A FTWW HQ Opinion Piece

17/08/2019

At FTWW HQ, we read with interest Wales Online’s opinion piece on ovarian tissue transplantation for women who have gone through an early menopause. At the start of her piece, author Carolyn Hitt asked an interesting question, ‘In dealing with the hormonal rollercoaster we are strapped to from puberty should we let science apply the brakes to nature?’

Our immediate response was, ‘well, why not?’ Isn’t the human brain, and its capacity for scientific thought, something bestowed upon us by nature? And, in doing so, throughout the time on which we’ve been on this planet, haven’t those brains been responsible for countless interventions that pit us against nature’s foibles?

When we talk about ‘allowing science to apply the brakes to nature’, let’s not forget that we’re constantly engaged in such activity, precisely in order to survive as a species. We take medications to treat disease, we use antibiotics to ward off life-threatening infections, we take the contraceptive pill to manage our menstrual cycles and prevent pregnancy.

So, if, with ‘a simple half-hour surgical procedure, doctors can now delay the menopause for up to 20 years’, we say, ‘Go for it’!

You see, this isn’t necessarily just about those who have entered the menopause early – whether that be as a result of premature ovarian insufficiency (which, by the way, is another of nature’s foibles), or treatment for cancer or any other disease, be that medical or surgical treatment (and, oops, there we go again, interfering with nature)! It’s about how – for a not insignificant number of women – menopause can be absolutely unbearable, and its effects last until we die.

Women can suffer life-long effects as a result of menopause

We say, ‘Go for it’, not because we’re all terrified of getting old and developing wrinkles (although maybe some are) or because we desperately want to have more babies (although maybe some do), but because menopause can cause cognitive problems so awful they’re mistaken for dementia, joint pain so bad it’s as debilitating as arthritis, mucus membranes so dry that they rip, bleed, and result in infections, insomnia so wretched that we can no longer function.

It’s about how loss of oestrogen means we are just as likely to develop cardiac disease as men – but far more likely to die of it because we present differently when having a heart attack. It’s about how loss of oestrogen results in half of all women over the age of 50 developing osteoporosis – where our bones are so weak and brittle that 300,000 fractures per year can be attributed to it, costing the NHS £6million per day. It’s about how the highest number of completed suicides amongst women in the UK is in the 45 – 55 age bracket, precisely when menopause usually hits.

Osteoporosis kills more women than all gynaecological cancers put together

This is about – finally – having scientists recognising and doing something meaningful about a health issue which affects 52% of us, something which isn’t necessarily as simple as patting away a few delicate beads of perspiration on our foreheads.

Let’s not forget that, actually, because of science already ‘putting the brakes on nature’, we are already living far longer as a species than we should. We were never intended to get far beyond menopause because, according to nature, we’ve outlived our usefulness in terms of procreation.

We were never intended to have over 400 periods during our lifetimes, because nature intended for us to be pregnant more or less continually. And yet, we don’t question the science that has led us to this situation. We don’t merely accept it; we welcome it! It’s given us time: time, choices, and freedom to explore what life has to offer us as women.

Why shouldn’t we similarly welcome scientific advances that extend those choices further? Options that, instead of expecting us to put artificial chemicals into our bodies day after day (such as psychiatric medication often erroneously prescribed to deal with the mental health-related symptoms of menopause) actually enable us to utilise our own flesh to ward off its worst effects?

Wales Online’s piece does countless women a disservice when it underplays menopause as merely a ‘natural transition half the population face’. Certainly, whilst factually correct, this kind of comment is just as dangerous in its over-simplification as the stigma and stereotypes which it (rightly) decries.

There’s more to menopause than facing our wrinkles

The author – again rightly – laments the pressure women feel to look youthful and attractive, and expresses concerns over how the prospect of ovarian tissue transplantation will serve merely to ameliorate society’s distaste for less than aesthetically-pleasing older women. But here’s the thing: for a huge number of women reading, menopause has been more than ‘distasteful’, it’s been a bloody disaster (ironic, given the absence of periods)!

For those women who aren’t living but existing, as menopause wreaks its havoc on their bodies and minds, being considered unattractive is probably the least of their concerns.

Let’s be clear: that there is a ridiculous amount of stigma around female ageing is undebatable – and it’s enraging. Who amongst us hasn’t noticed the absence of ‘older women’ on our TV screens – or the fact that it’s 20-somethings advertising anti-ageing face creams because we’re perceived as being too hideous to be seen in public?

None of us is disagreeing that, as a society, we treat older women pretty damn abominably and that it needs to change. So too does the stigma around menopause and those attitudes which have resulted in so many women choosing to leave work because they simply can’t cope. The question is, with what exactly are they struggling to cope?

An unsympathetic, even hostile, workplace can absolutely be held responsible for so many women feeling that they have no choice but to leave – but that isn’t the ONLY reason. Horrendous menopausal symptoms to which, currently, there seem to be only a few possible solutions are another.

Without access to dedicated menopause specialists, HRT is hard to fathom or get right, especially when one has a complex medical history. The other alternatives – unproven herbal remedies, yoga, magnets in our knickers – aren’t necessarily satisfactory alternatives at all for many women.

Menopause care can be hard to navigate, especially without access to a specialist

In truth, we couldn’t agree more with the desire to see the social stigma of menopause banished once and for all, and every employer working with its female employees to ensure that menopause policy and practice is co-produced. It’s why FTWW was involved in bringing to Wales the first-ever Menopause Summit in June and why we’re also organising a Women’s Health Equality Event for October (featuring menopause and reasonable adjustments in the workplace, amongst many other topics).

Our October 23rd event in North Wales is open to all who are interested in women’s health and equality. For tickets, check out Eventbrite.

However, that doesn’t negate the positive development that any potential mainstreaming of ovarian tissue transplantation may well prove to be for those women who want it. Undoubtedly, for some, that will mean thoughts of prolonging fertility (and more of those dreaded periods), even smoothing out some of those wretched wrinkles but, hey, isn’t pesky ‘science’ already laying claim to all of that, with the likes of IVF and cosmetic surgery?

Of course, we need to apply some serious moral thinking to it all but that’s the other beauty of having a brain like ours (thanks, Nature!) We can be creative, scientific, and ethical all at the same time. And, just as with IVF, gene therapy, or any other scientific intervention which seems to frustrate nature, we’d expect nothing less than a huge amount of philosophical debate and scrutiny to accompany any rolling out of this technology to ‘the rest of us’.

For many members of FTWW, who have either been forced into early menopause or are simply struggling like crazy to deal with its long-term health ramifications, the prospect of ovarian tissue transplantation isn’t about halting the ageing process or retaining erstwhile looks, nor is it about trying to subvert our natural destiny so that we can progress in our careers and let employers off the hook; it’s about survival.

It’s not about turning back time: it’s about surviving what’s happening now and off-setting progressive health conditions

To say otherwise seems to come from a position of privilege – the privilege, almost certainly, of having a menopause which can be overcome by the taking of vitamins, evening primrose oil or, as the author herself cites, ‘a designated Hormone Hour (with some) Narnia-like air-con’. If only it were that easy…

So, yes, by all means let’s continue to challenge damaging stereotypes – and that includes the one that exhorts us to embrace our wonderful, natural menopause, the one that suggests that with some kind words and access to an open window we can get through it.

A truly supportive society supports women’s choices about how best to manage her biology; it supports good health; it supports those scientific interventions which can make women’s lives easier. It’s about time!