The Menopause Manifesto

Menopause is not a flaw in our biology, but a purposeful chapter in life – one that society needs to understand and embrace.

1. Menopause Needs to be a Public Discussion

Menopause remains one of society's taboo subjects, mentioned even less than menstruation. This silence has led to a widespread lack of knowledge about what menopause is and how it affects health and life. Without proper information, individuals often find themselves unprepared for its onset and unclear about how to address its effects.

The term "menopause" originates from the Greek words for "month" and "cessation," suggesting finality. Yet, different cultures interpret and approach this stage differently. While countries like Japan use more positive phrases like "change of life" and experience fewer reported symptoms, Western countries often shroud menopause in negativity or misinformation.

Breaking this cultural silence is not only empowering but necessary. Roughly a third of a person's life can be spent postmenopausal, making it essential that society supports this transition both medically and socially. By openly discussing menopause, we can help dismantle harmful stereotypes and provide much-needed education.

Examples

• Societal indifference in Western societies contrasts with Japan's positive phrase "kōnenki."
• Pharma's misleading marketing in the 1960s labeled menopause a medical "pause," sparking fears.
• Studies show women in cultures with encouraging menopause narratives experience milder symptoms.

2. Menopause is a Biological Feature, Not a Defect

Contrary to outdated beliefs, menopause is not a biological failure but an evolved advantage. In essence, menopause allows the body to conserve energy by ceasing reproductive functions and redirecting it toward survival and caregiving roles.

The grandmother hypothesis illustrates this benefit – postmenopausal women contribute to society by helping raise grandchildren and pass on knowledge. This collective support ensures better survival rates for children. Human lifespans have always extended beyond 50, which means that menopause is not a product of modern times but an evolutionary trait.

Hormonal changes during menopause result in periods becoming irregular and eventually stopping. While this can bring challenges like hot flashes or bone loss, it’s a natural process embedded in women’s biology for a reason – life beyond reproduction strengthens communities.

Examples

• The "grandmother hypothesis" highlights how human survival hinges on older generations’ caregiving roles.
• Anthropological evidence shows even ancient Greeks and Chinese documented menopause.
• Smoking can trigger earlier menopause, affecting this natural life transition.

3. Physical Symptoms of Menopause are Manageable

Although physical symptoms like hot flashes, vaginal dryness, and mood swings can seem overwhelming, they are temporary and manageable. Most symptoms arise due to declining estrogen levels, which disrupt the hormonal balance established during reproductive years.

Carrying extra weight, especially around the stomach, is common during menopause. Unfortunately, visceral fat increases health risks, including heart disease. Osteoporosis is another concern as bone density decreases rapidly after menopause. Over half of U.S. women over 50 already have low bone mass, which increases the risk of fractures.

Identifying these changes as normal equips individuals to focus on proactive measures like regular health screenings, exercise, and dietary changes. Taking these steps early can ensure a smooth transition and better overall well-being.

Examples

• Hot flashes, often lasting just minutes, can persist for up to seven years during the transition.
• U.S. data shows that 51% of women over 50 live with low bone mass post-menopause.
• Cardiovascular disease remains the leading cause of death for women, underscoring the need for vigilance.

4. Hormone Therapy: Tool, Not a Cure-All

Hormone therapy (MHT) replenishes declining estrogen and progesterone levels to alleviate symptoms like hot flashes, sleeplessness, and hormonal depression. While incredibly effective for some, its use requires a nuanced approach given the risks linked to breast cancer and blood clots.

The 2002 Women’s Health Initiative caused alarm around MHT, citing increased cancer and heart disease risks. However, later reviews revealed that these risks were misinterpreted when therapy began before age 60 or within 10 years of menopause.

To maximize benefits, individuals should tailor treatment to their needs. Start with small doses and use trusted pharmaceutical options rather than unregulated “bioidentical” hormone supplements. Patience is key – some therapies can take months to yield visible results.

Examples

• MHT in the 1970s led to rising endometrial cancer rates due to missing progesterone in treatment.
• Later research clarified that starting MHT within a "safety window" significantly reduces risk.
• Transdermal estrogen patches are lower-risk alternatives to oral pills.

