Introduction by Croakey: Following the recent Federal Budget, several groups acknowledged the significance of its wide-ranging announcements for women’s health, including around research and management of menopause.
However, it’s important to critically examine how menopause is being framed in public and policy debate, and whose interests are being served, or not.
In the article below, arising from a new editorial in Health Promotion International, public health experts from Deakin University, the University of Wollongong and Jean Hailes for Women’s Health propose five areas of focus in public health research, policy and practice about menopause.
“The health and wellbeing of older women must not fly under the radar for the public health and health promotion communities,” they write.
Meanwhile, on related topics, don’t miss this Friday’s webinar by Women in Public Health (register here). And follow @WePublicHealth this week, where @WPHau is in the chair, covering #WomenInPublicHealth.
Samantha Thomas, Melanie Randle and Sarah White write:
Over half of the world’s population will experience menopause. To date there has been significant research focus on the medicalised symptoms and treatment of menopause. However, a current Australian Senate Inquiry is looking at a broader range of factors that may influence the attitudes towards and experiences of menopause.
In our new editorial in Health Promotion International we argue that the public health community has an important role to play in considering the range of socio-cultural, environmental, commercial and political determinants that may either promote women’s health and wellbeing and lead to positive experiences, or may (un)intentionally exacerbate inequalities for different population subgroups.
We argue that there is an urgent need in particular to prevent the risks posed by the commercial capture of women’s health, including understanding how powerful commercial interests may seek to shape the narrative about menopause to stimulate and drive (often unnecessary) product purchases.
There is a growing focus on the range of factors that may shape how women (and those who go through menopause but do not identify as women) experience and respond to menopause.
For example, researchers have demonstrated the challenges associated with the often competing and conflicting framings of menopause – ranging from a taboo and sensitive issue, through to a natural part of aging.
One of the concerning unintended consequences of an increased problematisation of menopause is that it may exacerbate experiences of stigma and shame, and create or reinforce gendered ageism towards women in midlife and beyond.
Much less research has documented how women’s experiences of menopause may intersect with other issues in mid-life – such as the structural inequalities that may occur for women in multiple contexts, including gendered ageism the workplace, financial stressors as a result of the gender pay gap and the burden of caring.
Understanding the impact of these structural and situational factors is essential in understanding how older women’s voices and experiences may be marginalised and even silenced.
Framing matters
There is no doubt that a range of powerful groups and institutions shape discursive narratives about women’s bodies. In relation to menopause, this includes health and medical groups and professionals, commercial entities seeking to profit from menopause (not only the pharmaceutical industry, but also the wellness and ‘workplace’ industries), the media, and governments.
How menopause is framed by these groups influences public attitudes – including how menopause should be experienced and talked about.
The public health community has played an important role in documenting how (predatory) commercial entities have co-opted feminist narratives, and used a range of symbolic consumption practices to commercialise women’s health and social concerns and fears. This includes the catastrophising of menopause by those with vested to drive product consumption.
While there is increasing visibility of menopause in the media, these narratives may focus on ‘debilitating’ personal experiences, and individualised ‘solutions’ for menopause. These individualised narratives are also being amplified by celebrity ambassadors and influencers who place a focus on the consumption of ‘solutions’ for menopause, rather than focusing on the broader structural, social and cultural issues faced by women in midlife.
Dismissing menopause as nothing is equally problematic and particularly minimises the one in four Australian women who will experience symptoms in midlife that make it difficult to do daily activities.
A range of government inquiries in Australia, the United Kingdom, and Ireland provides a new and welcome focus on menopause in government policy.
However, decades of experience shows us that comprehensive approaches to public health must be guided by the best available, independent (that is, free from vested interests) evidence.
In our editorial, we argue that transformative approaches will contribute to shaping new meanings and expectations of menopause, reducing negative stereotypes and stigma, challenging inequalities, and providing trustworthy and tailored information to different sub-groups of women.
Five ways forward
We propose five areas of focus in public health research, policy and practice:
- Understanding the lived experiences of menopause in a range of social and health contexts, with an emphasis on the factors that may exacerbate health inequities.
- Research which investigates the discursive representations of menopause, including dis/misinformation. This includes understanding how menopause is framed by different stakeholders and the impact of this framing on attitudes and experiences.
- The intersection of menopause with the other health, economic and social stressors during midlife, including the impacts of gendered ageism on overall health and social equity.
- The commercial determinants of menopause, including the impacts of novel products and promotions – such as social media influencer and celebrity endorsements, and the influence of those with vested interests in driving information, policy responses and ‘solutions’.
- How strengths-based approaches can be developed which seek to protecting and promoting health and wellbeing in the transition to menopause. This must include ‘upstream’ approaches that respond to gendered ageism, the power structures that may influence the responses to menopause, and the points of leverage to create change.
The health and wellbeing of older women must not fly under the radar for the public health and health promotion communities.
These communities have an important role to play in shaping framings that inform and support people going through menopause and disrupting destructive and potentially harmful framings of menopause that may have a significant impact on women’s health and equity through the menopause transition and beyond.
Author details
Samantha L. Thomas is Professor of Public Health, Deakin University, and Editor-in-Chief of Health Promotion International
Melanie Randle is Professor of Marketing, University of Wollongong
Sarah L. White is CEO, Jean Hailes for Women’s Health
See Croakey’s archive of articles on women’s health
