Menopause and mental health

On the Edge

PAUSE FOR THOUGHT Societal and medical support for women going through peri-menopause and menopause is woefully lacking.

On The Edge
Áine Ryan

WHEN ‘Menopause the Musical’ was first staged back in 2001, the Los Angeles Times opined that its ‘supreme silliness’ was ‘fresh, funny and simply terrific’. I’m not sure if the  critic was a man, but one thing is for sure: there is nothing funny about the menopause.
One wonders if the shoe was put on the foot of the gender that dominates our daily discourse would night sweats, hot flushes, joint pains, heavy periods, heart palpitations, depression, mood swings, anxiety, weight gain and lack of libido be a subject for ridicule and snide jokes? I doubt it.
Isn’t it hard to believe after all the campaigns for women’s liberation, particularly over the last century, that Davina McCaul recently revealed in a Channel 4 documentary, ‘Davina McCaul: Sex, Myths and the Menopause’, that she had been advised not to talk about the symptoms she began suffering in her mid 40s lest it ruin her image.
Even more shocking was the inability of GPs to recognise the symptoms – both peri-menopausal (the years before the menstrual cycle ends) and menopausal. Instead they often treated these women for conditions such as fibromyalgia or depression.             
Speaking to The Irish Times recently, the founder of the Menopause Hub, Loretta Dignam, said: “We live in an ageist society and many women don’t want to admit they are menopausal and won’t talk about it to their friends. I didn’t tell anyone when I was menopausal. You feel like you’re old and past your sell-by-date when your reproductive ability is over. We value youth in women. A grey-haired man is seen as wise but a grey-haired woman is seen as old.”
But should we blame the subtle misogyny that permeates our society for a reality that we women should have addressed long ago? Why hasn’t it been central to the feminist debate from the beginning? That’s a conundrum this columnist needs to reflect on further. One thing is for sure, it is directly related to the increased numbers of women who work outside the home these days and feel they must compete with their male counterparts for their so-called equal rights to their positions and promotion.
In her Irish Times column last Saturday, Breda O’Brien writes that the ‘work of feminism is far from over so long as male bodies and patterns are considered the norm and female needs are sidelined, belittled or mocked’. She make the very interesting point that the ‘bias in favour of the male body is present even in medical and pharmaceutical research’, citing the fact that ‘much more research is conducted on male animals than on female ones’.
“When studies are conducted only on male mammals, including human males, it can have serious adverse impacts on women,” O’Brien argues.
So how are the fundamental hormonal and physiological differences accounted for in the chemical make-up of drugs?    
O’Brien cites a  2020 study, published in the Biology of Sex Differences journal which found that for 86 common prescription medications, ‘including antidepressants, cardiovascular and anti-seizure drugs and painkillers, women were twice as likely to have adverse drug reactions than men. Women also experienced worse side effects, such as nausea, headache, depression, cognitive deficits, seizures, hallucinations, agitation, and cardiac anomalies’.
Rather shocking, isn’t it. So how do we even begin to influence big pharma on such matters?  
Back to Loretta Dignam of the Menopause Hub. She gives menopause workshops to businesses. “The menopause impacts on everyone, whether it’s your mother, sister, daughter, line manager or co-worker. If a company becomes a menopause-friendly workplace, it gives people permission to talk about it and offer things like flexible and agile working and easy access to rest rooms,” she says.
Sadly, she is so correct when she says that ‘the menopause is where mental health was ten years ago’. However, the basic reality is that mental health and the menopause are inextricably enmeshed, no matter what silly musicals are staged.