March 8, 2023

Welcome to the Rebranding of Menopause

Written by Fiorella Valdesolo
The Globe and Mail
The Globe and Mail

Celebrities are helping to lead a cultural shift in how we talk about once-taboo life changes. From left, Jennifer Lopez, Pamela Anderson, Tracee Ellis Ross, Naomi Watts and Michelle Obama. Illustration by Photo Illustration by The Globe and Mail. Source images: Getty Images (Lopez, Ellis Ross, Watts, Obama), George Pimentel (Anderson).

In a recent video for British Vogue, Pamela Anderson revealed the contents of her vegan Stella McCartney bag: there was CBD oil for her arthritic hands, a g-string to moonlight as a scrunchie (a nineties trick-of-the-trade, she said), and a fan for her hot flashes.
Former U.S. first lady Michelle Obama was refreshingly candid on her podcast about the highs and lows of her menopause experience, from her decision to take HRT to the acceptance that she will no longer have so-called “Michelle Obama arms.”
And Tracee Ellis Ross, in a 2021 issue of Harper’s Bazaar, shared the impact perimenopause had on her –

“I’m going through it at the moment and it’s really frying my brain”

– and lamented the lack of resources. She said:

“There’s no information about it. There’s shame talking about it.”

She’s helping change that. This growing league of high-profile women daring to speak publicly about an experience that’s near-universal for women is significant. “[Celebrities’] experiences and willingness to talk, share and get involved are a crucial part of how cultural shifts happen,” says Celeste Lee, founder of Caire, billed as “skincare for grown-up women.”
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That cultural shift is a long time coming. When Lee was researching pop culture for a panel discussion at a recent menopause forum in New York, she found that of more than 100,000 television episodes that had aired since 1970, fewer than 10 included a mention of menopause in the storyline. “Edith’s Problem,” the 1972 episode of All in the Family that famously delved into menopause, chronicled the sudden chaos in the Bunker household stemming from Edith’s unpredictable and intense mood swings.
In one memorable scene, Archie, exasperated and confused by his wife’s state, yells: “If you’re gonna change, Edith, change! Right now! Change!” Edith (played by Jean Stapleton) was meant to be in her mid-40s on the show; her character would die of a stroke in a 1980 episode at age 52.
For women in that same age bracket now looking back at Edith, they don’t necessarily see a reflection of themselves. “For too long menopause equaled old,” says Michelle Jacobs, co-founder of menopause beauty and lifestyle brand Womaness, which offers customers everything from vaginal moisturizer to neck serum to leak protection liners. “Fifty today is not like fifty twenty years ago.” And that’s not just about how we look; we’ve all seen the meme, and yes, Jennifer Lopez, at 53, thanks to a host of reasons, looks very different from the Golden Girls actresses, but who cares
The real point is that women now are healthier and wealthier than previous generations and, therefore, are living much longer than even Edith did just a few decades back. “Now menopause is more than 40 per cent of our lifetime,” adds Fiona Lovely, MD, a doctor of chiropractic and expert in restorative endocrinology, functional neurology and functional medicine based in Calgary, who also hosts the podcast Not Your Mother’s Menopause.
The Golden Girls (above) and All in the Family (right) both tackled menopause in storylines – but today, many women don't feel reflected in those characters.
Technically, menopause is just the day that marks 12 months without menstruation. The time leading up to that day, called perimenopause or the menopause transition, can last five to ten years – years marked for some by a host of unwelcome symptoms like anxiety and depression, low libido, vaginal pain and head-to-toe dryness, not just hot flashes and night sweats as many of us are often led to believe. The years after are called postmenopause, and can be marked by the same symptoms.
Why many women feel ill-equipped for this transition – according to a report released in October by the Menopause Foundation of Canada, nearly 50 per cent of women in Canada consider themselves unprepared for menopause – may be partially because the doctors they are seeing are themselves ill-equipped to field questions about it. Stephanie Faubion, the director of the office of women’s health at the Mayo Clinic and medical director of the North American Menopause Society (NAMS), says that menopause management is not covered at all in most medical schools, and, if it is, the teaching is limited to one or two hours of lecture in residency programs.”
For doctors who want to be more informed and learn more, NAMS offers education in menopause management in the form of a Menopause 101 course offered in person and online,” says Faubion.
