A woman in her late 50s and another in her early 30s serendipitously meet at a bar and get to talking. The younger woman is clearly miserable; the older one is not. There is something about the older woman—confidence, sensuality, humor that hails far from jadedness. It is a quality won through age, awarded only to those who refuse to argue against time.
I’ve described a scene from “Fleabag.” A striking older woman (played by Dame Kristin Scott Thomas) metaphorically takes Phoebe Waller-Bridge’s titular anti-heroine by the shoulders, and says, “it does get better.” She then goes on to perform what has been widely known as “the menopause monologue.”
“Women are born with pain built in,” she says, “it’s our physical destiny—period pains, sore boobs, childbirth… We have pain on a cycle for years, and years, and years, and then just when you feel you are making peace with it all, what happens? The menopause comes.”
“Women are born with pain built in. It’s our physical destiny—period pains, sore boobs, childbirth… We have pain on a cycle for years, and years, and years, and then just when you feel you are making peace with it all, what happens? The menopause comes”
I’m not quite convinced it’s a monologue that ages particularly well. Some may find that it contains sentiments of biological essentialism. But it is a testament to a pattern of pain throughout a woman’s life. And when she is done talking, what you receive is not a lamentation, but a triumph. Menopause is a battle, she practically says, but what you win is freedom.
Whether you resonate with this feeling or would narrativize the experience of menopause differently, it’s important to talk about it. Here’s where we can begin.
Perimenopause: The basics
Menopause is defined as 12 consecutive months without menstruation. While many speak about menopause as if it is a single point in a person’s life, it is actually much more complex. The shift in one’s hormones can begin in perimenopause, up to 10 years before the final menstrual period. This means that menopause is a long and often deeply uncomfortable process, with symptoms manifesting much earlier than one might expect.
During the perimenopausal phase in a person’s life, they are producing fewer hormones that assist their ovulation. But it’s important to know that one is still ovulating during this time—and that it is still possible to get pregnant. But because of the decline in estrogen levels, one may feel a wide range of symptoms.
Symptoms vary from person to person, and so does the degree to which one is affected. According to a study published in the Philippine Journal of Obstetrics and Gynecology, the average age of menopause in a Western country is 51 years old, while in the Philippines the average is 48 years old. This means that not only are Filipino women experiencing menopause a little earlier, but that—given the life expectancy of 71 years old in Filipino women—they spend more than a third of their lives post-menopausal.
Common symptoms of perimenopause
The easiest way to identify perimenopause is through a person’s age. Perimenopause is most commonly experienced when someone is in their mid to late 40s, but some people can even begin to notice hormonal changes as early as their mid 30s.
Symptoms include: irregular periods, heavier or lighter menstrual flow than usual, erratic shifts in mood, depressive episodes, low libido, hot flashes, night sweats, insomnia, vaginal dryness, which may cause discomfort during sex, and increased frequency in urination.
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How can I manage my symptoms better?
When estrogen levels decline, your bones can become less dense and more prone to fractures. Osteoporosis is among the risks involved in this stage of life. Heart disease and other cardiovascular health conditions also require more attention because the hormonal shifts can trigger changes in cholesterol, blood pressure, and metabolism. This is why it is important to initiate conversations with your healthcare provider, should they recommend supplements or medications.
When it comes to lifestyle changes you can make to relieve some of the symptoms, there are dietary habits you may want to consider. Limiting alcohol and caffeine is one of the things that can alleviate your insomnia and lower your cholesterol. Eating fruits, vegetables, whole grains, and healthy fats can also work wonders to cushion the drop in estrogen and protect your heart and bones.
A lot of the symptoms are exacerbated by stress, so stress management is extremely important. Whether you decide to meditate, go on walks, or explore new exercise routines, it’s important to foreground mindfulness as key to an overall healthy disposition.
Navigating the stigma
It can be overwhelming to navigate your potential symptoms, especially as perimenopause and menopause are still experiences that are shrouded in stigma. The first thing you need to hold within yourself is the reminder that the shame surrounding menopause is perpetuated by a myth.
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Menopause, or the transition into menopause, is not a loss of vitality. A person’s worth is not tied to their ability to carry children. Menopause itself is merely a fact of life; the social experience of it is an entirely different terrain.
Menopause, or the transition into menopause, is not a loss of vitality. A person’s worth is not tied to their ability to carry children. Menopause itself is merely a fact of life
It’s okay to have conflicting feelings about the beginning of menopause. You need neither to celebrate the experience nor conceal it. Women’s bodies have always been subject to cultural transgressions, to narratives that are imposed upon lived experiences. It’s okay if you are reticent about certain aspects of your menopausal journey.
The problem occurs when the arbitrary meanings assigned to these bodily functions get in the way of important conversations.
