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Many, have asked why we don’t talk about menopause when what we really should be asking is ‘How can we learn to talk about menopause?’
The word menopause appears twice on the Relationships and Sex Education and Health Education guidance published by the Department of Education in 2019.
You will find it on page 29 under the section titled –
By the end of secondary school – Schools should continue to develop knowledge on topics specified for primary as required and in addition, cover the following content by the end of secondary: Intimate and sexual relationships, including sexual health
To have the word menopause mentioned in the curriculum was certainly a huge leap forward and a long overdue addition to the other relationship and sex education topics. However, in specific content, I have not been able to speak with anyone who knows exactly what is being delivered across the country.
What about Menstrual Health?
As with all topics in education they need to be introduced at various points, in relevant and meaningful terms for the age group and cohorts.
The word menstrual gets 7 mentions in various forms as either products, cycle, or wellbeing, and menstruation gets 6 mentions. Go the Period Campaigners!
However, there is still no mention of menstrual health in the curriculum, currently.
The term Menstrual Health was developed through a multi-stage process, led by the Terminology Action Group of the Global Menstrual Collective in 2021 – only 200 years after the word menopause was formally adopted thanks to French Physician Charles-Pierre-Louis de Gardanne to describe the permanent cessation of menstruation.
Since 2021 the World Health Organisation has placed menstrual health firmly on the global agenda.
What about the missed generations who have not learned about menstrual health?
Trying to learn about menopause without first learning about the prequel event called menstrual health, has proven time and time again to be the one thing that is holding back the conversation.
Let’s take a closer look at the missing menopause memo.
Menstrual health, like mental health, can be positive or negative. Most narratives place anything to do with menstruation in the negative column and refer to ‘period problems’.
Menstrual health is every single day of a menstruators life, not only the days of bleed.
For those who follow the typical timeline, they will experience around 450 menstrual cycles over 40-years. The menstrual health timeline is forecast the moment two sets of chromosomes unite. Menstruation will start a couple of years after the ovaries have ‘switched on’.
The regular infradian rhythm called the menstrual cycle has an unpredictable sequence to start with and then within a few years becomes mostly predictable, creating ovarian/uterine patterns that are relative to each person. On average menstrual cycles range from 21-35 days in length.
The first 30 years of circulating menstrual cycle hormones influence everything from muscles, bones, digestion, energy, metabolism, immunity, respiration, and the brain. In total, there are around 400 roles in the body that are collectively driven by sex hormones, in all humans not only those who menstruate.
It subsequently makes sense that the fluctuating cyclical version of events, driven by the ovaries in a menstruator will have a cyclical impact on physiology, second by second. The last 10 years of pre-planned ovarian activity is one that becomes less predictable, known as perimenopause. The tipping point of perimenopause, also known as accelerated ovarian aging, is estimated to be on average age thirty-seven and a half years.
Aging conundrum: A perspective for ovarian aging. Research has shown that the decline in follicle numbers is a bi-exponential function of age, and this change occurs at the critical value of 25,000 follicles at the age of 37.5 years. Frontiers in Endocrinology
From this point forward ovarian aging speeds up, slows down, does a loop the loop and then closer to the typical menopause day (51) the menstrual cycle stops for several months at a time, until it finally stops, permanently.
In my opinion, to truly understand menopause and create confident conversations, you have to know about the menstrual health timeline and the sequence of events that start 40 years prior.
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A Menopause Tool Kit …
… is a collection of actions and items that will enable you to manage symptoms and optimize your physical and mental health as you travel the menstrual health timeline.
It could equally be called a Menstrual Health Tool Kit. Choosing what to add to the robust selection of items can only happen when you have a clear understanding of where you are and what the options are.
What you choose today, may not be what you choose tomorrow. It’s all about balance.
1. Learn about the menstrual health timeline
You can read a copy of Menopausology (no email required). This short read will explain the process of menopausing and give you an insight into why menopause transition may lead to some physical and emotional challenges.
2. Keep a Journal to collect the data on you
Use a symptom tracker, pen and paper will do, to identify the signs and indicators that you are noticing now. You could also recall any other symptoms that may have come and gone in the last few months or years. Write down as much as you can about your historic menstrual health.
3. Tune in to you
As you start to notice more things about yourself, start to record the information in terms of food, mood, movement, and stress. Also, note any significant differences in relation to your menstrual cycle. It may take 30 days or so to collect enough information but gradually you will start to get a much clearer picture of when symptoms occur, what makes them better, and when they are worse.
5 Key ‘supplements’ that could be in any menstrual or peri/menopause tool kit, are*:
Breathing (Vit O) – get plenty of Oxygen. Controlled breathing, on purpose with a purpose, will instantly reduce stress which triggers a reduction in cortisol, which then helps all hormones work better. What kind of symptoms may be helped? Feelings of sadness, anxiety, physical strains, vasomotor symptoms (hot & cold flushes, and sweats)
Move (Vit E) – exercise that helps to maintain muscle strength and joint flexibility will keep you mobile for longer in your lifespan. Moving requires the heart to pump and the lungs to inflate. Both help with circulation and cardiovascular strength. What kind of symptoms may be helped? Mindset, emotions, aches and pains, flexibility, brain fog.
Food (Vit N) – a good quality of nutrients is essential. Without a great source of vitamins and minerals from a wide variety of real foods you are not going to experience the best kind of natural hormone cascades that your body should be experiencing to function well. What kind of symptoms may be helped? Crushing fatigue, brain fog, joint aches & pains, temperature regulation, insomnia.