5. Menopause and Sexual Health Require Attention

Menopause impacts sexual health, with changes in genital tissues causing dryness, discomfort, or difficulty achieving orgasm. Genito-urinary syndrome of menopause (GUSM) can also lead to bladder issues and frequent infections.

These changes can be addressed with localized estrogen therapy, lubricants, and pelvic floor exercises like Kegels. Emotional openness about desires can also boost connection. Hormonal shifts may lower desire, but therapy or antidepressants like Bupropion can help when emotional well-being or relational intimacy takes a hit.

A fulfilling sex life is achievable post-menopause, with small lifestyle changes and a tailored approach to physical needs.

Examples

• Over 80% of women experience GUSM symptoms during menopause.
• Using coconut oil or petroleum jelly for vaginal dryness provides affordable, effective relief.
• Kegel exercises fortify pelvic muscles, bolstering sexual enjoyment while reducing incontinence.

6. Exercise Safeguards Health in All Stages of Life

Staying active counters much of menopause's long-term health risks. Aerobic exercises improve cardiovascular health, while weight or resistance training builds bone strength to lower osteoporosis risks.

Leading experts recommend at least 150 minutes of light activity a week, such as brisk walking. Adding weight-based exercises twice weekly maintains both muscle mass and a healthy metabolism. Combine this with stretching or yoga to protect both flexibility and mental wellness.

Breaking a sweat at any level ensures longevity, with menopause marking an important period to prioritize physical activity.

Examples

• Weight-bearing exercises fortify bones that naturally lose density post-menopause.
• Cardiologists recommend 75 minutes of moderate jogging each week for heart strength.
• Yoga combining mindfulness helps alleviate menopause-related stress and mood swings.

7. Diet Determines Well-Being Beyond Menopause

Food choices reverberate across all stages of life but are especially impactful during and after menopause. Balanced diets rich in fiber, lean protein, and whole foods help manage weight, regulate energy levels, and lower risks of illnesses.

Calcium and vitamin D are critical for maintaining bone health, especially as bone density decreases. Fish provides omega-3 fatty acids to combat heart issues. While supplements abound, whole foods offer preferable solutions.

The best "diet" isn't restrictive but focuses on preparing and enjoying nutritious meals every day.

Examples

• Calcium-rich foods like leafy greens safeguard bones.
• Studies link omega-3s with better heart function, especially postmenopause.
• Avoiding ultraprocessed snacks helps manage sugar spikes and hormonal hunger.

8. Emotional and Mental Health Are Non-Negotiable

Hormonal fluctuations during menopause can lead to mood swings or depression. For some, these persist beyond physical symptoms. Seeking therapy helps individuals build coping strategies for emotional shifts, develop healthy boundaries, and alleviate physical discomfort.

Cognitive behavioral therapy (CBT) offers direct tools to manage anxiety or insomnia. Meditation and mindfulness also teach resilience during moments of loneliness or frustration. Opening up to loved ones strengthens connections and removes feelings of isolation.

Maintaining mental clarity ensures menopause is seen as a chance for new opportunities rather than loss.

Examples

• CBT reduces both hot flashes and depressive episodes by reframing triggers.
• Meditation calms the stress associated with career or caregiving demands.
• Community groups offer comfort in shared experiences navigating menopause.

9. Knowledge Empowers Menopause Management

Education equips individuals to manage menopause with confidence, whether they choose natural remedies, medication, or both. Many myths still circulate, making reputable advice from verified medical bodies key.

Be wary of snake-oil "natural hormones" or untested supplements. Reliable answers come from trusted sources like the International Menopause Society. Choosing doctors who listen and personalize care is equally vital.

Menopause doesn’t end life; it transitions you into a new and fulfilling chapter.

Examples

• Question medical providers offering unreliable saliva tests for hormone levels.
• The International Menopause Society provides science-based guidance on treatments.
• Tailoring care ensures options align with personal health priorities.

Takeaways

1. Prioritize lifestyle changes like regular exercise and a varied, whole food diet to ensure long-term health post-menopause.
2. Seek trusted medical advice to explore hormone therapy options if symptoms overwhelm, but do thorough research first.
3. Address emotional and relational needs; therapy, mindfulness, and honest conversations enhance well-being.