Why we need more women engaging in menopause research

Menopausal women are the fastest-growing workforce demographic, with 8 in 10 in work and many servicing many public sector jobs and others. Almost 1 in 5 of the average workforce are menopausal; and 1 in 4 consider leaving due to their symptoms with 1 in 10 leaving. The economic cost and consequences of women leaving the workforce due to menopause is enormous and can have implications on a workplace impacting loss of productivity, talent, organisational knowledge and experienced workers. Women experience menopausal symptoms, and this is a significant milestone in a woman's life. It is marked by the end of reproductive capabilities and accompanied by various physical, psychological, and social changes.

Despite being a natural biological process, the treatment and understanding of menopause have historically been shaped by male-dominated medical research, often sidelining the voices and lived experiences of women. However, in recent years, there has been a shift towards recognising the importance of women’s subjective experiences in menopause research, with a growing focus on person-centred care. This blog explores the invisibility of menopause, the role of feminist health movements, and the current approaches to incorporating diverse experiences into menopause research.

The marginalisation of women’s voices in menopause research

For much of the 20th century, menopause research was dominated by a biomedical perspective, primarily focused on hormone replacement therapy (HRT). Oestrogen replacement was framed as the primary solution to menopause, seen as a deficiency in hormones rather than a natural life stage. Menopause was often treated as a condition in need of medical intervention, reinforcing the idea that aging female bodies were inherently flawed.

During this time, women’s personal experiences of menopause and how they felt about the transition and how it impacted their live were largely ignored. The medical community relied on clinical measurements such as hormone levels and bone density, while subjective experiences were sidelined. Emotional and psychological symptoms, like mood swings and feelings of loss, were often downplayed. As a result, menopause was frequently pathologized, with little attention paid to how women navigated their identities or coped with the transition.

This approach not only reinforced negative stereotypes about ageing women but also created a narrative in which women’s bodies required fixing. The medicalisation of menopause placed the control of the transition in the hands of male doctors and researchers, leaving little room for women to assert their experiences or make informed choices about their health.

World Menopause Day

The theme for this year’s World Menopause Day is Menopause Hormone Therapy (MHT), and the International Menopause Society (IMS) will be launching an IMS White Paper (2024) that aims to report on the current controversies regarding prescribing of MHT. We have also seen the mass marketing on women’s health with off the shelf treatments, pop up clinics, menopause related tablets and advice around MHT. This is why the evidence base is so important and why consultation with women in research is even more important.

World Menopause Day is held every year on the 18 October. The purpose of the day is to raise awareness of the menopause and the support options available for improving health and wellbeing. IMS encourages professionals and women to take part in this global awareness raising campaign by printing and sharing these materials, organising events to engage their communities, and sharing World Menopause Day social media posts.

The feminist health movement and a new perspective

The feminist health movement of the 1970s and 1980s was pivotal in challenging the medical establishment’s approach to menopause. Feminists critiqued the over-medicalisation of menopause and argued that it reduced women’s bodies to biological mechanisms in need of repair. In 2022, The World Health Organization (WHO) advocated for viewing menopause as a natural life stage rather than a disease that required treatment.

Central to this movement was the call to listen to women’s voices. Feminist scholars emphasized the importance of subjective experience in understanding menopause. Dr. Susan Love’s influential work in the 1990s, particularly her Menopause and Hormone Book, encouraged women to take control of their health, to understand their bodies and make informed decisions about treatment options. She advocated for personalised approaches to menopause treatment reflecting the growing recognition that women’s experiences were unique and diverse, and that one-size-fits-all approach was not the right way to in women’s health practices.

Organisations such as the National Women’s Health Network (NWHN), British Menopause Society (BMS), Wellbeing of Women (WoW), International Menopause Society (IMS) have played a key role in challenging the dominance of hormone replacement therapy, examining the evidence, and advocating for more research and for women to have a greater say in their healthcare decisions. These efforts led to a more person-centred approaches in menopause research and treatment, where the voices and experiences of women are considered.

A person-centred approach to menopause research

Today, menopause research increasingly values women’s subjective experiences and recognises the need for person-centred care. One of the key developments in recent years has been the rise of qualitative research methodologies, which prioritise women’s voices and allow for a deeper exploration of their personal narratives.

Qualitative research has revealed the variability in women’s experiences of menopause. Some women report intense physical symptoms, such as hot flushes and sleep disturbances, while others emphasize the emotional and psychological aspects of the transition. Importantly, studies have shown that these experiences are shaped by social, cultural, and economic contexts. For example, women from different racial and ethnic backgrounds often experience and interpret menopause differently.

Furthermore, menopause intersects with other aspects of women’s lives, such as work, relationships, and mental health. Many women report that menopause affects their work lives, with symptoms like fatigue and difficulty concentrating impacting job performance. However, workplace policies often fail to address the needs of menopausal women, leaving many uncomfortable discussing their symptoms with employers.

This growing body of research underscores the importance of listening to women’s voices in all aspects of menopause, from medical research to workplace policy. By focusing on women’s experiences, researchers can develop more inclusive and effective approaches to managing menopause.

Addressing intersectionality in menopause research

While progress has been made in incorporating women’s voices into menopause research, there is still work to be done to ensure that the diversity of women’s experiences is fully represented. Much of the existing research has focused on white, middle-class women, with relatively little attention paid to how menopause is experienced by women from different racial, ethnic, and socioeconomic backgrounds.

For example, research by Nadeem (2021) has shown that Black and Asian women tend to experience more intense and frequent hot flushes than white women, yet there is limited understanding of why this is the case. Similarly, Latina women often view menopause as a positive transition into a new life stage, but these cultural perspectives are often overlooked in mainstream research, which tends to focus on the negative aspects of menopause.

The concept of intersectionality, introduced by Kimberlé Crenshaw, describes how multiple forms of inequality can overlap and create unique experiences for people. It is crucial to understand how different aspects of women’s identities such as race, class, and sexuality shape their experiences of menopause. Intersectional approaches to menopause research recognise that factors such as systemic racism, economic inequality, and cultural norms all play a role in shaping how women experience and interpret menopause.

By adopting intersectional approaches, researchers and healthcare providers can better understand the unique challenges faced by marginalized women and develop more inclusive treatment options and policies.

Conclusion: Moving forward by listening to women’s voices

The integration of women’s voices in menopause research represents a significant shift towards a more holistic and inclusive understanding of this life transition. While the medical model historically marginalized women’s subjective experiences, feminist health movements and person-centred research have challenged this narrative, emphasizing the importance of listening to women. However, there is still work to be done to ensure that menopause research reflects the diversity of women’s experiences, particularly those from marginalized racial, ethnic, and socioeconomic backgrounds. By continuing to prioritise women’s voices and subjective experiences, researchers, healthcare providers, and policymakers can develop more compassionate and effective approaches to menopause that truly meet the needs of all women.

Where to seek for information and support on the menopause

The Women’s Health Concern provides a service to advise, inform and reassure women about their health. Here you will find a range of detailed factsheets providing information and advice on gynaecological, sexual and post reproductive health issues.

Menopause self care: 3Ts

It is important to start looking after yourself and focus in on the three Ts which are: 1. Talk about the Menopause; 2. to Track and know your cycle and seek 3. Treatment which can be either through medication or other therapeutic and non-pharmacological interventions. Please see this blog for further information.