Rest & Destress (Vit Sr) – Stress and Sleep are two vital components of life. Whilst we need positive stressors to function, too many for too long of the negative stressors will impair all hormone functions, slowly grinding us to a halt. Sleep, or rest, must be good quality to balance out the stress. Sleep can become impaired not only because of changes in ovarian hormone levels but also because we rush into it. Take more break points in the day to connect with the parasympathetic nervous system. For example, while the kettle is boiling stand still and breathe, prep your real food meals, and chop/mix in a mindful way, let your mind wander, and journal for 5 mins before bedtime. What kind of symptoms may be helped? Insomnia, overwhelm, lack of joy, anxiety, vasomotor symptoms, ear and eye ones (anything related to the vestibular system)
Social Connections (Vit L) – finding joy and laughter during times of confusion feels like a complex ask. ‘Shouldn’t you be focusing on the core elements?’. We are human beings and we benefit from being human with others. Oestrogen has a direct relationship with oxytocin the ‘cuddle and care’ hormone, which also happens to be a brain chemical. Without enough oxytocin, it directly affects our happiness dial. The bad news is oxytocin depletion can present as aching muscles, sleep disturbance, and a bigger appetite for sugary foods. The good news is laughter swaps the cortisol in the bloodstream with the happy hormones oxytocin, dopamine, and endorphins. Altogether they can improve immune functioning, stress relief, cardiovascular health, reduced anxiety, sense of safety, and improved mood. What kind of symptoms may be helped? All of the above.
*The Bottom Line – Obviously, there is a play on the word ‘supplement’ and those 5 vitamins are not real – but I honestly think they should be.
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A Menopause Doula is someone who can guide, nurture, and support you, from periods to perimenopause and beyond.
Guide – I do this by providing general and specific information about menopausing, and how it applies to you. Before you talk with me I will send you some questions to answer so we can have a good insight of which direction our chat needs to go.
Nurture – This is where I listen to your menstrual health experience so far and find out more about what matters to you. It may also include some mindset work, and exploring your values and beliefs so we can start to build a menopause tool kit.
Support – Using my Menopause Mapping principles we gradually explore the glimmers and triggers and start planning your next best step along the menstrual health timeline
What kind of menopause information do we talk about?
Sometimes it’s a bit like a menopause lesson. I provide some helpful resources to give you some background knowledge and then you have plenty of time to ask me questions. My years of experience talking about menopause have given me some practical tools to explain the hormone biology, without being boring. Very early on in helping people navigate this time, I realised that you can’t manage what you don’t understand, so some basic menstrual health know-how helps you see the bigger picture, of where you’ve come from and where you are going.
Who can work with a Menopause Doula?
Anyone. It could be the person going through the experience or the people who love them.
- Most often if you can’t see the wood for the trees and want to reach it and speak with someone with lived experience and a lot of helpful tools and resources then this is the conversation for you.
- You could be someone who’s done a lot of homework, but hasn’t quite figured out the best way forward and would like some signposting and support.
- Maybe you have tried all the lifestyle measures, even added a sprinkle of HRT, but still feel exhausted and want some help.
I’m here for all of the above.
How often can you speak with a Menopause Doula?
As often as you wish. Unlike a therapist with a specific modality, we can give you a broad perspective of the dynamics of menopausing. I see myself as a generalised specialist.
However please do not confuse me with a clinical menopause specialist who prescribes pharmaceuticals.
- You may find that one menopause therapy conversation, with your Menopause Mapping guide in hand, is enough for you. You can always pop back again another time.
- Perhaps you know that you are the kind of person who will need a little prompt for a few weeks to keep you heading in the right direction. I can do that too.
- At any point, I am happy to speak with you and a special someone who is planning on being part of your Team Meno. It’s not always easy to explain to others what you’re feeling, so I can help you with that as well.
I have been in the holistic health and wellbeing arena for nearly 35 years, starting as a Beauty Therapist. I also trained in Applied Biology and became a Biology teacher. As I was going through perimenopause in a very haphazard way I realised that I had never been taught about menstrual health, let alone menopause health.
My vision is to increase access to information about menstrual health for everyone who needs it, across life stages. I didn’t have anyone to reach out to and ask the simplest of questions so I became one, for others. My particular style of Menopause Doula-ing also expands to menstrual health with a wider lens. So you don’t need to be perimenopausal to benefit from a conversation with me.
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What an amazing event! I am so glad I came.
The MAC Centre in Edgbaston, Birmingham become the hub of Menopause education on Sunday 27th January 2024.
The event was hosted by the Menopause Group CIC, accompanied by Aamilah Begum from Menopause Talk CIC.
The room was full of people looking to learn and understand what it means to menopause, particularly as a person of faith.
Through the session we hear people saying things like:
Why don’t we learn this at school?
I’ve been to five other menopause talks to try and understand what was happening. After this one, I don’t need to go to anymore.
We lead them on an educational journey through The Story of Menopause – from periods to perimenopause and beyond. Aamilah talked about her lived experience of endometriosis and both a chemical and surgical menopause.
As a woman of colour and faith the elements that impact her and many others, are rarely talked about and understood. The audience resonated with everything she said and were inspired to empower themselves with understanding the menstrual health timeline, as explained by Fiona.
