Menopause Matters: Shifting the narrative from taboo to empowerment

Menopause denotes a woman's final menstrual cycle. During this phase, the ovarian follicles responsible for generating eggs are depleted. Experts share ways to break free from taboos associated with menopause

Consider a medical transition that impacts half of the global population. A pivotal shift from one life stage to another, a significant phase coupled with challenges – Menopause. This transition influences not only personal well-being but also careers, relationships and self-perception. Astonishingly, this experience, despite its magnitude and implications, has remained largely shrouded in silence. 

No need for conjecture; this is the reality of menopause, the intricate process marking a transformative phase in every woman’s life. Over time, it has stood as an isolated journey, overshadowed by limited research and inadequate explanation. Within this scenario, women have shouldered the brunt of symptoms like hot flashes, mood oscillations and vaginal dryness often without adequate conversations or support. 

Majority of women experience menopause during middle age, precisely when they enter what is often termed the ‘invisibility zone.’ This phase is marked by diminished attention towards women, as they are perceived as less attractive and vital once their childbearing years conclude. These prevailing stereotypes continue to exert their influence. 

Understanding menopause 
Menopause denotes a woman's final menstrual cycle, shares Swathi Kulkarni, co-founder and CEO at Elda Health. While the average age is 50 years, the perimenopausal phase commonly begins at around 46 years in India (younger in varying regions). During this time, the ovarian follicles responsible for generating eggs are depleted. 

These follicles serve as the primary source of oestrogen for women. Their depletion triggers a decline in oestrogen levels which manifests physiological changes in a woman’s body. Kulkarni shares the symptoms: 
  
Hot flashes and night sweats
Hot flashes are one of the hallmark symptoms of menopause. These sudden, intense sensations of heat can start in the chest, neck and face and radiate throughout the body. They are often accompanied by profuse sweating. Night sweats are essentially hot flashes that occur during sleep, leading to damp bedding and sleep disturbances. Hot flashes and night sweats can range from mild to severe and can be quite disruptive to daily life. 

Irregular menstrual cycles
Menopause is defined as the cessation of menstruation for 12 consecutive months. Leading up to this point, women often experience irregular periods. Menstrual cycles may become shorter or longer and bleeding may be lighter or heavier than usual. The unpredictability of periods can be a source of frustration and inconvenience for many women. 

Vaginal and sexual changes
Decreased oestrogen levels during menopause can lead to vaginal dryness, itching and discomfort. This can make sexual intercourse painful, reducing sexual desire and impacting intimacy. Additionally, changes in the vaginal and urinary tissues may result in an increased risk of urinary tract infections and urinary incontinence. 

Mood swings and emotional symptoms         
Hormonal fluctuations during menopause can lead to mood swings, irritability and increased susceptibility to stress and anxiety. Some women also experience symptoms of depression. These emotional changes can impact overall well-being and relationships. It's important to seek support and coping strategies when dealing with these mood fluctuations. 

Bone health and cognitive changes
The decrease in oestrogen levels can affect bone health, potentially leading to osteoporosis, a condition that weakens bones and makes them more susceptible to fractures. Cognitive changes, such as difficulties with memory and concentration, are also reported by some menopausal women. While these changes are generally subtle and temporary, they can be concerning. 

Lack of conversations and existing taboo 
A substantial part of the challenge around menopause lies in the inadequate awareness and confidence among medical professionals, including doctors and pharmacists, regarding treatments. Their hesitancy to address the issue translates into a sense of shame for women seeking help. They often encounter feelings of guilt and thus, the dialogue around menopause dwindles, and women avoid discussing it altogether.

It prompts them to explore alternative avenues such as diets and naturopathy, often to no avail. At the peak of their careers when women should be moving into senior positions and guiding younger workers, many leave their jobs due to lack of understanding at the workplace or relevant provisions. 

A shift of narrative 
The recent years have ushered in a gradual transformation, driven by a broader cultural shift that directly challenges ageism and unequivocally affirms the worth of older women, informs Kulkarni. This growing camaraderie amongst women is fostering a platform for shared experiences and discussions that empower them to confront menopause-related challenges openly and without reservation. 

Governments, NGOs, and organisations worldwide are also taking strides to change the way society views menopause. In India, the government's National Programme for Health Care of the Elderly provides essential healthcare services for senior citizens, including menopausal women. 

Additionally, NGOs like the Menopause Research Society of India are working to increase awareness and support. Countries like the UK have integrated menopause education into workplace wellness programmes. Initiatives like these not only empower women to manage their health but also create an environment of understanding and empathy. 

Femtech startups are playing a significant role in transforming the menopause narrative. These technology-driven ventures are developing innovative solutions to address menopause-related challenges. From symptom-tracking apps to telemedicine platforms connecting women with specialised healthcare professionals, femtech startups are making menopause management more accessible and personalised. 
India’s efforts to address menopause-related challenges 

India is gradually addressing menopause-related challenges to transform the narrative from a taboo subject to one of empowerment. Several key initiatives and policies have contributed to this shift in perception. Firstly, the Indian government recognises the importance of addressing women's health during menopause. 
  
For example, under the National Health Mission (NHM), the government has aimed to improve women's health and well-being across their lifespan, including during the menopausal years. This has led to the development of educational materials and campaigns focused on menopause, aiming to dispel myths and provide essential information. 

Secondly, healthcare institutions and organisations in India have established specialised menopause clinics. One such example is the "Menopause Clinic" at the All India Institute of Medical Sciences (AIIMS) in New Delhi. These clinics provide a comprehensive approach to managing menopause-related challenges by offering medical advice, lifestyle counselling, and mental health support, effectively empowering women to manage their symptoms and take charge of their health.
 
Lastly, non-governmental organisations and women's support groups, such as the Menopause Society of India, have played a pivotal role in shifting the narrative surrounding menopause. They organise awareness programs, workshops, and support networks to help women understand and embrace this life stage. Such community initiatives help create a sense of empowerment by fostering an environment where women can openly discuss menopause-related challenges, share experiences and seek emotional support. 

While significant progress has been made in shifting the narrative around menopause in India, continued efforts are needed to address the specific needs of women during this phase of life, particularly in rural and underserved areas. Furthermore, policy changes that further integrate menopause into the healthcare system, and wider societal shifts in attitude and awareness, will be vital in empowering women to manage their health during menopause with confidence and dignity. 

Empowering society to address menopause 
The transformation of the menopause narrative requires a collective effort. Educating families and spouses is essential to fostering support networks. When partners understand the physical and emotional changes women experience during menopause, they can provide invaluable support. This can further destigmatise menopause and encourage women to seek help when needed. 

The society at large must play an active role in dismantling the taboo surrounding menopause. There is a need to include comprehensive sex education in schools that covers menopause, helping young generations understand and normalise this phase. Media representation can also influence perception; by portraying menopause positively and realistically, it can contribute to the broader conversation. 

Beyond anything, education and awareness are at the heart of this transformation. Women need accurate information about menopause's physical and emotional aspects, as well as available treatments. Empowering women with knowledge can enable them to make informed decisions about their health and well-being. 
The more women embrace menopause as a natural life phase, the less its stigma will persist. It will also empower them to consider menopause not as the end of something but more as the beginning of another chapter of their lives. As a new generation of women is discovering, the more that we talk about the big M, the better informed we become, and therefore, more liberated to embrace this phase. 

Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.

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