‘I’m only halfway through my life’: Midlife women are done with being dismissed
By Sophie Aubrey
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When Karen Anderson stumbled upon a menopause support group on Facebook in June, she learnt for the first time that hormone therapy is typically the best way to treat symptoms of the natural transition that all women go through in their 40s or 50s.
“I was wondering why hadn’t any doctors mentioned it to me? I was very pissed off. It’s very disillusioning,” Anderson says.
Karen Anderson, 51, says she has felt dismissed by her GP over her symptoms. Credit:Joe Armao
The mother and grandmother, from Pakenham on Melbourne’s south-eastern fringe, is perimenopausal dealing with severe joint pain, brain fog and night sweats. She also has fibromyalgia, a syndrome which causes widespread pain through her muscles, and adenomyosis, which results in heavy, excruciating menstrual bleeds – both conditions that can affect women in midlife.
Desperate for some relief, she worked up the courage to ask her GP about menopausal hormone therapy. But she was shut down. “He didn’t even want to have the discussion,” Anderson says.
Sue Loncaric, founder of Women Living Well After 50.
“It’s, ‘you’re in the perimenopausal stage, live with it’ … Doctors just fob you off, ‘oh it’s your age’, or, ‘it’s a bit of anxiety, so your pain is heightened’. It’s not good enough.
“I’m only 51. I’m only halfway through my life.”
Anderson’s exasperation is echoed by many midlife and older women around the country who are increasingly demanding to be listened to over their health concerns.
Sue Loncaric, 63, is the Gold Coast-based founder of website Women Living Well After 50, and she says she has noticed a groundswell building around health issues that affect midlife women, in particular menopause, in the last two years.
“There has been a massive shift,” Loncaric says. “Women are making it happen. They’re not being silent anymore. They’re confident and informed and supporting each other. Once one woman speaks out, somebody else gets the courage and it builds up. It’s been a long time coming.”
Michelle Obama, Oprah Winfrey and Sophie, Countess of Wessex, have all spoken about their experiences with menopause.Credit:Getty Images
Menopause, once a subject of shame, has been dragged out of the shadows by celebrities speaking about their experiences, from Michelle Obama to Oprah Winfrey and the royal family’s Sophie, Countess of Wessex, or Gwyneth Paltrow, who declared three years ago that menopause “needs a bit of a rebranding”. Prominent no-nonsense US gynaecologist Dr Jennifer Gunter recently released a book, The Menopause Manifesto, while closer to home Dr Ginni Mansberg published The M Word last year. Australian businesses, including Future Super and ModiBodi, are starting to introduce menopause leave; while in Britain, menopause – like puberty and pregnancy – has been added to the school curriculum.
There is growing political momentum around women’s health more broadly. The federal government announced $354 million for women’s health research in this year’s budget, while the National Women’s Health Strategy 2020-2030 stipulates that gender-specific healthy ageing and menopause are among the priorities.
Janet Michelmore, acting chief executive and patron of Jean Hailes for Women’s Health, says she “could not be more thrilled” with the building discourse about mature women.
Michelmore believes this is partly down to the fact there are more women over 50 in influential positions in workplaces and the media. She also suspects there is more interest in women’s health from women who used to cast themselves as “past it”, and that COVID-19 has put a focus on personal wellbeing.
“Older women are thinking ‘I’ve got a lot of living to do, I want to be well, I want to be fit, and I want to make sure I know how to maximise the last third or half of my life’,” Michelmore says.
Gwyneth Paltrow wants a “rebranding” of menopause.Credit:Netflix
She says that older women have watched their younger counterparts interrogate the medical system and advocate for conditions such as endometriosis and PCOS, and they are now doing their own lobbying. “Older women haven’t been brought up with the same confidence or skills to do that,” Michelmore says. “Seeing others do it, they start to reflect on their own status and how it could be better for them.”
The Australia Talks National Survey 2021 found that one in three women feels their health concerns have been dismissed by their GP, which is double the number among men.
There is, of course, a long history of women’s health concerns being diminished by the medical system. Research shows that women’s pain is taken less seriously and is treated with less medication than men’s, and it’s also more likely to be discounted as rooted in emotion, and therefore “not real”. Studies examining patient data in emergency departments have found women wait longer than men despite describing the same symptoms.
While the experience of dismissal affects women of all ages, author and social commentator Jane Caro says it can be magnified for those over 50, who are also dealing with the sense of invisibility.
“We simply stop seeing women,” Caro says. “Because we value women still for their appearance and their reproductive abilities, once women reach menopause we think they’re past their use-by date.”
Elinor Cleghorn, author of Unwell Women.
British cultural historian Elinor Cleghorn says the loss of fertility inflicts a loss of relevance.
“We talk about ‘women of childbearing age’ like they should be protected at all costs, in a really Handmaid’s Tale-y way,” Cleghorn says, pointing to the recently scrapped World Heath Organisation draft advice that fertile women avoid drinking alcohol. “What about women post-childbearing age who have their own complex health needs? … I think that’s what a lot of older women battle with, not just being invisible but also being seen as less valuable and worth caring for.”
