Menopause, Menstruation, Miscarriage and... Men?

There are some things that almost everybody knows happens, but somehow it is often still seen as awkward, yucky or shameful subjects to talk about.  

Periods. Pregnancy. Miscarriage. Childbirth. Menopause.  The common changes that may happen to a female body throughout life.  They are not rare, or unexpected.  They are not fringe medical conditions – it affects 50% of the population.  Why do they still exist in a strange place somewhere between medical necessity and social taboo.  They are an ordinary, yet wonderous, part of human life.

A history of being overlooked

It would be too simplistic to say that every doctor, scientist or man throughout history deliberately decided that women's health didn't matter. The reality is more complicated than that.  None-the-less, the outcome of centuries of male-dominated societies, medical institutions and research systems has created a significant imbalance in what has been studied, what we understood and what was considered important.  That history matters because research determines knowledge; and knowledge determines diagnosis, treatment and understanding.  If you don't study something properly, you won’t understand it properly.

The outcome has often been that women have spent years being told that what they are experiencing is normal, to be expected, insignificant, Imagined, exaggerated or simply something they have to put up with.  The UK's Women's Health Strategy has acknowledged this problem, stating that not enough focus has historically been placed on issues such as miscarriage and menopause and that women have been under-represented in important clinical trials.

Why is menopause still something we whisper about?

Every person with a female reproductive system will experience it, yet for an astonishingly long time it was something people were expected to endure quietly.  Perimenopause often lasts for years and can involve a huge range of physical and psychological changes.  Yet how many young people are taught about it?  How many men understand what perimenopause actually means?

How many workplaces genuinely understand what it can mean for somebody trying to function normally while experiencing symptoms that may affect sleep, concentration, pain, temperature regulation, mood, fatigue and mental wellbeing?

PERIODS

We can go even further back.  A girl may start her periods in primary school.  It can happen when she is frightened, embarrassed, confused or completely unprepared.  She may experience headaches, nausea, fatigue or severe cramping… and then there is the blood!  For generations, the cultural message was essentially:  Don't let anybody know.  Hide the sanitary product, hide the blood. Don't say ‘period’ too loudly.

Until recently, menstrual products were often demonstrated using blue liquid rather than something that looked like blood. The symbolism is difficult to miss; the companies were apparently comfortable making money out of advertising these products, but not comfortable showing menstruation itself.  It’s remarkable that something so ordinary could spend so long being treated as something that had to be disguised. 

Then there is the TAX!  Period products are not luxury goods, yet in the UK, sanitary products were historically subject to VAT.  It took decades of campaigning, before the zero rate for menstrual sanitary products came into effect on 1 January 2021.  Unfortunately for many, removing VAT does not magically remove period poverty.  For somebody who has to choose between buying food, or paying an electricity bill and buying sanitary products, a period does not politely wait until payday.

And this becomes even more stark when we think beyond the UK, to women and girls living in poverty, displacement, refugee camps, conflict zones and places where access to clean water, sanitation and basic healthcare is already precarious.  The biology doesn't stop because circumstances are terrible.

What about pregnancy

‘We're having a baby’, but what does that actually mean to her body, emotions, hormones, body image, mental wellbeing.  What happens when she is exhausted but expected to carry on as normal.  What happens during labour, what happens afterwards, and what happens to the partner standing beside her?  Pregnancy is not simply the 9 months between conception and the birth.  It is a profound physical event happening to another human being.

How can we expect young men to understand what their partners may be experiencing if nobody has ever explained it to them?  Schools teach about basic reproduction, but it makes sense to teach all genders about what reproduction actually involves – the good, the bad and the horrid.

And then there is miscarriage

Perhaps this is where our silence becomes most painful.  Miscarriage is common – very common.  Yet people often don't know how common it is until it happens to them.

It is estimated that around 20% of pregnancies will suffer an early miscarriage. The precise scale of these miscarriages in the UK is uncertain, as they are not routinely recorded in the same way as births or stillbirths.   But behind every statistic is a person, couple, family; dreams, possibilities and hope.  Then everything changes.

One of the cruellest things about miscarriage is that people can be left feeling incredibly alone.  They may not know anyone else who has experienced it.  Except, statistically, they probably do.  The experience is widespread but the conversation isn't.

Loss in later pregnancy is devastating too

The further a pregnancy progresses, the more complicated the emotional and physical experience becomes.  It can involve doctors, hospitals, procedures and giving birth to your baby.  It also means going home without the baby you expected, cherished and love. 

Men can experience this silence too.  A man may lose a pregnancy with his partner and have absolutely no idea what he is supposed to do.  He may keep busy trying to support others, whilst devastated, confused and grieving themselves, and because the physical loss happens to the partner, his grief can sometimes feel like it is supposed to occupy the passenger seat.

Childbirth is not risk-free

We also need to be honest about childbirth.  Modern maternity care saves enormous numbers of lives, and childbirth in the UK is generally safe, but ‘generally safe’ is not the same as RISK-FREE.

Women can still die during pregnancy or following childbirth.  The numbers are small compared with the total number of births, but that should never be interpreted as meaning those deaths don't matter.

Menstruation - Miscarriage – Menopause and Men.  We need more conversation.

Perhaps the greatest change we could make is to stop treating women's health as a specialist subject that only women need to understand.  Let's fund research into the questions we still cannot answer and make it normal for a woman to say, ‘Something isn't right’ and be taken seriously.

Let's stop confusing silence with dignity.  Some things are private, that doesn't mean they should be secret, because when something affects roughly half the population at some point in their lives, perhaps it isn't simply a women's issue at all - women's health is human health.

Let’s talk more!

Lindsie – Puzzling Minds Counselling