Move over West Village Girls; Menopause Mavens are having a moment.
Melinda French Gates has called it a “menopause revolution.” Olivia Wilde and Penélope Cruz are talking about perimenopause in a magazine interview. Halle Berry and Kate Winslet are promoting hormonal therapies. Being menopausal used to be embarrassing. Now it’s a credential in a fast-growing, $10 billion-plus market with little top-down competition for an “underdiagnosed and undertreated” consumer. Philanthropy and private equity are betting that menopause research and product development are the next wave of women’s consumer future.
It’s a good bet. Most women will live up to a third of their lives after their reproductive years have ended. While this life stage has long been considered a salacious taboo, menopausal and perimenopausal women are in the process of upgrading sexist, ageist scripts about our biological reality. They aren’t content to speak about that in euphemisms or to fall into the cultural abyss. A recent punk festival about menopause (called “Menopunkapalooza”) made me ask: Is our youth-obsessed culture finally entering the golden age of the crone?
The feminist case for rebranding menopause has long been clear. American health care largely treats every woman as if she were either prepregnant, pregnant or invisible. That sort of bias can be why medical providers deny women tubal ligations — “in case she changes her mind.” This state of affairs is so demoralizing that a lot of women are relieved when they enter menopause. Sure, the symptoms may be mysterious and uncomfortable. But being invisible beats being an infantilized baby-making machine.
A new generation is not willing to settle for being invisible. Millennials get a lot of flak for being idealistic and demanding, but their generational impulse to demand better health care is making menopause easier for all of us. Millennial women, the oldest of whom are entering into or approaching their crone eras, have more education, money and autonomy than their foremothers. Importantly, the elder millennials leading the charge aren’t afraid to ask for more. That’s a great model for women of all ages.
Unfortunately, those greater expectations have not necessarily resulted in a consistent, effective women’s health care system. Most women experiencing menopausal symptoms still do not receive any medical treatment for them. As is often true, that bad news is even worse for Hispanic and Black women. Despite entering menopause earlier and having more health-related consequences (like fibroids), Black and Hispanic women are least likely to have medical support for menopausal symptoms.
For centuries, women have turned to communal health practices when science fails us. Sometimes, these folk practices got a little too folksy. I’ve been getting invitations to “celebrate my womb in a healing social circle.” One such party asked guests to wear all white, which frankly seems like a bad idea for a bunch of women dealing with unpredictable cycles. I took that in stride until I read the part where there would be chanting. I screamed, “Let me be a crone in peace,” loudly enough to scare the cat.
But communal medicine can also look like a new cadre of influencers and online community members focused squarely on menopause. I was 17 years old the first time I asked a doctor if my allergy symptoms might be related to my hormonal cycle. He shrugged. No doctor whom I have asked since has ever followed through. During a debilitating flare-up six months ago, I skipped the doctor’s office. Instead, I tried the viral antihistamine hack I heard about online. It worked. Score for folk wisdom. It turns out that medical research has long understood the link between progesterone, estrogen and histamine responses. Why did it take a social media celebrity filming in her car for me to get help? That’s the thing — menopause support from an influencer is the best that many women can do.
Where there are influencers, there needs to be something to sell. And more than anything else, the generational change in women’s rights and expectations is reshaping the consumer market for all menopausal people. Hard numbers on new menopause products are difficult to verify. But, a survey of my own media just today shows: a menopausal cream packaged like a luxury moisturizer; three menopause influencers; a red wine that won’t trigger menopause migraines. That’s a lot more than women had even 15 years ago.
If you are in the market for something to manage your hot flashes or thinning hair, the menopause-industrial complex probably will be able to help you. But menopause is about more than these uncomfortable, embarrassing symptoms. For millions of women, menopause is a transition into new health risks. The race to sell menopause solutions to women isn’t improving our health outcomes; it’s obscuring chronic disinvestment in research that could save our lives.
In her book “A Terrible Strength,” the board-certified gynecologic oncologist Dr. Kemi Doll argues that menopause must be about more than managing symptoms. As Dr. Doll said at a recent book talk: “Treat any menopause advice that doesn’t also mention cancer screenings with suspicion.”
For one example of the way that menopausal women’s invisibility in the medical system can severely harm their health, look at uterine cancer. Entering menopause increases a woman’s risk for uterine cancers. Roughly 75 percent of women diagnosed with uterine cancer are also menopausal. While mortality rates of many other cancers have declined, uterine cancer diagnoses and deaths are expected to increase substantially in the next 30 years. Early medical intervention could help, if women’s health and concerns were taken seriously. White women’s mortality rate from uterine cancer is expected to rise, but that of Black women will continue to climb even faster. The cruel optimism of drowning in menopause marketing while being at higher risk of dying from menopause-related cancers lingered after I finished the book.
There’s a lot to be said for elevating the menopause brand. A-list celebrities speaking openly about hot flashes can destigmatize. But a menopause revolution cannot just rebrand aging or offer us cosmetic solutions. To revolutionize menopause, we will have to revolutionize women’s health care.
Funding may be most important. Gates recently announced a donation of $215 million to fund, among many women’s health issues, the menopause revolution. Even that whole sum would not be enough in the face of the sad, scary state of health care in President Trump’s America. Stalled research. Shuttered hospitals. Doctors silenced. Expertise demonized. Abortions criminalized. Taken together, they’re a more sobering depiction of women’s future than the millennial-coded menopause being sold to us.
But the first step to solving this problem is recognizing it. We have earned this menopause makeover. Revel in its newfound punk ethos. Women should reinvent their crone years as their most powerful, authentic and healthy years.
Share the folk wisdom on histamines and hormones. Follow your favorite menopause influencers. Relish the sexual freedom that reportedly comes with menopause. Ask your doctor about uterine cancer, early. Choose your own menopause adventure — just don’t feel guilty for wanting more.
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