Photo by Luca Sage

How should we talk about menopause?

We need understanding stripped of condescension and contempt

Artillery Row

I don’t know if I’m menopausal, perimenopausal or not quite there yet. I am at that age where anything could be something or nothing at all. 

The urge to categorise physical or emotional experiences — “is that menopausal? What about this?” — is coming upon me more and more. Sometimes it feels as though I am being kind, checking in myself, preparing for the worst. Other times, the questions seem mocking. What’s that? Is it your hormones? Crazy bitch.

In memoir Flash Count Diary, Darcey Steinke discusses anger as a symptom of menopause: “irritability is a demeaning word, laughably imprecise when what I actually feel is a bright, ascendant rage”. She compares it to her experiences of PMS and medical responses to it:

 I was taught not to trust my feelings of frustration and fury in those days before my period when my hormones would drop. I was told instead that I was crazy, that the world I inhabited was not real.

I feel anger, too, but I am unsure how to categorise it. I am always reluctant to situate anything to do with my moods in relation to hormones. I want to be seen as rationally, purely angry. Angry like a man.

How we discuss the relationship between menopause and women’s emotional lives cannot be separated from the way in which women have been viewed as emotionally unstable because of our bodies. As Rachel Hewitt notes, “for millennia, male philosophers and theologians have defined themselves in opposition to female flesh, which has been associated with apparently undesirable qualities such as irrationality, chaos and instinct — as opposed to the so-called masculine and attractive traits of reason, intellect and self-control”. 

Female bodily processes — menstruation, pregnancy, childbirth, breastfeeding, menopause — not only influence our moods, but have long-term psychological impacts. To discuss this is dangerous, though. Whilst men commit the majority of violent acts, “testosterone-fuelled” behaviour is not considered a reason to limit male involvement in public life (if anything, we celebrate the “testosterone-fuelled” man as the manliest). Women, meanwhile, have had to demonstrate that our hormones do not make us unsuited to anything other than domesticity. 

The positioning of maleness as a biological norm has demonised women

This has created a double-edged situation in which to talk of the female body and its cycles is to expose ourselves to accusations that we are mad, unreliable, intellectually inferior. On the other hand, to remain silent is to perpetuate the positioning of male bodies and life cycles as the default. When we argue for a change in perspective, we are accused of wanting to have it both ways. How dare we wish for better treatments for PMS if we are not also prepared to put up with jokes about “time of the month”! How dare we want pregnancy and breastfeeding to be accommodated if we do not wish women to be seen as liabilities! How dare we mention the impact of menopause on our minds and bodies if we do not wish to be dismissed as past-it, crazy hausfraus, reproductively obsolete and politically irrelevant!

As Caroline Criado Perez writes, we live in a male-dominated culture in which “the male experience, the male perspective, has come to be seen as universal, whilst the female experience — that of half the global population, after all — is seen as, well, niche”. The positioning of maleness as a biological norm has not just created inconveniences for women; it has also led to their demonisation, particularly in middle age. In his 1966 book Feminine Forever, the physician Robert Wilson describes the male lifecycle in the following terms:

A man remains male as long as he lives … No abrupt crisis is faced. A man’s life proceeds in smooth continuity. His feeling of self remains unbroken.

Things are not so straightforward for the menopausal woman:

Though modern diets, cosmetics, and fashions make her outwardly look even younger than her husband, her body ultimately betrays her. It destroys her womanhood during her prime. At the very moment when she is most able and eager to enjoy her achievements, her femininity — the very basis of her selfhood — crumbles in ruins.

It is fair to say that menopause is discussed in less overtly offensive terms today. Nonetheless, the characterisation of middle-aged women as shouty, entitled, bigoted, irrelevant — a generation of Karens whose Mumsnet views should be kept out of politics — tallies with age-old views of menopausal women as difficult and obsolete. When Wilson wrote of the “malicious cackle” of menopausal women “flocking together”, he did not sound entirely unlike many a modern-day critic of the idea that women who are no longer reproductively useful should organise politically. 

The everpresent hum of misogyny means the line between discussing menopause in a way which challenges stigma, and one which reinforces it, can be fine to non-existent. When she starred in the Channel 4 drama Close To Me, the actress Connie Nielson said she felt “the menopause has been invisible on TV for far too long”. Yet the TV critic Jo Berry argued that whilst there was an attempt to tackle menopause as taboo, Close To Me made a mess of it:

Is it the bang to her head or Jo’s changing hormones that are causing her to imagine things? “Brain fog” — forgetfulness and anxiety can be menopausal symptoms.

Could her disinhibition — well, that’s what the doctors call it, but we call it rudeness — be blamed on the menopause too? And shall we blame her strained relationship with her kids on it as well? Or is she just not a very nice person?

No, let’s just use menopause as an excuse for everything, as if it was some sort of hormonal ghost taking over Jo’s body that should be avoided at all costs.

Having watched the series myself, I am inclined to agree with Berry. My lasting feeling was “bloody hell, mustn’t end up like Jo”. How, then, do we deal with the fact that some women need extra support?

In situations of crisis, it is hard to know whether sharing details about a woman’s menopause symptoms is stigmatising or victim-blaming in a way that sharing other details about a person’s mental health is not. The weight of prejudice — millennia of it — surrounding discussions of women’s bodies and minds ensures that every time the words “menopause” or “menopausal” are mentioned, they are loaded. Are you simply describing a woman, or are you attempting to devalue her?

The problem is not with our bodies and minds, but with a narrative fit for only half the world, one that makes our crises sources of shame. We try to be ourselves at all times, in a world that others the female lifecycle to make it appear as though we — but not men — regularly veer off course. 

An understanding of menopause stripped of the othering, the moralising, the sexist distaste, is what we most desperately need. We cannot achieve this only by speaking of menopause; we also must deal with the background noise. 

Victoria Smith’s book Hags: The Demonisation of Middle-Aged Women will be published by Fleet next week.

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