The pairing of God and menopause hearkens back to the famous, bestselling book, “Are You There God? It’s me, Margaret” by Judy Blume, where Blume explores tween related issues through the character of Margaret. Margaret is faced with menstruation (e.g. first period, sanitary napkins), her personal relationship with God ( without a particular religious affiliation) and boys. I love Margaret’s prayer notes to God about her various problems, such as, her father’s accident where she is worried about his finger being cut off by the new lawn mower, asking for help in “growing her bust”, questioning whether she should celebrate Christmas or Hannukah, and visiting different churches and temples, as her parents have different religious backgrounds. I love Margaret’s raw honesty in expressing her feelings to God, especially, her frustration that she is “not normal” because she has no religion and has not started her menstruation. She even angrily breaks up with God for a while after both sets of grandparents try to force her to choose a religion. I relate to Margaret in some regards. I, too, formulate short email- like prayers (with capital letters and exclamation marks) in my mind during stressful times. Like Margaret’s prayer notes to God about her menstruation, I sent a lot of prayer emails during my struggles with menopause. The experience of menopause during the pandemic hit me like a ton of bricks, kicked me in the butt and knocked me over. Without getting too much into the meandering details of my own particular menopause experience, I found myself physically, psychologically and spiritually shaken and stirred during my perimenopausal and menopausal experiences. Drastically different from the movie character, James Bond’s general philosophical approach to his turbulent adventurous life, “shaken, not stirred” (which is also how Bond prefers his vodka martini).
Like menstruation in the past, menopause is still very much a taboo topic. Please note that the experience of menopause is not monolithic. The World Health Organization (WHO) views the experience of menopause as influenced by biological, familial, psychological, social and cultural factors in each woman’s life. This blog post addresses menopause through the lens of the biopsychosocial-spiritual model of psychology. Menopause refers to the end of the menstrual periods in a woman’s life. There are many symptoms associated with perimenopause (before menopause) and menopause. Whiteley and colleagues (2013) reported the following specific menopausal symptoms from women in their study: hot flashes, night sweats, insomnia/difficulty sleeping, forgetfulness, mood changes, decreased interest in sex, joint stiffness, anxiety, vaginal dryness, urine leakage, depression, and heart racing. Whiteley and colleagues (2013) collected data from the 2005 United States National Health and Wellness Survey of women in the age range of 40-64 years, where 4116 women in the sample experienced menopause compared to 4695 women who did not experience menopausal symptoms. The WHO frames menopause as a public health challenge because, even though, half the world’s population experience symptoms related to perimenopause, menopause and post menopause, these symptoms are not openly discussed in many families, communities, work-places or health care systems. The Society for Endocrinology reported that 75 % or more of women experience symptoms of menopause and 25 % of women report severe symptoms of menopause. In the Harvard Business Review, Alicia A. Grandey (2022) discussed the stigma of menopause impacting women in the workplace. It is also important to note that the time of menopause may also be a time that many women are considered for leadership positions in their work domains. Stefanie D’Angelo and colleagues (2023) conducted a research study of 400 women in the United Kingdom, who were working in their time of menopause, and found that one-third of the women reported difficulty coping with their menopausal symptoms at work. These researchers found that three symptoms, psychological factors of irritability, tearfulness, anxiety and depression, severe headaches, and aches, pains in the joint, contributed to the most difficulty in coping at work. Additionally, Dr. Wen Shen and colleagues, (2013) found in their study that out of 510 residents in obstetrical -gynecology training in the U.S, only 100 residents reported a formal menopause learning curriculum in their residency programs and 78 residents reported that they identified a menopause clinic to train further. This speaks to the importance of finding a physician who is trained in menopause as there appears to be alarmingly high numbers of physicians not trained in this area of menopause.
