In our youth-obsessed culture, conversations around menopause tend to be hushed. That is, if they occur at all.
Menopause — the cessation of menstruation — is obliquely and frighteningly referred to as The Change. Depictions in popular culture consist of, like, a sweating lady leaning into an open freezer to a laugh track. Our culture talks about women "over a certain age," as though we fall off a cliff and disappear the moment we turn 50. As though we have an expiration date, like a jug of 2%.
"If menopause is sold as your graduation date to your irrelevance," says Dr. Jen Gunter, "who wants to talk about it?"
Gunter does want to talk about it — but she wants to change the conversation.
The Winnipeg-born and raised obstetrician-gynecologist is back with her second book, The Menopause Manifesto: Own Your Health With Facts and Feminism, which was released in May via Random House Canada. (I will be hosting her virtual book launch hosted by McNally Robinson on June 17, at 7 p.m. Registration is required to participate in the Zoom seminar, and it will be simultaneously streamed on YouTube and available for viewing afterwards. To register, go to wfp.to/jengunter)
A practical, reassuring menopause manifesto was a natural followup her bestselling 2019 debut, The Vagina Bible, which has since been translated into 19 languages.
"I’m gonna be honest, (a menopause book) is what people asked for," says Gunter, 54, with a laugh, over the phone from her office in San Francisco. "When I when I was on tour for The Vagina Bible, I just got asked question after question about menopause, or what did I think about this book, or what did I think about that book on menopause? I’d be like, OK, I think there’s something here. Clearly just addressing the vaginal health part of menopause in the Vagina Bible was not enough."
But it was a specific observation a woman made that really stuck out to Gunter: menopause was lonely, and there was no culture around it.
"It just made me really think about that," she says. "I started to think that every single thing we’ve really heard about menopause has been given to us through this patriarchal gaze, and I wanted to go back and not only give women the medical facts, but also explain how we got to where we are, to give them basically some culture."
Indeed, there is no Are You There God, It’s Me Margaret? for menopause.
The Menopause Manifesto does what Gunter specializes in, which is empowering women with facts. Gunter has been fighting against misinformation about women’s bodies and the snake-oil of the wellness industrial complex for years, emerging as a trusted, no-bull — and also funny — voice on all things related to women’s health. In addition to her regular practice, Gunter is active on Twitter, where she has 340,000 followers, writes columns for the New York Times, hosts a podcast called Body Stuff and hosts the CBC Gem show Jensplaining, which is heading into its second season.
The Menopause Manifesto delves into specific menopause symptoms, why they are happening, and how to manage them, Gunter challenges the way we think about menopause. As she points out, it is a planned change. It is not a disease or something to be "cured." That’s one of the biggest myths and misconceptions she’s run into.
"Menopause doesn’t need to be cured any more than being a child needs to be cured or being an adult needs to be cured," she says. "It’s a phase of life."
Another big myth she’s encountered is that hormone tests are useful in determining whether or not menopause is occurring.
"They’re not, at all," she says. "Just like you didn’t need a hormone test to see if you were going through puberty, you don’t need a hormone test to see if you’re going through menopause — if it’s happening at the right time. So if you’re 12, and having a growth spurt and having acne, no one needs to do a blood test to see where you are in your puberty, right? That’s all happening as it should, just like if you’re 47, and having hot flashes and irregular periods.
"Menopause doesn’t need to be cured any more than being a child needs to be cured or being an adult needs to be cured. It’s a phase of life." ‐ Dr. Jen Gunter
"If we’re able to not medicalize puberty that way, we should be able to not medicalize menopause."
In addition to being a medical expert, Gunter has gone through menopause. Her experience included incredibly heavy bleeding or, as she calls it, "catastrophic flooding."
"But I knew it could happen, so I wasn’t freaked out," she says. "And I think that’s one of the big differences. When you know something unpleasant could happen and it does, you don’t have that extra level of fear on top of the inconvenience."
She knows that not everyone is a gynecologist, so Gunter wanted to put something out in the world that could serve as a map or a guidebook for a journey most women will take in their lifetimes. Think of The Menopause Manifesto as a What To Expect When You’re Expecting Menopause, which is, as it happens, the title of part two of the manifesto.
"Imagine you have to take this journey and you really have no idea what’s ahead," she says. "Dragons! Who knows? Maybe they’re tame? Whatever! Like, you have no idea and every single step you’re taking, you’re like, am I going in the right direction? Is this right? You have no idea and then you’re alone. You’re thinking, am I the only person whose this is happening to? Am I the only one who’s gone down this pathway?
"Knowing that there’s all these pathways, and that there’s this guidebook — you still have to take the journey, but it takes out a lot of the unknowns and a lot of the fear."