A global view of menopause with Ulrike Lemmin-Woolfrey

It was in Melbourne, Australia, that I was first assumed to be menopausal. At the doctors with a sore thumb joint, I saw on my record sheet that the physician had ticked the ‘menopausal’ box. When I mentioned that I was not, despite about to turn 50, she quipped that a sore joint would at least hint at being perimenopausal and told me to go home and just accept it. I was left to research perimenopause myself. Despite seeing the odd magazine article, I had little or no understanding of what I was heading toward.

It seemed that despite Australians on the whole being an educated and open-minded lot, and even holding the odd awareness week, the average women was still left in the dark when it comes to what to expect when your life changes from being a youthful, fertile woman to one that is basically put on the fast path to retirement from life as you once knew it, instead facing hot flushes, fragile bones, hair as well as memory loss, and who knows what else.

La menopause à la Parisienne

As a serial expatriate having lived around the globe with my husband’s work, I soon after found myself living in Paris, France, and was by then officially perimenopausal, with a couple of periods missed over the previous few months. Surrounded by women who embraced their age without any outwardly evident negative effects, I wondered how these women, many celebrating their grey hair, flaunting their wrinkles without covering them with thick makeup, and others who strolled in high heels without giving a second’s thought to osteoporosis, managed.

Visiting a gynecologist for an annual check-up, she immediately raised the subject of HRT and was surprised to find that I had more than severe hesitations.  It seems that this was an immediate go-to of the French women visiting her clinic, practically switching from taking the birth control pill one day to taking HRT the next.

Even though I spent nearly six years in France, I found not one woman my age who would talk openly about the menopause, its symptoms, or its remedies. I did see one brief article in the back of a fashion magazine, but on the whole, it seemed that either French women did not suffer, they ignored the symptoms with ease, or indeed, they approached the pesky changes just as they do their manner of keeping stylish and slim.

Ask any Parisienne, and chances are they say they do not ever go to the gym or work out, yet you see them drinking wine and eating out several times a week, while still fitting into figure-conscious outfits. Their secret? Not talking about it. Daily maintenance such as workouts are done religiously but not admitted to, just like that I-just-got-out-of-bed tousled hairstyle and no-make-up look, which can take hours to perfect in private. Age or fertility-levels don’t seem to affect the attitude of the average French woman, who just gets on with life, and doesn’t wash her pretty matching underwear in public.

The middle-aged English rose

Moving across the Channel for a spell of living in the UK, imagine my surprise when I was surrounded by women who were aware, talked about their problems, and doctors who offered sensible advice for all sorts of potentially embarrassing symptoms. Here, women talked about what to wear when hot flushes hit, pros and cons of HRT, about painful sex, and everything in between. Nearly too much for my non-accustomed Frenchie-fied ears, but that did not stop me from soaking up all the information all around me.

By now I was properly menopausal but had luckily not suffered too many adverse symptoms apart from not having felt cold for about five years now and rushing out to start taking supplements after my husband very (un-)kindly told me that my hair seemed to look thinner.

My sojourn in the UK coinciding with the pandemic, I reveled in being middle-aged for a while, wearing comfy clothes and allowing my grey roots to show occasionally, feeling that I was surrounded by plenty of women who were in the same stage of their lives as I was, and who decided to accept their lot and just get comfortable with that. And what was wrong with that?

The Middle Eastern ‘Age of Despair’

But before I knew it, I relocated to Qatar, in the Middle East, and was faced with a new challenge. Here, the term menopause is reportedly translated to the phrase ‘age of despair’, relating to the end of a woman’s child-bearing years. While for some the end of her fertile years might well be a sad time, to other, young Arabs, who in modern times more and more often choose career over motherhood and see the end of the child-bearing years as nothing to despair over, menopause will hopefully soon be a more openly talked about subject, and one not to be feared.

For now, it is mostly much more open places such as Dubai which dare to speak up and out aloud about women’s health, from breast cancer to extra-marital pregnancy and menopause, and, while moving forward at a noticeable rate, the Middle East is still lagging behind the rest of the world when it comes to giving women the support they need during these times.

So, imagine my relief when I went to a morning meeting with a bunch of global expat women living in Doha, most coming from the UK and all mostly of ‘that’ age, and one piped up asking if anybody else was hot, and everybody clamored to have the AC turned up, because hot flushes in the desert heat are simply THE worst.

Of all the approaches to coping with the menopause around the world, I have learned the most from the stoic Parisiennes of a certain age, and the relaxed and accepting English women. French women realize their status and value in life, and one fertile egg more or less is not going to change that. They love looking good, and no hot flush will ever make them wear an ugly jogging outfit or a baggy t-shirt, nor will the odd wrinkle or grey hair affect their natural sensuality. The menopause is merely a brief hick-up that is soon forgotten while they forge ahead.

But it is difficult to beat the sense of belonging and solidarity that is a like (too) warm hug when it comes to menopausal English women. And there is no harm at all in giving in a little, and wearing the odd loose top, or carrying a fan for those moments when it all gets too much. What is important is to be open and to allow women their rightful place in society regardless of age or fertility, in every culture.

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We understand there’s a lot of information out there on the menopause. You can read through the NICE guidance on menopause management, as well as the NHS overview on the menopause.