In my own journey of reading about menopause, I came across Dr. Dana E. King, Dr. Melissa H. Hunter and Jerri R. Harris MPH, ‘s (2005) book, “Dealing with the Psychological and Spiritual Aspects of Menopause: Finding Hope in the Midlife”. I found the book very informative, rich and impactful, especially due to the book addressing menopause through the biopsychosocial-spiritual lens. This book addressed the seismic psychosocial and spiritual shifts that may be occurring in menopause, critical to explore and navigate effectively for the overall health and well-being of women. Dr. King and his colleagues discussed major psychological shifts that women may be experiencing during biological changes, such as, facing the empty nest syndrome, taking care of elderly parents, grief , loss and regrets, shifts in partnerships where their partners may be experiencing their own “midlife crises” and difficulty managing menopausal symptoms with work demands, especially, in work places with minimal support. Dr. King and his colleagues addressed the sociocultural factors impacting women in midlife, such as, overall stereotypical images of psychological and physical decline in aging women. The authors argue that spirituality of women can serve as a powerful resiliency factor as women face many changes in midlife and develop new identities, explore meaning and purpose. I agree that women develop spiritually with wisdom and excellent skills to navigate life as they age.
I am very honored to present my interview with Dr. King, a family physician, researcher, and prolific author in women’s health and spirituality . He retired as professor and Chair of the Department of Family Medicine at West Virginia University School of Medicine. He was an associate professor of Family Medicine at Medical University of South Carolina, completed an academic fellowship at University of North Carolina, Chapel Hill and received his medical degree from University of Kentucky. I was struck with Dr. King discussing that although he is a male physician, he learned much about menopause by listening to his female patients and co-authors. I very highly recommend the book as it also lists numerous resources for women dealing with menopause. Please see video link for my interview with Dr. King. Much gratitude to Dr. King for his generosity in sharing his knowledge and wisdom with compassion.
Video Link for Interview:
Interview with Dr. King
Concluding Thoughts:
Margaret Simon, Judy Blume’s character, renews her conversations with God in the final chapter after she starts her periods. Margaret writes, “Are you still there God? It’s me, Margaret. I know you’re there God. I know you wouldn’t have missed this for anything!. Thank you God. Thanks an awful lot….” (p.171). Like Margaret, I am deeply grateful that God or the Divine Source got me through the menopause mess I was in. Also a big thanks to my doctors, nurses, family and friends for all their support.
REFERENCES
Blume, J. (1970). Are You There God? It’s Me, Margaret …, Atheneum Books.
King, D. E., Hunter, M. H. & Harris, J. R. (2005). Dealing with the Psychological and Spiritual Aspects of Menopause: Finding Hope in the Midlife. The Hayworth Press, Inc.
D’Angelo, S., Bevilacqua, G., Hammond, J., Zaballa, E., Dennison, E. M. & Walker-Bone, K. (2023). Impact on Menopausal Symptoms on Work: Findings from Women in the Health and Employment after Fifty (HEAF) Study. International Journal of Environmental Research and Public Health, 20(1), 295-312. doi:10.3390/ijerph20010295
Grandey, A. (2022). Research: Workplace Stigma Around Menopause Is Real. Harvard Business Review. https://hbr.org/2022/12/research-workplace-stigma-around-menopause-is- real#:~:text=A%20recent%20survey%20of%20women%20in%20the%20UK,people%2C%20and%20just%20a%20third%20would%20disclose%20openly.
Society for Endocrinology (2022). Evidence Based Recommendations on Menopause Management Advise Individualized Care. https://www.endocrinology.org/press/press-releases/evidence-based-recommendations-on-menopause-management-advise-individualised-care/
Wen, S., Ducie, J.A., Altman, K., Khafagy, (2013). What Do Ob/Gyns In Training Learn About Menopause? Not Nearly Enough, New Study Suggests. John Hopkins Medicine. https://www.hopkinsmedicine.org/news/media/releases/what_do_obgyns_in_training_learn_about_menopause_not_nearly_enough_new_study_suggests
Whiteley, J., DiBonaventura, MC., Wagner, J-S., Alvir, J. & Shah, S. (2013). The Impact of Menopausal Symptoms on Quality of Life, Productivity, and Economic Outcomes. Journal of Women’s Health. 22(11). 983-990. doi: 10.1089/jwh.2012.3719
World Health Organization(2022) Menopause. https://www.who.int/news-room/fact-sheets/detail/menopause
PLEASE NOTE THAT THIS IS NOT A SUBSTITUTE FOR PROFESSIONAL MEDICAL OR MENTAL HEALTH CONSULTATION. PLEASE SEEK PROFESSIONAL MEDICAL AND MENTAL HEALTH SERVICES AS NEEDED.