Unlike the glorious feeling of lazing about in the heat of the warm sun on a beach, there was nothing pleasant when my friend Liz experienced a severe hot flash. She was serving hot chocolate to a family at the ski resort where she worked. When a 7-year-old pointed out to everyone that the lady was as red as Santa Claus, with sweat dripping from her chin, the moment became embarrassingly memorable.
At 56, Liz had entered perimenopause, that mysterious phase buried under layers of silence. We need creative solutions to break the taboo surrounding menopause.
Perimenopause Symptoms and Challenges
While menopause marks the end of menstruation, perimenopause brings challenging symptoms we barely discuss.
Vasomotor symptoms (VMS) caused by fluctuating estrogen levels include hot flashes accompanied by sweating, flushing and sometimes chills, and night sweats. Beyond VMS, women face:
- vaginal dryness,
- decreased libido,
- cognitive symptoms (including brain fog and memory issues),
- mood and mental health issues,
- sleeping problems and
- weight changes.
The list of women’s health issues goes on.
Global Experiences of Menopause
While the silence surrounding menopause is global, the experience varies remarkably across cultures, nations and ethnic groups.
In North America, for example, research shows Black and Hispanic/Latina women experience symptoms for 10 and 8.4 years respectively, while white women typically deal with menopause for about 6 years. Indigenous women often enter menopause earlier than other ethnicities.
Japanese women report far fewer hot flashes in comparison to other women globally. This is possibly linked to their soy-rich diet and cultural perception of menopause as “konenki” – a time of renewal and energy. During a 1990s study in Japan, women spoke of ‘chi no michi’ (path of blood), representing their sense of control over health during menopause.
Menopause and Shaming
I grew up in the 70s and 80s in an extended, inter-generational family household in Western Europe. There were more women across the generations than men. Mine was not a particularly coy, reserved kind of family, probably more the opposite. But never ever did the M-word come up.
Now, when I think about my father making oddly scathing remarks about my grandma’s “red head” and “huge, ever-present handkerchief to mop at her face”, it occurs to me she was most likely experiencing peri-menopausal hot flashes.
Lack of understanding
My friend Priti shares: “Menopause breaks your body and takes a toll on your mind.” Despite this hardship, silence around menopause persists globally. “Here in India, there is a lack of understanding because we rarely see a gynecologist. Women like me depend mostly on Google,” Priti continues. “I remember leaving my kids alone in a mall because I had to find a bathroom to wait for the hot flash and sweating to subside.”
Because of the stigma, women develop ingenious coping strategies on their own: “I survived on cold watermelon last night to counter hot flashes.” But the general lack of understanding and acknowledgement of menopause means the same strategies can’t be used at home and in the workplace. A big fear for Priti is “getting a sudden hot flash and an urgent need to move in the middle of a presentation.”
Workplace Challenges
“Look, I’m running around at the restaurant all the time, who wouldn’t get hot?” Liz says, normalizing her symptoms. She’s part of a growing demographic of women aged 55 and over who have increased their labor force participation by more than seven percentage points since 2000, reaching 33.6% in 2023. But, even in workplaces where 80% of employees are women, the culture of silence persists.
Breaking the Menopause Taboo
From Japan’s “konenki” to India’s silence, from Western medicalization to diverse cultural attitudes, menopause remains a universal experience shaped by local perspectives. It’s time to break the silence and support women through this significant life transition, especially as they continue contributing to the workforce in unprecedented numbers.
Let’s open the windows and get a fresh perspective on women’s health.