I’m an average woman. And I am fifty. So, as a good average person I am premonopausal. I get a hot flush every two hours or so, some stronger, some lesser. A hot flush feels like extreme blushing but there’s nothing you are embarrassed about. Nobody can see a hot flush because actually you are not blushing. It’s just the heart racing, the head becoming all hot from the ears, and sweating, sweating, sweating as if I’ve just done 25 push-ups in 30 seconds (or so). At night it wakes me up and I can appreciate my stress level by the time it takes me to fall asleep again (sometimes never) and how quickly loss of sleep will turn my commonly very soft tinnitus into a wild water river racing through my ears. As an average woman, I do what the majority of women do in this case. I suck it up. Eventually get nervous and do what far fewer women do: I go and talk about it, and seek out whether this is not something else like hyperthyroid or (beware) some strange cancer, look it up on the internet, see the doctor and get blood tests done.
And yet, the response is the same everywhere. That’s how it is, we know that it’s a symptom of your body not producing as much oestrogen as before and, no, we don’t know why that causes hot flushes, headache, dizziness, migraines, muscle and joint pain, and exceptionally unpredictable mood swings, and, no, there’s no real thing medicine can offer you except munching artificial hormones that might cause breast cancer in 10 years. Your cholesterol is fine, by the way.
A long list of well intended advice follows: do more yoga, get the shrink in, eat more tofu. What? Yes, eat more tofu because in Asia and Africa women do not complain about menopause because they eat more tofu (in Africa?) and tofu has some sort of fake oestrogen (or was it progesterone?) and that’s why they don’t experience all the ‘uncomfortable’ symptoms of menopause. Because that’s what they are; they are ‘uncomfortable’. Not really worth talking about, actually. Like trousers sitting too tight (did I mention the weight gain?), a mosquito bite or a fibre between your front teeth. Uncomfortable.
There are a multitude of studies now that show that a doctor’s attention to a patient is dependent on gender, race and class. Every woman will have at least one story to share about how a serious disease of hers has been not taken seriously by the doctor she has been seeing, how she has been administered useless or, worse, inappropriate medicines, and how she had to insist and fight to get the right diagnosis or treatment. For many women, this means that serious illnesses are not diagnosed early enough, treatments ill administered and lives cut short (as for instance in the case of my not-to-be-colleague at the University of Sussex, Dr Lisa Smirl). Every time this means that women’s experience of pain or bodily dysfunction are downplayed or outrightly ignored. They are considered as ‘discomfort’ in the best case, as ‘hysterical’ in the worst – a disdain that gets reinforced if a woman is of lower social status or of colour as the doctor as the experience of even such a powerful woman like Serena Williams (who should really be trusted of knowing her body in and out) shows.
So, when I am told that women in Asia and Africa do not seem to experience ‘uncomfortable’ symptoms of menopause, what does this mean? Well, it can actually mean anything and a lot except that women in Asia and Africa don’t experience hot flushes, migraines, muscle and joint paint, heart rate roller coasters, mood swings, depression, fatigue or abdominal pains. It can mean that they do not complain because they know that they will not be taken seriously, because they have so much internalised that all this is just ‘discomfort’ that comes with being a woman (and shameful discomfort as it is since it’s our sexual reproductive organs that are changing!), that it’s all in our heads and a question of the right attitude. Or it can mean that they do complain but that nobody listens, nobody records, nobody who has the power to record does so, or that nobody takes them seriously. Or it can mean both. It definitely means that women’s bodies and especially women’s bodily functions that have to do with sex, reproduction and intimacy continue to be shamed, denied, neglected, ignored, silenced, disdained, and only taken so far into consideration as they can serve as consumerist dumping ground for the pharmaceutical industries. It also means that modern medicine is more dominated by capitalist and consumerist logics than by genuine interest in the functioning and well-being of human bodies; and that these logics are, in turn, gendered, classed and racialized (which wouldn’t really come as surprise) as they sort out what is worth medical attention and what is not.