What is menopause?
Participants listed a number of different definitions of menopause and various menopausal experiences, both cultural and biological, which were seen to epitomise menopause as a significant event in a woman’s life. Many women understood menopause in a very biologically-oriented way, such as the cessation of periods, decreasing bone density, weight gain, sleep disturbance, hot flushes, brain fuzziness, changes to the uterus, inability to produce eggs and the end of fertility and reproduction. Of these biological changes, many women expressed joy at not having a period anymore and not having to buy the associated products.
“Okay, so biologically I understand that it’s when I run out of eggs. So no more periods. So my oestrogen levels fall […] and that means physiologically that there’s a period of stopping and starting. So I suppose that’s what it is. And I know the symptoms associated with it are hot flushes or heat, any way heat waves, and what else … a whole heap of other symptoms that I’m getting” (Kirsty, 51, Academic at Uni A, peri-menopausal).
However there were many women that saw menopause as a defining period in a woman’s life, which signalled the ageing process responsible for bodily changes such as wrinkles, grey hair, skin dryness and the increased risk of diseases such as breast cancer. Similarly, there was some confusion around what menopause actually is and how it can be ‘treated’, which fed into their own menopausal perceptions and experiences. For example, many women were fearful of Hormone Replacement Therapies (HRT). Thus, it became clear that menopause is a very subjective experience and one that is culturally and socially interpreted on varying levels.
“There’s, you know, aspects of that, that people need to be very mindful of […] menopause is actually quite a psychological step change in people’s lives […] it’s about mid-life, I don’t call them crises, I just think it’s a real review period. […] I think that’s a really important time for women.” (Cassie, 53, Professional at Uni A, post-menopausal).
Pre-menopausal Women’s Perceptions of Menopause
Because pre-menopausal women have not experienced menopause first hand, participants tended to draw correlations between menstruation and menopause, and generally viewed it as just another hormonal ‘stage of life’ to deal with. Much of their knowledge of menopause was attained through mothers relating their experiences to their daughters, or by witnessing menopausal women’s visible symptoms in the workplace, such as hot flushes or irritability. Although there was awareness they would experience menopause at some stage, it did not appear to be something on their immediate horizon.
“What comes to mind? Not much really. I can’t say, I suppose I haven’t given it that much thought. If you’re asking me to think about it, I think it’s, you know, it’s another stage of life to manage and I think that there are all sorts of things that people bring to work that they’re managing […] menopause would be one of many things. It doesn’t have particular significance for me, perhaps becomes I’m not in the middle of it.” (Alisha, 43, Professional at Uni A, pre-menopausal).
Moreover, pre-menopausal women tended to see work and their bodies and bodily functions as distinctly separate from the workplace and perceived any discussion about these matters as unnecessary or inappropriate. However, women originating from a more female-oriented Faculty, described more space and openness for discussions around female bodily matters. Nonetheless, the lack of thought surrounding menopause was part of a broader indication of menopause being a ‘silent’ issue, both within and beyond work spaces.
Many women acknowledged that although menopause and other hormonal issues were not discussed formally in the workplace, it was still being discussed during private or informal conversations at times. Most women expressed a willingness to discuss these matters with other female colleagues or close friends around the same age group as this made them feel more comfortable knowing they could self-identify. Although there were informal discussions that took place in hallways and lunchrooms, they were significantly less likely to occur when the environment was dominated by men, as almost all women expressed reluctance to discuss private bodily matters with other male staff.
It was striking that a number of women drew on the motif of ‘women’s business’, evoking particular cultural and national associations. Most women expressed they were more likely to want to discuss bodily or private matters with another female if they needed to have that conversation. Some did note this was not because they thought their male bosses could not handle the conversation, more that another woman would be better equipped to understand. In this sense, women were more likely to seek out the solidarity of another woman who could relate to or share their experience through empathy, and not express judgement.
“If you’ve got a manager and head of department who are female who perhaps have been there, or who are sharing their experience with you, then naturally there’s more acceptance and understanding of it; whereas if you’ve got a male head of department and perhaps male manager, I think you’d suffer more in silence and you wouldn’t share as much, you wouldn’t be saying “oh I’m sorry I’m menopausal, I’m quite emotional at the moment.” (Beth, 40-50, Professional at Uni B, pre-menopausal).
