The Public Face of Menopause

On a single night last month, Menopause The Musical played to a full house in Rochester, New York. After opening in 2001 in a 76‐seat theater in Orlando, Florida, it now shows worldwide and incorporates 25 popular songs from the 1960s to the 1980s. With clever word arrangements provided by four outstanding vocalists, it addresses most of the common personal menopausal issues women struggle to understand. Everyone who has had the opportunity to see this musical knows how brilliant it is. Yet, as I looked around the room, I was impressed by the large number of men in the audience. And with musical humor, this singular entertainment event has become the poster child of a major change that is occurring in our society; the public conversation of a one‐time forbidden topic.

Have we elevated the biology of menopause to parallel public efforts in diabetes, heart disease, and cancer? Not yet. We are more comfortable with the topic of women’s health than in the days of the twin beds of I Love Lucy. But have we made meaningful progress? The media certainly have desensitized us with nonstop sex and violence. How many magazines displayed in grocery stores offer lead articles suggesting “100 Ways That Your Man Can Make Your Sex Better.” Or, “What Women Want From Their Toyboy.” Yet, the personal and intimate discussions that women should have with their partners and their care providers about their own bodies have been off limits until recently.

As with any topic involving the female body, there are issues that are personal to the woman and those that impact directly on the partnership. Menopause medicine today is elevating women’s medicine to a new level. Today’s caregiver must be educated in the management of mood swings, memory loss, hot flashes, skin changes, pain during intercourse, incontinence, and breast, bone, and cardiac health.

Pain during intercourse (dyspareunia), however, is possibly the most private of menopausal issues a couple must deal with. Lower levels of estrogen lead to vaginal dryness and tissue changes, which can cause painful intercourse. Why do I say “couple?” Why were there so many men at Menopause The Musical? Menopause is not just a woman’s problem; it embraces the entire relationship, and men realize that. Loss of intimacy leads to struggles with depression. Mood swings accelerate her depression. And with those changes comes a further deterioration of the relationship. Witness the husband and wife who present for an initial consult. He says, “Please, can you help us? She has no energy, she never laughs anymore, and we no longer have sex.” In that same safe environment, she says, “what has happened to me? In my forties I had lots of energy, pep, was full of fun, and loved sex. Now I don’t even know who I am. Please help me. ”

Today, we as care providers benefit from the knowledge that scientists have provided to help us to become better educators in the field of menopause. And from our heightened awareness of the couple’s needs, we can advance the importance of diet and exercise, weight loss, role of alternative medicines, and finally, hormonal management. The menopause pendulum is swinging in a positive direction, and women and their families will benefit. Knowledge is power.

By James Woods, M.D.
Dr. Woods treats patients for menopause at the Hess/Woods Gynecology Practice.

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James Woods | 2/16/2015