What’s the difference between menopause and depression? asks Jo Brand with a cheeky wink on my Twitter feed. “Nothing according to some doctors …” She’s followed by a series of famous women offering such gags as: “Why are menopausal women so good at poker?… All those flushes!” This Menopause is Beyond a Joke campaign is promoting a rally in Parliament Square on Tuesday to celebrate World Menopause Day. And all power to their elbow.
Ever since Davina McCall burst onto our screens with her documentary last year, the menopause has been out and proud. Brands are peddling menopause creams and potions, there are menopause clothes to help combat symptoms – The Bookseller even ran a special menopause edition.
In all of this (welcome) noise, the most important piece of the puzzle is the all-party parliamentary group on menopause report. Published last week it has five key recommendations: funding research into the benefits of hormone replacement therapy (HRT); ensuring doctors are trained (scandalously most aren’t); scrapping prescription charges for HRT in England; a national drug formulary for HRT (so all local doctors can prescribe products given the green light by NICE); and last but most crucial, summoning all women aged 45 to the GP to discuss menopause.
Labour MP Carolyn Harris, who has led the political charge, explained why this last point is so important when I interviewed her for my platform for women in midife, noon.org.uk. “I was talking to a group of shopworkers the other day and one of them said: ‘Aren’t you posh having a menopause!’ That’s why we need all women to be summoned to see the doctor about it at 45, so all women get the care that they need, not just the ones who can go private. I worry about the women on low incomes. They are working all day and they don’t have access to the right information. They aren’t sitting there in coffee mornings or on social media. They have all these symptoms and they don’t know that there is an answer, they just think it is to do with their age. They end up on antidepressants, really suffering. It is really sad. So unfair. That lower income demographic of women, they are the ones we need to reach,” she said.
Harris is right. Since the first Davina documentary, 500,000 more women have received HRT prescriptions. But while prescription rates doubled in the richest areas of the UK, in the most deprived areas only half as many women have got it. There is also a massive discrepancy in the treatment received by black, Asian and minority ethnic women.
“In my South Asian communities,” explains Dr Nighat Arif, “there is no word for menopause. Many think menopause is a white middle class or western phenomenon. In my community, menopause is treated with ambivalence. It is the endurance of being a woman, like menstruation, pregnancy and childbirth … the menopause is simply not viewed as a medical condition.”
Writer Yasmin Alibhai-Brown agrees: “For my aunties and for many women in my community today menopause is a dirty secret, a shame that could not be verbalised. Perimenopausal and menopausal women are invisible within the culture and mostly unseen and unheard outside.”
Despite the drumbeat in the media and online, the parliamentary rally and the celebrities lining up to talk about their anxiety and hot flushes, there is still little research dedicated to the menopause experience for women of colour.
Data from the US shows that they experience perimenopause and menopause at earlier ages than their white peers, have longer transition periods, and suffer some symptoms more acutely and for longer. Additionally dangerous myths such as HRT being made from horse urine and a historical lack of trust in white scientists and doctors in these communities can stop women seeking the treatment they need.
Anita Powell, a community advocate for Samson’s Academy Charity, who helps disadvantaged people overcome class and ethnic exclusion from services, says the women she sees get little support. “Many are dismissed or ignored by medical professionals,” she said.
“They do not engage much in the traditional menopause spaces which tend to be white and middle class and the dialogues do not include narratives around the taboos, family/relationships, social structures, barriers and culture.” To combat this she links women up with experts by Zoom so they can get free advice.
I am delighted that menopause has come out of the shadows and is no longer a taboo. All credit to everyone who has worked so hard to make that a reality. Now we need to make sure that menopause is not just for posh white women like me; we need a truly inclusive conversation.
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