There was a unified belief that women simply ‘just get on with it’ and menopause was not something that was (or should be) used to justify diminished levels of work performance or collegial engagement. Importantly, most women found that although menopause is often acknowledged and privately shared between female colleagues, it was always separated from the professional aspect of their workplace.
“It’s almost like a women’s in-joke, you know you make jokes about it whether you’re going through it or not. You’ve got the older women, or older than me, who will make references to it but much more on a personal level rather than a work level; but it’s as visible as women talking about periods or talking about their children or child birth or that sort of thing. It’s just one of those stages.” (Belinda, 47, Academic at Uni B, pre-menopausal).
Menopause as Positive and Negative Experiences
From previous findings, we can see that menopause is a highly subjective experience that can vary according to a number of different factors, such as cultural factors, state of health, pre-existing health conditions and time of life events. It is therefore not surprising that women can view menopause in a number of different ways according to their own lived experiences. For many women, menopause is characterised as a very positive change in their lives and their experience was viewed favourably, even if they endured the physical symptoms. The cessation of periods and not having to worry about unexpected pregnancies were welcomed biological changes, yet the more meaningful changes appeared to arise from a psychological perspective. Some women experienced an increased sense of awareness about the world and their position within it. They felt more at peace and more in line with their emotions and ability to create a positive identity for their self, as well as manage their lives both in and out of work.
“I really thought that it (menopause) would affect me far more than I thought it would affect my sense of being a woman, and maybe from that a sense of a working woman; but it sort of actually corresponded with quite a positive time in my life.” (Maria, Academic at Uni B, post-menopausal).
Conversely, there were also negative experiences that created a time for feelings of regretful reflection about missed opportunities, past transgressions and the inability to let them all go. This was often compounded by realisations that the broader job market was a lot harder to secure work in for older women, as opportunities began to dry up. Chiefly, some women felt that they ceased to actually be a woman, as their identities were subsumed to that of older feminine gender roles.
“It’s almost like […] you’re not a woman any more in your own right – you’re a mother or a grandmother, or you know just a good citizen […] there’s expectations sort of put on your behaviour […] shopkeepers and that kind of thing will address you is a whole different way […] they kind of pigeon hole you into, you know, well ‘you’re going to be interested in crochet’ or something stupid like that, rather than you might be in there buying sexy lingerie.” (Belinda, 47, Academic at Uni B, pre-menopausal).
Complex intersections were present between biologically-attributed experiences, perceptions or feelings and the overall sense of menopause as positive or negative. However, this in itself suggests the need to view menopause as impossible to separate medical or biological symptoms from the cultural, social and temporal aspects of women’s life that culminate in and around the ‘menopausal’ period.
Heterogeneity of Menopausal Experiences
The data revealed that women can have very different experiences of menopause as there is no definitive chronological age or set of symptoms that can account for every woman’s physical, mental, social and bodily experience of menopause. Common symptoms included, but were not limited to, forgetfulness, sleep deprivation, dizziness, hot flushes and extreme heat at night, irritability, ants crawling under the skin, brain fuzziness and weight gain. How women experienced and managed these symptoms, if at all, varied greatly and depended on a number of different factors. For instance, the sudden onset of symptoms such as hot flushes or forgetfulness was often exacerbated during times of stress or situations where there was ‘no place to hide’, e.g. during meetings/business gatherings or on an aeroplane. Some women had very few symptoms and expressed relief at having gone through menopause reasonably ‘unscathed’, or even experiencing it as a ‘non-event’, whereas some women experienced the full gamut of symptoms commonly associated with menopause, and for longer periods of time.
“I have a lot of night sweats and hot flushes, I feel moody things, break outs, but I don’t think it’s as extreme as some of the people I’ve heard […] I mean have a hot flushes but it wasn’t embarrassing, it didn’t affect my work that I had to stay at home […] in the spectrum I think I’m low to medium sort of experiences […] I just went with the flow […] there was insomnia, yeah, a lot of, because you wake up in a sweat, but I haven’t been a good sleeper for the last 25 years anyway so it hasn’t impacted that much” (Gina, 57, Professional at Uni A, peri-menopausal).
