Women & midlife wellbeing – what have we learned?
October marked, once again, Menopause month in the UK. Given half the population will go through menopause at some point in their lives – and it is estimated that there are around 13 million women who are currently peri or menopausal in the UK (Wellbeing of Women) - we should celebrate every opportunity to help improve education and reduce stigmatisation.
Menopause is the time in our lives when we run out of eggs and menstruation ceases. But the resultant dramatic fall in hormones – most notably oestrogen, progesterone and testosterone - can have a big impact on our mental as well as our physical wellbeing.
Health concerns, such as weight gain, poor sleep, mood swings, anxiety, panic attacks and depression can all be symptoms of menopause, often leaving women debilitated, as well as feeling isolated and lonely.
Menopause is further compounded by the fact that midlife women also tend to be a sandwich generation - many leading pressurised lives juggling school age children and ageing parents. And not only do women worry about it all, they often prioritise others’ needs over their own.
As menopause cuts through to the mainstream, there are positive outcomes for women; firstly we are finally seeing more research on menopause and its impact on women’s later life health. Secondly, women – and their partners - are starting to better understand the process and impacts of the menopause. And thirdly, there is increasing impetus for women to start prioritising their own health and wellbeing.
There is still a relative lack of attention to midlife health, but there is growing interest in scientific research. Already, according to Women’s Midlife Health (source) ‘the evidence strongly suggests that the midlife represents a critical window for preventing chronic disease and optimizing health and functioning.’
Researchers have labelled this midlife change a ‘vulnerable window’, as it becomes increasingly apparent that quality of health through midlife is an important determinant of a healthy and fully functional life in later life. It is also a ‘critical period’ for preventing the loss of bone strength - women undergo rapid bone loss during menopause as the levels of oestrogen falls.
Approximately 20-30 % of midlife women also experience incident or recurrent episodes of clinical depression, the leading cause of health-related disability in women. Further, several cohort studies with advanced scientific understanding of menopause have identified an inter-relationship between ovarian ageing and health concerns such as bone, cardiovascular, cognitive, and musculoskeletal health.
The research clearly shows evidence that there are critical changes occurring during midlife that warrant changes in lifestyle, behaviour, social engagement and health care practices.
And yet, currently there are only 29 NHS menopause clinics in the U.K. (with waiting times for appointments up to 6 months). There are also disproportionate levels of menopause care across the country depending on geography and socio-economic status. These challenges are not just impacting individual health but the workplace at large:
· 72% of women in work say they feel unsupported
· 9 out of 10 women say they feel unable to talk to managers at work
· 1 in 5 take time off to deal with menopausal symptoms, 1 in 50 are on long term sick leave
Women of menopausal age make up 11% of all people in employment, numbering 3.5 million women (TUC.org.uk). According to the Nuffield research, no less than 10 per cent of women seriously consider giving up work due to their symptoms; a serious blow when we consider that menopausal women are the fastest-growing demographic in the workplace (Faculty of Occupational Medicine). In the NHS alone, women make up 77% of NHS staff, with an average age of 43!
Education around and access to HRT are getting better. However, not everyone needs, can or wants to take HRT. Menopause requires a holistic lifestyle overhaul that spans dietary changes, improved sleep hygiene, stress reduction, as well as increased physical exercise. Nevertheless, according to Sport England, a third of women aged 41 to 60 are not meeting the CMO guidelines of 150 minutes per week of exercise and a fifth are not achieving even 30 minutes per week (source: womeninsport.org).
What is clear, women need the time and resources to take control and prioritise their own health. Arguably, there is already enough information out there now to enable women to do this. However, there is also a lot of misinformation – and big pharma, corporates and snakeskin salespeople alike have all jumped on the bandwagon looking to make a buck.
I think the real shift will come when women fully realise that midlife is not just a time to navigate the menopause, but a fundamental opportunity to re-educate themselves and lay the foundations for a healthy second half. This will not only support women through menopause but will also lead to greater outcomes as we age, guaranteeing the quality of our lives in our senior years.
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