Menopause

1. The personal impact of the menopause

Karin

"I enjoyed not having periods any more. I always got them fairly late. I always got cramps, and my breasts ached. If the kids bumped against me or I had to climb stairs, it hurt. It was great when that didn't happen any more."

Susanne

"This was a turning point in my life. I found it a real burden. I also had these doubts: 'Am I still a woman? What makes you a woman?'"

Maria

"I found it a great relief that I couldn't get pregnant any more."

Menopause does not have a very good image. Little wonder, when women have been confronted for decades with the message that they should worry about their health, as though menopause speeds up the ageing process. This turned menopause into a medical problem with a medical solution: treating it with hormones.

When women are asked, though, how they judge their own experience of the menopause, they often describe a very different and more comprehensive picture [3], [4], [1]. Women find their own way through the menopause. There is no one right way to handle it. Some women pay it very little attention. Others see it as an important phase in their life, with a generally positive perspective. Some take the opportunity to think about their life and ask themselves critical questions about what is important for them. The menopause signals a new orientation in life for about one in every two women [5], [2]. They change their lifestyle [5], their focus in life and/or they concentrate more on their own interests or future. Others start paying more attention to their friends and social circle [2].

Nevertheless, it is also normal for re-orientation in life to make women feel insecure or cause mixed feelings. Impressions of the menopause are about as varied as women are themselves: they range from "new freedom and energy" through "loss of energy" to "feeling old and useless" [2].

Susan

"I think the menopause is a real crisis, and you have to find yourself again. You can really compare it to puberty. You have to find your place again. A lot of questions come up, not from others, but for yourself.

I can't say whether or not I was aware of the menopause as a time of opportunity. I never looked at the menopause as an opportunity.

When I was around 50 I got calmer and more easy-going. I worked through insecurities and some issues. Until then I hadn't been aware that the menopause could also be an opportunity."

Maria

"I think I got more independent during the menopause. I went alone to talks and to the theatre. My first grandchild was born around the time. I could concentrate more on myself and my grandchild. Without being aware of it, I was trying to adapt to a new life situation."

Many women like to talk about their feelings with their friends, their mother or their partner [2]. But that is not always easy. Some women prefer to avoid the topic, or to talk to their doctor or another professional advisor.

Karin

"It wasn't an issue in the past. People didn't talk about it. At the most, I maybe saw my mother in a petticoat. It was another time... A lot has changed. I envy my daughters. I missed out on a lot."

Some women find that their partner is not interested in their experience of the menopause or show little understanding for what they are going through [2]. Perhaps one in four men know almost nothing about this phase of life for women [6], [7]. Or you could look at that another way: most men try to be supportive [7].

Karin

"When I told him it must be the menopause, my husband said, 'Nothing will change for us.' I didn't feel like he took me seriously (laughs). My husband wasn't very sympathetic."

Physical change is only one of many aspects of the menopause for many women, as long as they are not having very severe symptoms. They do not usually feel less attractive or feminine because of the menopause [1], [2]. However physical changes can be unsettling for some women [2]. For many women it is important to feel good about their bodies.

Karin

"Maybe some women think: “Now I will never be able to have a child”. I never thought that way, but I can imagine it. I didn’t feel that way about it."

Maria

"I found the menopause irrelevant for me. I just thought, I need to get through this. I didn't find the menopause unpleasant, but it wasn't bad. It was fairly uncomplicated."

In this article we concentrate on the medical aspects of the menopause. But that doesn’t mean that menopause is primarily a medical problem.

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