Discussion of the menopause tends be negative. Take the video introduction to “menopause week” held this week on BBC Radio 4 and BBC Radio Sheffield. The well-meaning presenters talk of “distress”, the impact, the “troubling” changes, and “how to get through it”. Of course the aim is to support and educate, and it’s important to acknowledge the seriousness of some women’s problems. However, there’s arguably a risk that an overly negative tone perpetuates beliefs and stereotypes that may foster unjustified dread about the menopause.
In fact, according to a recent study in the Journal of PsychoSomatic Obstetrics and Gynecology, involving nearly 400 women aged between 40 and 60, overall women have a positive view of the menopause. What’s more, women who’ve gone through the menopause have a more positive take on it than those who’ve yet to start or who are in the middle of it. “In other words,” write Lydia Brown at the University of Melbourne and her colleagues, “for most women the menopausal transition may turn out to be not as bad as they think”.
The researchers asked their participants to complete the Menopausal Representations Questionnaire that includes questions about symptoms they attribute to the menopause, their thoughts and beliefs about the consequences of the menopause, the menopause timeline, and their perceptions of control. The researchers also devised a new scale addressing the participants’ emotions in relation to the menopause.
For example, participants said whether they felt (or expected to feel) anxious or less confident; whether they thought the menopause would last a long time; whether they were anxious about it; whether they were, or would be, pleased to be free of the risk of pregnancy.
The women’s responses were positive overall. On average they disagreed that the menopause made them feel upset, angry or afraid, although they agreed it made them feel somewhat anxious and slightly more depressed. The women agreed most strongly with statements about what may be considered advantages to going through the menopause, such as the end of periods and the end of using birth control.
Among the sample, 54 of the women were premenopausal, 48 were in the early or later stages of the menopause, and 286 had finished going through the menopause. The postmenopausal women were more positive about the menopause than the women currently going through it, although this difference was modest. In terms of their emotions, the postmenopausal women were more positive about the menopause than the premenopausal women and those currently in the menopause, and the magnitude of this difference was “clinically significant”.
The researchers speculated that perhaps the more negative views and emotions of the premenopausal and early menopausal women is related to “affective forecasting theory”, which describes how we tend to overestimate the impact of future events on our emotions, and underestimate our ability to adapt and cope. Alternatively, perhaps the findings are explained by a more general trend for people to become more optimistic as they get older. Alternatively, or as well, maybe the postmenopausal women had developed more effective coping strategies over time.
Whatever the explanation, and while acknowledging that their study was limited by its cross-sectional design (it would be better to study the same women before, during and after the menopause), the researchers said their findings suggest that the more negative views held by premenopausal women may reflect a “degree of stereotype internalisation”. It may be “that the ‘dread’ of the upcoming menopause is culturally influenced”, they said, adding: “Our data show that cognitive and emotional representations of the menopause are most positive in the post menopause, when women have had the lived experience of the menopause”.