There was a time a few years ago when Gwenyth Paltrow on Goop was advocating for jade eggs to
improve your vaginal area. They were pricey, trendy, and not so sanitary. I read a retort by a fabulous ObGyn MD who slayed the pseudoscience babble of Goop. It was spot on and awesome. That was my introduction to Dr. Jen Gunter.
So when I got closer to the dreaded M word (yes, menopause), I was thrilled to see Dr. Gunter (who wrote The Vagina Bible, yes clearly she does not shy away from the charged words of female genitalia and aging) wrote a book called “The Menopause Manifesto.” This will be a quick peek as to what I learned there. I don’t want you to skip buying the book to 1. Support Dr. Gunter and 2. Read her fabulous writing style by buying The Menopause Manifesto yourself. (I get nothing from referring you to her- I just truly think she is super smart, and her writing is awesome.)
She starts with her dedication. “For every woman. Your awesomeness is unrelated to your estrogen.” She continues with the first line of the book, “If menopause were on Yelp, it would have one star. This establishment has temperature control issues. Drenching heat followed by terrible chills…. Bleeding was scheduled but was rebooked without notification so arrived 3 weeks later than expected while I was in the Uber…The sex was dry.”
Yup. She is that great.
She talks about how menopause is treated not like a phase of life but a phase of death, or a disease, or that somehow we are “weak” when our ovaries stop making estrogen. Menopause is a phase of life. It is the reverse of puberty. And just like the puberty transition is rocky with hormone swings and acne, so is menopause. Menopause varies widely in how severe your symptoms are and how long they last.
She talks about how unfair it is that we women are judged to be somehow lesser after menopause, when the perimenopause and menopause time might reflect 1/3 – 1/2 of our life. I saw in a different book how in 1900 the average woman lived to age 50. Now it is until age 80. So we have 30 years post-menopause. Women are not alone in aging. Dr. Gunter coined a term to show how men’s sexual function decreases as well when they age, which she calls “erectopause.” Men are aging just like women are. She equates women living long enough to reach menopause as an achievement, which we should celebrate as well for men. “Through good sanitation and health care, men are now living long enough to develop erectile dysfunction.” Other cultures terms for menopause mean “change of direction” or “change of stage of life.” So if we are going to bandy around the term menopause, let’s make an equivalent male version, or better yet, let’s come up with a new, non-charged word for menopause. (Can you see why I love her?)
She argues menopause is great because it creates grandmothers, and many studies have shown that grandmothers being near their grandchildren improved the survival of the grandchildren. The only other mammals known to have menopause are toothed whales. (I tell you this book is just fascinating!) These whales have menopause at 40 and can live til 90. The grandmother whale ensures the grandbaby calf will survive.
Why am I a plastic surgeon writing about menopause? Because menopause hits you like a wall, and the changes in your body: eyelids, breasts, abdomen, skin quality hit you hard. It is common for me to see women at this time. Frequently they are almost bewildered. “I looked great two months ago.” It is like they walk off a cliff. Just as Dr. Gunter talks about for the other symptoms (hot flashes, acne, etc), when I see these perimenopausal women, I educate them on how THESE CHANGES ARE COMMON and EXPECTED. And there are things you can do.