Cool Change

Hot flushes, irritability, libido free fall. That’s what Nickle James expected from menopause. The reality was far different.

Sunday Life

My mother had died. Two months later, so had my father. Was it my turn next? At 46, six months after my father’s death, I had a hysterectomy. Unexpectedly, the doctors found a cancer, yet it hadn’t spread. I was lucky. However another operation ensued, this time my ovaries were to be taken out ensuring immediate menopause.

I didn’t know much about this taboo subject, but after speaking to my gynaecologist and friends who had gone through it, it sounded like I’d be better off dead. Wet, sweaty sheets, hot flushes all day and night, lack of sleep, vaginal dryness, irritability, anxiety and the inability to think properly would turn me from my Jekyll-like state into some sort of hideous Mrs Hyde. The symptoms  of menopause read like the ingredients for Milton the Monster without the tincture of tenderness.

The weeks leading up to the operation were filled with preparation for my ghoulish makeover. Before my operation, I farewelled my friends, quite sure they wouldn’t want anything to do with the menopausal monster who would emerge from the anaesthetic. My husband and son were warned about my impending transformation.

Next came my wardrobe. I threw out all my jumpers. I wouldn’t be needing them where I was going – a one-way ticket to Satan’s lair. The lacy underwear and suspenders were next. Out they went. All I had to look forward to in my soon to be dreary life were the white and beige tones of Spanx.

My gynaecologist offered drugs which could make me feel more normal but, despite my depleted closet, I was firmly against them. “Expect to wake up from the operation with a hot flush,” he said. My GP offered different advice. “Wait and see,” she said. It was her who alerted me to the different ways menopause is viewed in certain cultures. In Thailand, she said, a menopausal women is someone to be revered and hence Thai women rarely have symptoms. Perhaps there was some hope, yet the only thing I had in common with those petite Asian women was my order of pad Thai and even that – with the chilli left out – was Australianised.

Apparently it is not just Thai women who are less susceptible to the side effects of menopause. Japanese women rarely experience hot flushes. Margaret Lock in her book Encounters with Aging: Mythologies of Menopause in Japan and North America showed that there wasn’t even a word for hot flush in the Japanese vocabulary until quite recently. For the Japanese, this is unusual. Their language is very precise and has a huge variety of words for other types of heat – from soaking in a bath through to the after effects of drinking too much alcohol. The most frequent complaint of menopausal Japanese women is frozen shoulder, something also common in middle-aged men.

In Guatemala and Mexico, rural Mayan women also report no traditional symptoms of menopause. In Western society it seems poor fading women need to be saved from the horrors of age, whereas the Mayans look forward to their new status, which enables them to become spiritual leaders in their communities.

Could it be that Australian women have been brainwashed by the marketing hype which pushes the message that once we have gone through menopause, we become invisible?

If we listened to esteemed doctors and philosophers, we would have cause to believe that our purpose had been served and now it’s time to step aside. Sigmund Freud described menopausal women as “quarrelsome, peevish and argumentative, petty and miserly”. The insults would keep getting worse. Psychiatrist David Reuben described the menopausal female as a woman who becomes “not really a man but no longer a functional woman” in his best-selling book, Everything You Always Wanted to Know About Sex, But Were Afraid to Ask.

During the last two decades there has been a standoff between medicos and anthropologists. Anthropologists believe that we are influenced by culture while many medicos argue that menopause is a purely physical occurrence.

Dr Vijay Roach, obstetrician and gynaecologist at Sydney’s North Shore Private Hospital agrees that symptoms vary between cultures, with hot flushes less frequent among Asian women. “This may be attributed to a high intake of plant oestrogens, or phytoestrogens, found particularly in legumes and soy products,“ he says. Yet it seems when these women come to Australia their immunity from the endless summer sizzle disappears.

“In Australia, migrants from non-European cultures report menopausal symptoms with the same frequency as Europeans,” says Roach.

Perhaps this is a reverse example to what Dr Dixie Mills, a Harvard-trained surgeon who co-founded the Women to Women website, describes when she says that there may be a relationship between what we experience physically and what we learn from our social environments. She gives the example of women in Papua New Guinea who welcome menopause without symptoms like many native Americans and sub-continental Indians.

In cultures where older women are valued, menopause seems to be either not noticed or a positive experience, yet in the West the disease model is paramount.

Feminine Forever, by New York gynaecologist Robert A. Wilson, trumpeted this model when he offered to rescue women from what he called “The living decay” of menopause with his oestrogen replacement pill. Therefore perhaps it is no surprise to find that in our ageist culture, 80 per cent of the approximately two million Australian women in the clutches of menopause, experience moderate or severe symptoms.

Before my operation, I asked my gynaecologist how many of his patients who had induced menopause had experienced no or very subtle symptoms. He could only name one. I awoke from the anaesthetic waiting for the fires of hell to seize me. I waited all day in hospital, ready to plunge my feet and wrists into buckets of ice as soon as I was set upon by the dragon’s breath. By the end of the week, I was still waiting. That was six months ago.

I haven’t experienced a hot flush, lack of sleep or loss of libido. I haven’t turned into the Wicked Witch of the West, or even the east; I have friends, real ones, not just on Facebook. The only downside was the extra trip to the Smith Family with my unopened packets of Spanx.