down production of oestrogen, progesterone and testosterone. As oestrogen fluctuates and then drops, periods become irregular, heavier or lighter, and women might suffer from hot flushes, headaches, night sweats, aching joints, sleep problems, anxiety and depression. Most women will have at least one of these symptoms, and one in four struggles to cope with aspects of their life due to their symptoms.
There’s a huge problem in the UK with education and accessibility to support, with only 118 NHS British Menopause Society recognised clinics for the millions of peri- and postmenopausal women in the country. There’s no mandatory menopause education for our overworked GPs, so women might be incorrectly prescribed antidepressants or refused hormone replacement therapy (HRT). There are still toxic myths surrounding the risks of HRT and for involuntarily childless women, menopause can be a time of deep grief when it comes to the hope of one day having children.
In addition, there’s the fact that society has for centuries erroneously and insensitively considered older women unattractive and rather useless. Thankfully, times are changing, but those around us can offer both practical and emotional help.
Female friendships are vital throughout life, and never more so than during the menopausal years
I am ashamed to admit that perimenopause didn’t occur to me when, in my mid-40s, my PMT started to become catastrophically worse – lasting for around 10 days of every month and affecting my sleep, my temper and my general mood. Fortunately – and this is where the support of friends is so important – I go running with my co-author, Mariella Frostrup, and a group of girlfriends who are highly supportive. Within a few weeks, I was at my GP asking about HRT.
"Female friendships are vital throughout life, and never more so than during the menopausal years," says Dr Meg Arroll, psychologist and menopause expert. ‘Being able to discuss anxiety, heavy periods or hot flushes can alleviate worries and encourage women to seek help if needed.’
As for partners, husbands and wives, these relationships can seriously suffer. It can be hard for men to understand menopause (ever tried explaining period pains?), and same-sex couples can also find it to be a stressful time.
"I had no idea what it was about until my wife suggested I read a book she'd bought," says James Stephens, 54. This acted as a useful starting point when it came to finding ways to help his wife. "Now I better understand her and feel I can ask questions. I know that lifestyle can affect symptoms, so we're trying to be healthier and getting fit together."
"Partners can be a great support not only by listening, caring and being kind, but by reading up about the problems associated with the menopause and being happy to sleep with the window open, with a lighter tog duvet and being aware that being irritable may not always be their fault," says Jane Ogden, a psychologist.
Many women are going through perimenopause when their children are teenagers, which is like a double whammy of hormones in the house
It’s important to talk about menopause to young people so that the stigma is lessened and menopause is seen as simply a stage of life, like puberty. We’re the first generation to realise the significance of it for women’s physical and emotional health – older generations talk about ‘getting through it’.
"Many women are going through perimenopause when their children are teenagers, which is like a double whammy of hormones in the house, and they are going through their own tribulations," says Tanith Carey, author of What’s My Teenager Thinking? and a mother of two girls. "Speak to them factually, explain what menopause is and why you might not be feeling on top form. Allow them to ask questions, and make it a discussion so that they feel respected and can better understand you."
"Once mum explained about it, I realised that was why she was so emotional," says Kitty, 16. "I try to be nicer – and keep my room tidy."
It’s vital that all employers recognise and put measures into place to support women who might need it
Work can also be affected. "I had terrible hot flushes, which made me look as though someone had tipped a bottle of water over me," says Elizabeth Stokoe, 50. "Eventually, rather than pretend it wasn’t happening, I ended up carrying around a fan and using it publicly."
A recent report revealed that one in 10 women leave their jobs because of menopause symptoms and eight out of 10 say that their employer hasn’t shared information, trained staff, or put in place a menopause absence policy. There isn’t specific menopause legislation or menopause leave, and women can often be embarrassed to speak out, especially in male-dominated workplaces.
"It’s vital that all employers recognise and put measures into place to support women who might need it," says Deborah Garlick, who has launched Menopause Friendly accreditation. "We work to help everyone understand what it is and be able to talk about it openly, and for managers to know how to help." Practical solutions can be as straightforward as reconsidering uniforms, access to loos and drinking water, and flexible hours.
When it comes to the menopause, a sense of community and support can prove invaluable. If you’re looking to support someone who’s currently going through it, it’s important to let them know that the lines of communication are always open. And if you’re going through it yourself, try not to think of the menopause as being an ending – research suggests our postmenopausal years are generally happier. We become more driven, confident and ambitious, and are far less concerned with what others think of us. Although the transition may have its challenges, it comes with a bright light at the end of the tunnel, and – hopefully – sunlit uplands of health, wealth and happiness.
Cracking the Menopause, by Mariella Frostrup and Alice Smellie, is available to buy online