Hot flushes – Universally Experienced?
‘Hot flushes’ was one of the most commonly used phrases that came up when discussing symptoms, which seemed to epitomise the menopausal experience. For those that did experience unexpected hot flushes, these episodes may cause a great amount of embarrassment and anxiety which affected their feelings of self-esteem and confidence. A reason for this may be that other visible symptoms of menopause are located in a more generalised sense of ill-health or ageing, such as tiredness, forgetfulness or irritability, symptoms which are not solely experienced by women. In this sense, hot flushes become the most commonly attributable symptom linked to the female-only experience of menopause. Women reported several strategies for dealing with hot flushes, such as wearing layers of clothing so pieces can be removed quickly if a sudden hot flush occurs, or avoiding environments that they associated with causing hot flush episodes. However, although hot flushes were commonly experienced by many women, there were also some participants that never had any issues with hot flushes and cited other symptoms such as stress and anxiety as causing more disturbance to their work.
“I’ve got to say it doesn’t impact on my work very much, personally or in my dealings with others. I guess, the one thing that I do notice is when people have hot flushes, because now I understand what it is, because that was the one symptom I did have. […] I think menopausal women who have a hot flush are a lot more self-conscious about it than they need to be. […] most people, almost everybody in the room, is just oblivious. You think it’s a big overt symptom and actually it’s not. […] Having gone through (menopause) I’m a little bit more sensitive so when people say ‘oh can we open a window now?’ or ‘can we turn the air conditioner on?’ I’m thinking, okay, yeah, whatever makes you comfortable.” (Janet, 54, Academic at Uni A, post-menopausal).
Ambiguity of menopausal symptoms
Menopausal symptoms were often problematised by what was attributed to hormone levels and what was attributable to other aspects of life, such as work stresses or private matters that impacted the workplace. Similar to common dysphemisms about women’s menstruation e.g. ‘oh she’s got her period or she’s menopausal – watch out’, women of a certain age who were perceived to be menopausal would also experience dismissive remarks.
“I think it’s a very Aussie way of, you know, fobbing it off, ‘oh don’t worry about her, she’s just menopausal’, where really women should be able to have that time to be emotive or to be sensitive […] if someone is going through maybe even a separation or a very bitter divorce and they’re around that age, it will get fobbed off as menopause and that’s really sad.” (Beth, 40-50, Professional at Uni B, pre-menopausal).
Several women noted an awareness that their moods had become harder to manage at work and were sometimes quicker to get angry in stressful situations. However, there were not always clearly defined attributes linking this to menopausal symptoms, and other factors such as increased responsibilities and workloads, or the general ageing process, were also associated with, or had some influence on, their experience of the menopause/work relationship.
Unpredictability of Menopausal Symptoms
The unexpected nature of menopausal symptoms meant that most women were caught off guard during highly inopportune moments, such as meetings or conferences. The sudden onset of symptoms can include hot flushes, sweating, headaches, feelings of panic, anger or frustration, forgetfulness and brain fuzziness. Often, the severity of one symptom can cause such anxiety that subsequent symptoms will arise as a result.
“I could feel this headache starting and then I had it for the entire time we were there […] I had to really focus and concentrate on the workshop and I ended up forgetting a couple of activities… I started to get really hot as well, so the emotion brings on the hot flush so that wasn’t a nice experience.” (Tracey, n/a, Professional at Uni B, peri-menopausal).
The inability to perform to the best of one’s ability creates a significant amount of stress and anxiety, which again can lead to poor self-esteem and loss of confidence. Symptoms are often so distracting it can cause a total lack of concentration and focus which then places enormous pressure on the individual, which was exacerbated by possible stigma associated with menopause
“It did affect my confidence for a while, because I’d be in a meeting and I’d be looking at someone and then I’d go blank, for example someone’s name. I’d be talking about reporting back or talking about a conversation that I had with someone and I’d just go blank on that name.” (Marta, 50-55, Professional at Uni B, peri-menopausal).