"My mum's generation thought the menopause was something to suffer; for me, it’s something that I’m in control of,” says Sarah Russell, a 52-year-old City financial analyst whose name we have changed. She’s just back from a menopause yoga session at a studio in Notting Hill — “It’s all about keeping a supple, strong body” — and knocks back menopause vitamins with breakfast. “One of my friends recommended them. We all share tips. There’s no shame in talking about the menopause now.”
Aristotle wrote about the menopause thousands of years ago but it’s only now that the period when women’s ovaries stop producing hormones, usually in their early fifties, triggering symptoms from night sweats and hot flushes to depression and sexual problems, is headline news. There’s UK surgeons’ pioneering ovarian transplant that could delay the menopause by up to 20 years; Parliament has decided that school pupils will learn about it for the first time as part of the sex education curriculum; and doctors are warning of a national shortage of hormone replacement therapy.
About 10 million women in the UK are going through the menopause now — and London’s booming hormone clinics are thriving. The British Menopause Society lists 41 accredited menopause centres in the capital. Once, women were hormone hostages, their only option to talk to a GP who’d either dismiss the menopause or disapprovingly scrawl out a prescription for HRT, (the standard treatment option until 2002, when studies, that have since been called into question, linked it to increased incidence of breast cancer and heart attacks). Now there’s a polished array of options, including more than 50 different types of HRT via tablets, skin patches, gels, hormone implants and vaginal creams and pessaries, as well as “bioidentical” hormones.
Then there’s the aesthetic procedures. Specialist Dr Shirin Lakhani’s menopause symptom-solvers including “the O-Shot, a treatment which relies on PRP [ Platelet-rich Plasma, used in so-called vampire facials] to treat conditions like dryness, the Ultra Femme 360, which uses radiofrequency to treat laxity, and Emsella, a non-invasive treatment which gives the equivalent of 11,500 kegel exercises to build the pelvic floor and treat incontinence”. Women, she says, “need to know that there are treatments available. Don’t put up with these symptoms — you can spend up to a third of your life post-menopausal.”
The Change, as the menopause was mystically dubbed for decades, was long overdue a re-brand. As Gwyneth Paltrow put it when discussing her own experience, “Menopause gets a really bad rap. I can feel the hormonal shifts happening. The sweating, the moods — you’re just all of a sudden furious for no reason.” Paltrow, plus Davina McCall, Zoe Ball, Kirsty Wark and BBC Breakfast presenter Louise Minchin, former Olympic swimmer Sharron Davies, beauty expert Liz Earle and entrepreneur Meg Mathews are among the celebrities who have recently spoken out about their menopause.
Celebrities’ new openness, says Dr Jane Woyka, menopause specialist at the Clementine Churchill Hospital, is encouraging others to seek help. “Women can take control of their symptoms far more now,” she adds. “Transdermal HRT, patches and gels mean women can safely take them for longer and adjust their dose themselves, cutting both symptoms and side-effects.”
It’s not just medication. A flurry of nutritionists and trainers have honed in on the menopause as a new market. Mayoni Gooneratne, an NHS surgeon turned cosmetic doctor, says: “We don’t always need to medicalise the menopause. Our clinic also offers nutritional help, because the way we metabolise carbs and fats changes, and exercise advice. When a woman’s under a lot of stress, even from cardiovascular exercise, the body produces more cortisol, which dampens sex hormones and can make the menopause worse. That hard spinning class you rocked in your thirties may not be the best option now, but yoga and pilates can help with menopause. Women are now jumping at the chance to take control.”
Celebrity trainer Ruben Tabares is starting a “menopause training regime” to keep up with demand. “The majority of London women who approach me are successful, busy mothers and business women who are pre-menopause or going through it and want the best and most relevant advice on how to improve their quality of life, energy and how to prevent osteoporosis,” he says.
The global menopausal hot flush market alone is forecast to hit $5.3 billion by 2023. Tech start-up Thriva offers menopausal women the chance to “understand your hormones”, with a £79 home finger-prick blood test and an online report. Italy’s Deka launched MonaLisa Touch, a laser treatment that claims to stimulate new collagen and blood vessels and more moisture to alleviate menopause-related vaginal drynes. It costs about £2,000 for the recommended three treatments.
But Dr Woyka cautions on new treatments that haven’t yet stood the test of time: “Products like MonaLisa Touch are being pushed at women by the private sector ... but we’re still waiting for more information and trials to see if they actually come up with what they say they’re going to come up with. There are huge numbers of quacks in the industry ... They’re very good at marketing and pandering to women’s fears and wishes.”
When former Britpop manager Mathews looks back at the start of her menopause four years ago, she says it was “horrific”. “I didn’t leave my house for three months. I had the worst anxiety. Nobody was talking about the mental health part.”
So in 2017 she started megsmenopause.com, offering support, information and advice. “I had a launch party and was a bit nervous. Five years ago people wouldn’t be seen dead somewhere like that, but Lorraine Kelly sent a TV crew, and Tamara Beckwith and Davinia Taylor came.”
Within six months the site had a million hits. Mathews, 53, adds: “I wanted to take the taboo away. Every single woman in the world is going to go through it so why should there be any shame?”