Cleghorn charts how women’s pain has been ignored and misdiagnosed throughout history in her new book, Unwell Women.
“The best example of this is in the 19th century, when hysteria really came to prominence [as a diagnosis for women],” Cleghorn says. “Although science has moved exponentially over a century, it seems that these really crucial tenets of medicine’s relationship with women, especially women’s pain, are still with us.”
Cleghorn says this was highlighted in the recent landmark Australian lawsuit against Johnson & Johnson over its faulty vaginal mesh devices, which were implanted to treat pelvic organ prolapse and incontinence, but left many mature women with chronic pain and unable to have sex.
Shine Lawyers’ Rebecca Jancauskas, who established the class action, says more than 90 per cent of the 10,000 members are over 50, many of whom had “harrowing stories” of complications ignored by doctors for years.
“Older women are thinking ‘I’ve got a lot of living to do, I want to be well, I want to be fit, and I want to make sure I know how to maximise the last third or half of my life’.”
Professor Cassandra Szoeke, director of the University of Melbourne’s Healthy Ageing Program and author of Secrets of Women’s Healthy Ageing, has a clear message: “When women say ‘we feel we are being dismissed in our health concerns when we reach 50’, I think the most important thing is not to dismiss that.”
A major issue, Szoeke says, is that less research is done on women than men. For example, while just under half of heart attacks are in women, females only represent about a quarter of participants in drug trials for the condition.
“Our knowledge base is less for women, we don’t know as much about women’s hearts, brains. Then they get to menopause and start experiencing sometimes devastating symptoms that impact their capacity to function,” Szoeke says. “There isn’t a woman who doesn’t go through menopause … yet it’s had a minimal amount of research.”
But while some women continue to be told symptoms are in their head, they are also wiser and more educated. “There’s this maturing of the population, which means women are asking questions, Googling symptoms, saying ‘no, this is real’, joining support groups,” Szoeke says.
This, in turn, empowers women to trust their intuition and push back against the idea that they can’t be trusted to make decisions about their own body.
Older women copped criticism for being among the most hesitant to have the AstraZeneca COVID-19 vaccine over clotting fears, particularly before health authorities lifted the age of eligibility from 50 to 60.
Jane Caro says the hesitancy speaks to the long-standing issue of women being suspicious of the medical profession for not taking them seriously.
“I think people should have their AstraZeneca vaccine … but I think it’s worth saying that when you treat 51 per cent of the population as less important than the other 49 per cent you can’t be surprised when they don’t take your word at face value,” Caro says.
Jane Caro recalls her perimenopausal years as being horrific.Credit: Supplied
She says that midlife women’s growing willingness to speak out about their health has been fuelled by the cumulative effect of decades of feminism, the power of social media, and #MeToo, which she believes took the lid off not just sexual abuse, but the whole silent part of women’s lives.
Caro, who is now 64, recalls feeling let down when she was dealing with symptoms of perimenopause more than a decade ago, in particular unpredictable, heavy menstrual bleeds.
“I felt like nobody was terribly interested, it was just one of those things women have to put up with, but it makes going about your regular life, going to work, so difficult … I found [it] absolutely horrendous, and I mostly suffered in silence.”
“I think that’s what a lot of older women battle with, not just being invisible but also being seen as less valuable and worth caring for.”
Dr Karen Magraith, GP and president-elect of the Australian Menopause Society, believes the biggest problem is that our medical system isn’t well set up for women’s health because it rewards high turnover with short consultations.
“Even when doctors are interested and skilled in women’s health it is difficult for them to offer women the detailed care that they need. So getting the Medicare system working better so that it supports complex or longer consultations is absolutely critical,” she says.
Magraith adds that she is aware that some women’s symptoms are downplayed, or they are given the wrong treatments, for example anti-depressants in place of hormone therapy. She calls for more education in medical courses and national treatment guidelines.
There remains confusion and negativity about hormone therapies due to a contentious 2002 study that resulted in some patients declining treatment or clinicians being reluctant to prescribe, Magraith says.
The risk is that women can wind up resorting to unproven solutions peddled in wellness spaces.
Magraith stresses that for most women under 60 and within 10 years of menopause, hormone therapy is safe and the most effective treatment.
Melbourne-based Sally Berger runs the website Fit Fab Fiftyish, and says she feels lucky to have a GP who is interested in menopause and started the discussion about it early on.
“I don’t know what I would have done if it wasn’t for her … I would have been left to fend for myself and cobble together information online like a lot of women, but that rabbit hole can really have a [negative] impact,” Berger, 56, says.
With the right care, midlife women are getting to appreciate that they are in a powerful time of life, Caro says: “There’s an enormous freedom that comes for women as they get older. We’re always told that ageing is much worse for us. Actually it isn’t, it’s better.”
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