by OMISADE BURNEY-SCOTT
The end of menstruation has been stigmatized and misunderstood. The “menopausal multiverse” can change that.
Throughout history, individuals experiencing menstruation have faced the daunting task of navigating the complex, stigmatized landscape of menopausal symptoms without support. There’s a presumption that all individuals undergoing menopause will exclusively identify as women, be white and heterosexual, desire or have the ability to bear children, already have children, or be in their 40s or 50s.
The abundance of conflicting information surrounding menopause has made it challenging to comprehend its essence—its defining features, unique attributes, expected timing—and receive strategies to navigate this phase. And yet, it is crucial for anyone with a uterus and ovaries to have access to a clear and concise guide to help them navigate this inevitable and transformative journey.
Menopause takes place when a person has a continuous year without any menstrual cycle, including no instances of spotting or breakthrough bleeding. During menopause, the ovaries stop making estrogen and progesterone hormones and no longer release eggs. Before that happens, there is a perimenopausal period—“peri” meaning “pre”—that can last up to 10 years before an individual’s menstrual cycle ceases altogether. Menopause typically occurs during a person’s 40s or 50s, with the average age being 51 in the United States. The most common physical symptoms of menopause are hot flashes, night sweats, brain fog, vaginal dryness, weight gain, and dry skin. There are also lesser known physical manifestations such as migraines, dizziness, depression, burning mouth, and fatigue.
Unfortunately, the menopausal experience isn’t often depicted or celebrated as a positive life transition with various stages and expressions; instead, it’s frequently portrayed as a fearful conclusion of menstruation. In mainstream culture, especially in media, people going through menopause are often white, cisgender, heterosexual, middle-aged, and middle-class individuals depicted as hot, sweaty, confused, and angry. Consequently, the expanding landscape of support, services, education, and advocacy lacks intentional representation of the unique menopausal experiences, needs, and struggles faced by those marginalized along lines of race, ethnicity, gender identity, sexuality, and socioeconomic status.
Much of the stigma surrounding menopause is rooted in negative societal attitudes toward people who identify as women or who have been assigned female at birth. This objectification is amplified for older individuals no longer considered fertile, perpetuating the harmful notion that they are less valuable or “washed up.” It’s important to emphasize that menopause shouldn’t be seen as the end for anyone, including gender-expansive and racially diverse individuals. All individuals, regardless of gender identity, race, or age, should be equally respected and valued throughout their life stages.
Menopause as a physical, cultural, and political experience is often overlooked in discussions related to health outcomes and systemic oppression. But, like most public health experiences, it is affected by a range of factors, including poor access to health care, toxic work environments, unsafe neighborhoods, and socioeconomic hardships. These stressors place considerable strain on the body, disrupting hormonal and biological processes and contributing to chronic inflammation. As a result, menopausal experiences can become more challenging and occur earlier for individuals exposed to these systemic injustices.
I’d like to offer an intervention: I see the Earth’s evolution, at the remarkable age of 4.5 billion years, as parallel to the life of individuals experiencing menopause. As our planet warms through human intervention, we see species dying off. What if human beings are being offered the wisdom, medicine, and warnings of an Earth entering its cosmic menopausal phase? If so, are we listening?
By 2025, there will be more than 1 billion people experiencing menopause worldwide, which will represent 12% of the global population. Now, as individuals take charge of their bodies, a contemporary revolution is taking shape, one that’s dismantling age-old stereotypes and misinformation about this pivotal phase.
Menopause’s Origin Story
Across generations, Black, Indigenous, and women of color, as well as those who identify as transgender or have expansive gender identities, have grappled with the profound challenge of asserting agency over their own bodies. Historical injustices, such as the displacement and genocide of Indigenous peoples and the enslavement and racial violence endured by individuals of African descent, have hindered bodily autonomy. These obstacles find their origins in the socially constructed concept of race, where whiteness has been artificially elevated as the societal standard. Consequently, experiences outside of this norm consistently face othering, marginalization, and dehumanization.
In 1821, the French physician Charles-Pierre-Louis de Gardanne coined the term “menopause” by drawing upon the Greek language, where “men” denotes “month” and “pausis” signifies “cessation.” The Greeks can also be credited for coining the term “hysterikos” (a word that shares the same root as “hysterical”), which translates to “suffering in the womb.” In ancient Greek belief, women displaying “irrational” behavior were thought to be influenced by their uteri moving around within their bodies, causing disruption.
Throughout the 19th century, the naming and defining of menopause became another means of reinforcing the perceived frailty of the female body. In the U.S., women faced a heightened vulnerability to receiving insufficient diagnoses and treatments. Prevailing beliefs of the time often attributed most of women’s physical ailments to their sexual organs or mental health issues, leading to distressing and occasionally fatal treatments. Such stereotypes became yet another vehicle to subjugate women and individuals assigned female at birth within the emerging field of gynecology.
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