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Why women still aren't getting the menopause info they need

4 min read

menopause

By Gena Hymowech

If you’re going through menopause today, or about to, consider yourself lucky in a way: On the internet, right at your fingertips, you can find an endless number of guides telling you what might await. You can get the latest on menopause research to spark informed conversations with your doctor. You can use Reddit to ask community members specific questions or share personal experiences.

In a pre-internet world, none of this was possible. What's more, you could expect to be stigmatized just for going through this natural change.

Menopause through the decades: Unstable Mabel, All in the Family, and the discovery of estrogen

Archie Bunker: I know all about your woman's troubles there, Edith, but when I had the hernia that time, I didn't make you wear the truss. If you're gonna have the change of life, you gotta do it right now. I'm gonna give you just 30 seconds. Now c'mon and change.
Edith Bunker: Can I finish my soup first?


“For years, especially during the mid-1900s, menopausal women were treated as if they were losing both their desirability and their grip on reality,” says Woman’s Day. “Ads for hormone treatments and ‘gentle daytime sedation’ called middle-aged women names like ‘Unstable Mabel’ and promised that drugs with a ‘low incidence of toxic reactions’ would make them ‘pleasant to live with once again’ and keep them ‘feminine forever.’”

1929 was big year for menopause because Edward Adelbert Doisy uncovered estrogen.  And in 1942, estrogen drug Premarin, used for hot flashes, got the green light from the FDA. Prior to the Internet, a major source of information about menopause was Feminine Forever by Dr. Robert A. Wilson, a top-selling book from 1966 that called women who experienced menopause without the treatment of HRT (hormone replacement therapy) “castrates." Treat a woman’s menopause with hormone replacement therapy, he wrote, and “breasts and genital organs will not shrivel. She will be much more pleasant to live with and will not become dull and unattractive.”

In the early 1970s, you may have heard menopause mentioned on All in the Family when Gloria, Edith’s daughter, had to tell her own mother she was going through it. And Edith wasn't in charge of her own care — her husband goes to the doctor’s appointment for her. But by the '90s, things were changing drastically. “What was once shrouded in shame and mystery became a source of sassy celebration soon after the first boomers reached menopause in the 1990s,” wrote Mary Jacobs of the Dallas Morning News.

We’ve come a long way, and we still have a long way to go.

The menopause information gap in the medical community

A 2018 survey conducted by AARP found that about a third of over 1500 American women from 40 to 89 did not get any information about menopause. Of those who were informed, less than half pointed to a doctor or other source of healthcare as a main source of knowledge, and 36% were not sufficiently educated about hormone replacement to decide how they felt about it in regards to menopause treatment. A mere 35% of women in their 40s had actually talked to their health care providers at all about menopause.

Of course, the medical community is not perfect when it comes to understanding menopause, which just throws another wrench into things.

“Most medical schools and residency programs don’t teach aspiring physicians about menopause,” notes AARP. “Indeed, a recent survey reveals that just 20 percent of ob-gyn residency programs provide any kind of menopause training. Mostly, the courses are elective. And nearly 80 percent of medical residents admit that they feel ‘barely comfortable’ discussing or treating menopause.”

So when women do seek out medical advice, they often come up short. Lisa, 55, felt "completely unprepared" for menopause. When she began having irregular periods and consulted her doctor, he glazed over her questions. A few months later, she began experiencing chronic bladder issues, hair loss, and exhaustion. "Nobody really talks about all the issues of menopause," she said. "We hear about hot flashes all the time but that’s one symptom of a huge change."

Anecdotal information still wins out for many

If you don’t believe your mother is a good source of menopause information, think again. She might be able to tell you when you can expect to go through it. The Harvard School of Public Health found that there is a link between when mothers and daughters experience menopause. And although it may be difficult to bring up, finding out if your mother had hot flashes may be able to give you some insight as to whether you’ll experience them.

Friends can be particularly great resources during menopause too, providing advice for managing symptoms and support when you need it most. Terry, 62, took Evening Primrose Oil to manage her hot flashes at a friend's recommendation. "At one point I quit doing it, and the hot flashes right came back," she said. "It's that anecdotal information that you get from other women that unexpectedly works."

Of course, input from friends can't replace medical advice. But it can turn up some gems —and at the very least, make you feel less alone as you navigate the journey. Friends were considered the most helpful by half of all women 40-55 in a small study, but the much larger AARP study found that only 20% of women 40-49 considered friends and family a main source of menopause information.

How to get the most out of your doctor's visits

When it is time to consult a doctor, coming to appointments prepared can make a big difference in the quality of care you receive. For a really effective visit, consider this advice from WebMD:

  • Compile questions and worries ahead of time.
  • Speak about symptoms in a quick and easy-to-understand way.
  • Have your drug and allergy history with you.
  • Be sure you understand all that is said.
  • Don’t be ashamed to bring along a friend or family member — she can come in handy at a doctor’s visit as an extra set of ears.

And most of all, don't be afraid to stand up for the care you deserve. As Terry said, "Women need to be the ones in charge."

 

Do you feel like your doctor prepared you well for menopause? Let us know about your experience in the comments below.


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