Why ‘menopause masking’ can have consequences

Back in November, I posted a note on LinkedIn about brain fog. I summarized it in about 10 minutes – for the first time in my 20-year career, I started using notes while doing live TV news, thanks to pre-menopausal brain fog. I wasn’t expecting much of an answer.

Surprisingly, it sparked a national debate. I was overwhelmed by the wonderfully supportive messages; Nearly 400 comments on LinkedIn, dozens of private messages, and hundreds more below them. a piece about this On the BBC News website. Many followed similar lines: they called me “brave” for speaking out. Or thanking me for “normalizing” brain fog.

I wasn’t feeling particularly brave (or normal!) at the time – but it showed me just how much shame and stigma is attached to some of the symptoms of perimenopause and menopause, even though it affects almost half the population at some point in their lives.

Hollywood stars such as Oprah Winfrey and Halle Berry have spoken out about their own menopause experiences and its effects, as have TV presenters Davina McCall and Lorraine Kelly. Gwyneth Paltrow called for a “rebranding” of menopause in 2018.

And there have been some changes. For example, menopause screening will be officially included in the application. NHS health checks in England Starting this year, it is offered to women over the age of 40. Additionally, the Employment Relations Act means that employers with 250 or more employees in the UK must have “menopause action plans”. This will come into force from April 2027 (and on a voluntary basis from this April).

But a self-selected survey of nearly 1,600 women published by University College London in October found that more than 75% of women felt they did not know enough about menopause. This shows that something is wrong.

What’s more, many women say there’s still stigma around menopause and they feel like they can’t talk openly about it.

A woman in her 60s, an academic specializing in social policy, texted me to say that she had begun to underestimate her “menopausal moments” around her female colleagues. But he added that it was still “a shame”; especially when he forgets some specific policy terms in his field of expertise.

But hiding symptoms or masking menopause can be tiring.

“The energy spent trying to mask or compensate for the difficulties women face will often further deplete reserves and reduce their threshold for overwhelm,” says Fionnuala Barton, a GP and certified menopause specialist from the British Menopause Society.

This, he argues, could potentially increase the risk of burnout. And this secrecy in itself raises the question of whether it will also affect women’s lives.

NHS lists 34 possible contacts menopause symptoms and some are more common than others. Many can feel debilitating.

A woman who contacted me after seeing my LinkedIn post explained that decreasing estrogen causes vaginal dryness, which makes walking painful.

A friend of mine told me that she was developing bladder weakness. He said it came to him “almost overnight”; He can’t always make it to the toilet on time anymore.

“This is more frustrating than anything,” he admitted, but told me that was why he didn’t want to return to the office and preferred to work from home.

Another woman told me that she was reluctant to socialize when the clouds of brain fog were thick because she felt unable to follow conversations.

Many people shared their own coping strategies: Some kept fans at their desks at work to deal with hot flashes, while others wrote notes to themselves, as I did, to get through brain fog during meetings and presentations.

On the one hand, all this points to the creativity and resilience of these women, that in some cases they were able to overcome such debilitating symptoms and still get on with life.

Fiona Clark, journalist and author of Menowars, says women often embark on the journey when they start noticing symptoms: “Initially there’s confusion and denial, then there’s grief, and then there’s acceptance.

“But if you’re hiding it or masking it, you can’t go out and get the help you need.”

This topic is especially prescient in the workplace. According to a government report published in 2024, an estimated four million women aged 45 to 55 are working in the UK; This is the most common window of menopause.

Jo Brewis, professor of people and organizations at The Open University Business School, says when people mask symptoms at work it can lead to a set of what economists call concentrated margin costs.

“In other words, the effort creates an extra burden for those affected.”

Some may quit their jobs altogether. It is estimated that one in 10 women aged 40 to 55 working during menopause quit their job because of their symptoms, according to a 2022 report from The Fawcett Society, which analyzed data from a survey of nearly 4,000 women in the UK by research consultancy Savanta ComRes.

“This burden can take the form of making themselves less visible, not applying for promotions, or even moving to a lower status (usually a lower-paid position),” says Jo Brewis.

“People may also put in extra effort to avoid the perception that they are slacking off or that their performance has diminished. For example, if they are experiencing common symptoms such as loss of focus or fatigue, they may work longer hours to ensure they are double-checking their work.”

Of course, some women have positive experiences with menopause, and it is important not to generalize these experiences.

Additionally, some cultures have different attitudes towards menopause as a society. For example, the Japanese word for menopause, “konenki,” means renewal and energy.

There it is sometimes described as the “second spring”, marking a positive transition to a different stage of life.

Dr. is an honorary research fellow in evolutionary anthropology at University College London. Megan Arnot says: “Many countries, such as the UK, still carry a stigma around menopause, but attitudes here seem to have started to change in recent years.”

But he suggests that there are cultures and countries where menopause is framed more positively.

“In many indigenous communities, including Native American and Mayan cultures, menopause is viewed as a transition to wisdom and leadership, earning women greater respect and influence.” […] “Similarly, among Australian Indigenous communities, postmenopausal women often become important cultural educators and spiritual guides.”

Melissa Melby, an anthropology professor at the University of Delaware, agrees that in the West, “there is a perception that menopause will be scary, that it will be difficult to navigate, and that everything will go downhill from there.”

“We often give women symptom checklists of negative symptoms. Problems. We never ask them, ‘Have there been any positive changes for you during this time?’

“If you only ask about negative things, you will have very negative perceptions.”

She lived and worked in Japan for ten years, and talking to women there gave her “a sense of potential and hope for the next level.” [her] life”.

Admittedly, I do not share this view now, and if my husband were to say this to me now, I could not guarantee his safety. But perhaps there’s something to the idea of ​​considering the bigger picture rather than focusing on the rollercoaster of symptoms.

Menopause has long been big business: Dietary supplements, symptom trackers, therapeutic headbands, and life coaches specialize in it. My targeted social media feeds are filled with ads for natural treatments for midlife.

The menopause market is estimated to be worth more than $17bn (£13bn) by 2024 and is expected to reach more than $24bn (£18bn) by 2030.

However, most of the time, none of these alone are sufficient.

When it comes to the workplace, Brewis emphasizes that employers need to be careful about how they offer support. In his view, line managers need specific training to be able to support their teams, for example in conducting sensitive conversations and making reasonable adjustments for individuals. It’s also important to clearly identify menopause as a legitimate reason for absenteeism, he adds.

“Some people will never want to disclose their menopause at work, no matter how compassionate or supportive their organization is, and that is absolutely their prerogative,” she adds. “But effective menopause interventions can and should facilitate disclosure and reduce stigma.”

Ultimately, I found that attitude plays a very important role.

It was pioneering US anthropologist Margaret Mead who coined the term “postmenopausal pleasure” more than 70 years ago.

“There is no greater power in the world than the pleasure of a post-menopausal woman,” she said in the 1950s.

This positive mindset is what most of us need to stick with for now.

As for me, as long as this continues, I will continue this and also put “konenki” on the channel. But the support and conversations sparked by my brain fog moments also showed me another, even more comforting truth: That I was definitely not alone.

Additional reporting: Harriet Whitehead

Top image credit: Getty Images

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