I feel it coming.
asserted
it → feel → ?
The slow transition towards the day it – my period, that is – eventually stops.
asserted
that → stop → day
There’s the unpredictable menstrual cycle that initially made me dig out a pregnancy test from the bowels of the medicine cabinet, the only blood rushing was away from my head as I awaited the negative result.
asserted
I → ’ → result
And I’m occasionally woken in the middle of the night by a hot flush, which reminds me that my body has become less tolerant of wine.
asserted
body → wake → wine
But generally, in my mid-40s, the path towards menopause – the permanent end of menstruation – has been gently winding.
asserted
path → wind → menstruation
I still feel strong and sleep well.
asserted
I → feel → ?
It has not felt like I’m hurtling towards a “physiological cliff” that is going to result in my destruction as a woman – as a human.
asserted
that → feel → human
Yet, this is precisely how a new study, published in the journal Nature Medicine, characterises it.
asserted
study → publish → it
The population average from the lab tests of more than 1 million women revealed a “physiological cliff” at the final menstrual period – including hormone, skeletal, liver, kidney and lipid systems – the study’s authors wrote.
asserted
authors → reveal → systems
Women can have vastly different experiences of perimenopause (the time when periods start changing, typically four to six years before menopause) and menopause.
asserted
periods → have → menopause
About one in four women will have no menopausal symptoms.
asserted
women → have → symptoms
A similar proportion will have severe symptoms, while the rest will experience manageable, albeit annoying symptoms.
asserted
rest → have → symptoms
On The Imperfects podcast this week, author and entrepreneur Zoë Foster Blake shared that she began perimenopause in her late 30s.
asserted
she → share → 30s
“So anxiety ramped up to an 11,” says the 46-year-old.
asserted
old → ramp → 11
“And sleep was terrible: waking up all through the night and never feeling rested.
asserted
sleep → wake → night
[I was] irritable: fury, rage over things that shouldn’t have been inciting that level of rage.”
asserted
that → incite → rage
The symptoms of many women can feel abrupt, says Stuart Phillips, a professor and chairman of the Department of Kinesiology at McMaster University in Canada.
asserted
Phillips → feel → Canada
“So ‘cliff’ matches lived experience.
asserted
cliff → match → experience
But, saying it’s a “physiological cliff” is both incorrect and untrue.
asserted
it → say → ?
“It’s not a thing,” says Professor Martha Hickey, a professor of obstetrics and gynaecology at the University of Melbourne.
asserted
Hickey → ’ → Melbourne
If the ‘cliff’ isn’t real, why is it being talked about?
asserted
it → talk → ?
The new Nature study is not the first to refer to menopause as a “cliff”.
asserted
study → refer → cliff
A study published in February corrected years of framing menopause as a muscle “cliff”.
asserted
study → publish → cliff
Menopausal women do not suddenly start wasting away, they found.
asserted
they → start → ?
“Women lose muscle with age much the way men do,” Phillips says.
asserted
Phillips → lose → age
The new study found that hormone levels starting to change 12 to 15 years before menopause and many of those changes were microscopic.
asserted
many → find → changes
“Nobody needed Nature Medicine to tell them estrogen falls when the ovaries stop,” says Phillips.
asserted
Phillips → need → them
”
But by marking the point of sharpest change across hundreds of millions of blood tests, they make it appear more dramatic than it is.
asserted
it → mark → tests
The one exception is bone loss, which does accelerate in that decade before a woman’s final period.
asserted
which → accelerate → period
And there’s a cheap fix for that, he adds: lift weights.
asserted
he → ’ → weights
“Why do we keep hearing it’s all a cliff?” I ask Dr Fatima Khan, menopause doctor and author of Hormone Health is Mental Health.
asserted
Health → keep → Khan
“One dramatic moment is an easier story to tell than a 10-year one,” says Khan.
asserted
Khan → tell → one
“Most women I see think of menopause as something that happens at 51, like a switch.
asserted
that → see → switch
It really doesn’t work like that.”
asserted
It → work → that
The “cliff” story is easier to tell.
asserted
story → tell → ?
It’s also easier to sell.
asserted
It → ’ → ?
“Watch the menoposse jump on this,” Phillips says.
asserted
Phillips → watch → this
“Calling it a cliff is good marketing, not good biology.”
asserted
Calling → call → it
Menopause has become “weaponised”, agrees Hickey, who heads menopause services at The Women’s Hospital in Melbourne.
asserted
who → become → Melbourne
A study published in September analysing #womenshealth posts on social media found that most were related to hormones and reproductive health, including menopause and perimenopause and either sold an intervention or had a financial interest.
asserted
most → publish → interest
…and 14 more, not listed.
The Aporia