This knowledge gap means doctors sometimes don’t draw a link between the symptoms women are experiencing and the menopause transition. Both Jacobs and Sally Mueller, Womaness co-founder, had similar experiences with their doctors not identifying a number of the physical and emotional issues they were having as the hormonal fluctuations of menopause. In some instances, women are also facing medical gaslighting around menopause, as doctors downplay or deny very real symptoms. “A woman being told ‘get used to it,’ ‘this is what happens at your age,’ or ‘this can’t be so,’ is so common it’s hard to quantify just how often I have heard this from my patients,” adds Lovely.
It may be part of the reason some women are turning to telehealth startups for menopause guidance. Convenience, which we’ve become increasingly accustomed to, is part of the appeal; so is expertise. “Telemedicine does provide access to care for women who may not otherwise be able to see a menopause expert,” says Faubion.
Alloy Health, a startup offering prescription delivery service (for now, just in the U.S.), exemplifies this new generation of menopause telehealth. Started by Anne Fulenwider and Monica Molenaar, after their own struggles finding effective care during their menopause transitions, Alloy’s goal is to fix the access gap for other women. “There are a lot of safe, evidence-based treatments that actually really work and are inexpensive,” says Molenaar. “They’re just not accessible to women because we’re not prioritized by the system.” Estrogen, which Alloy offers in the form of pills, patches and topical creams for both the face and the vagina, tops that list of treatments.
The startup also just introduced topical sildenafil, the generic form of Viagra for women, something men have had access to since 1998. “It’s always sort of been available for women if they were courageous enough to talk to their doctor about getting a prescription,” says Molenaar. “And if they were courageous enough to prioritize their own pleasure and think they deserve to have a feeling and sensation.”
Alloy is part of a wave of health and beauty brands (like State Of, Pause Well-Aging, Phenology and Stripes, which was started by celebrity Naomi Watts) focused on menopause, most of them led by Gen X-age founders whose inspiration is coming from their own lacklustre experience around it. This generation of women, the bulk of whom are currently passing through menopause, are the ones dramatically shifting the narrative around it.
“A woman being told ‘get used to it,’ ‘this is what happens at your age,’ or ‘this can’t be so,’ is so common it’s hard to quantify just how often I have heard this from my patients,” says Lovely.
The brands they’ve conjured boast a design and product packaging that is more chic than clinical, so they no longer need be relegated to bottom-shelf display. And the voice is inclusive and approachable, designed to forge a sense of community, with no topic out of bounds. In a recent Instagram post, Stripes founder Watts asked: What kind of Dry January have you had… Dry AF… am I right? Why is it that we can talk about periods and puberty with ease, but when it comes to menopause, and yes, drrrryness… we all get a little skittish.”
“There’s something really unique about Gen X in that we’re frank and we’re the first generation who, while not ‘digital native,’ we have experienced all of our life stages online,” says Fulenwider. Finding a partner, marriage, pregnancy and baby-rearing have all driven this generation online, and so has seeking out health information. And, Fulenwider points out, formerly shameful or taboo topics (menopause, but also sexuality, infertility and postpartum) are finding a new support network thanks to social media via accounts like @hotflashesandcooltopics, @drmaryclaire, @ohhelloperry, and @davinamccall.
But there is the concern, particularly in regards to the menopause brands focused on beauty products, that the focus on menopause is simply a new occasion for companies to market products to women. Products that, in some cases, women may not necessarily need or benefit from. “The attention from brands is great, but only if these brands are providing value as many of these products marketed to menopausal women offer nothing new, novel, or even effective,” says Faubion, adding that creating healthy habits around diet, exercise, sleep and stress are what’s critically important during this transition.
Fulenwider’s concern is that menopause, being a biological function in our bodies, should always be addressed in the context of health; that everyone is getting the medical information they need, in addition to all those really great cosmetic and beauty items. And it’s true the needs of our skin and hair do change with menopause so, as Lovely says, in many cases these menopause beauty products may make good sense.
What might have just as much of an impact as the buzzy State of Menopause cooling spray, though, is the sense of feeling not quite so alone. “Being seen helps with the isolation of experiencing symptoms we don’t understand, aren’t well prepared for, and that leaves us feeling like we are crazy, old, decrepit or any number of adjectives we can use to describe ourselves in the absence of validation,” says Lovely. One of the best results of these brands rebranding menopause is the community they are helping to forge. Says Fulenwider: “The fact that there are many more people out there unashamed and proud to say the word ‘menopause’ will help all women.”
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