We are all born with innate curiosity and bravery.
Without these characteristics, we would never crawl away from the warmth of our parents’ arms.
But then we get sucked into a dominant culture, which can interfere with our instincts, breed our own inner critic, and push us to listen to experts. In matters of health, we are taught that these experts and their products will save us from an alleged almost inevitable state of disease.
Rites of passage in life often disrupt these forces and reconnect us to our true selves. Giving birth and entering motherhood is a rite of passage, and so is menopause.
As women journey through the menopause transition, I’ve witnessed their innate wisdom bubble to the surface, often with an “I don’t give a damn what they think” attitude. Finally, women feel free to say what they want, follow their passions and unleash a zest for life. I see this happen so often in my clients that I consider it a brilliant part of our design – a shift to keep us healthy.
During a recent episode of the podcast Mayim Bialik’s Breakdown, it was almost uncomfortable to watch Mayim Bialik struggle with her wisdom bubbling to the surface, only to be pushed back down by a well-known menopause doctor.
Mayim was curious if perhaps we’re painting menopause as too much of a crisis.
Mayim shared that she’s a fan of home birth. She noted that when doctors discuss birth, they often relate to it as a crisis about to happen, and pregnant women are encouraged to focus on all the things that could go wrong.
She continued, “In terms of seeing this as a part of life that’s normal, natural, beautiful…has ups and downs, complexity, that’s kind of the way we’ve looked at perimenopause and menopause, right? What’s the crisis?”
The doctor folded her arms like an angry schoolteacher and responded:
“We have a 40% increased risk of…diagnosis of mental health disorders; the [increasing] divorce rate; the highest time for a woman to commit suicide is between the ages of 45 and 55; the most likely time for her to have a new autoimmune diagnosis is in perimenopause; we have the most rapid loss of muscle mass through the perimenopause transition; the most rapid expansion of visceral fat in the perimenopause transition. That’s a big f*cking deal.”
Actually, what’s a big f*cking deal is that if all this can be blamed on menopause, how can it be that women have outlived men, across all cultures and throughout history?
It’s not clear where these figures are from, but if they represent women’s experiences in the US, it’s worth remembering that the US has the worst health outcomes of OECD nations and is currently suffering from an epidemic of chronic disease and mental illness.
All states of imbalance are more likely to create symptoms during sensitive times of hormonal change – adolescence, pregnancy, postpartum, perimenopause and menopause. The symptoms are wake up calls.
By remembering the benefits of fear-free, natural birth with minimal medical intervention, Mayim allowed her curiosity to take her where the doctor didn’t want to go.
Mayim quickly fell back in line:“Less than 4% of eligible menopausal women use hormones approved by the FDA.”
The doctor explained that the actual use of HRT is probably double that figure due to women taking compounded formulas of hormones that are not approved by the FDA and cannot be tracked.
“That’s not enough!” declared Mayim. “Even if you told me 50% of eligible women, that’s not enough!”
But then Mayim flipped back:
“I sometimes wonder if there’s a danger to everything being thrown in the perimenopause-menopause bucket.”
The doctor laughed. And then listed off more conditions that menopause apparently triggers.
She sang the praises of HRT including making the claim that HRT is protective against heart disease. The doctor said, “If you start between the ages of 50 and 60, we can cut your risk of heart disease by 50% per year given that window of opportunity.”
She demanded that menopause education should be mandatory for every doctor, so they know “what happens to the human body after estrogen walks out the door and ovaries fail.”
What a picture.
I’m postmenopausal. I’ve never taken HRT and guess what? My estrogen hasn’t walked out of the door. Instead, I’m naturally producing the level of estrogen that my body currently needs, now that my reproductive years have ended. My ovaries also haven’t failed. They’ve changed and have a new important role to play in my health. How do I know? Because women whose ovaries are removed fall to a new trajectory of health and have higher risks of numerous conditions and diseases. Our ovaries aren’t machine parts that just stop working!
Let’s look at the doctor’s other claims.
Regarding her claim about suicide, it’s true that there’s a peak in suicide rates for women at midlife but we see a similar peak for men. Why didn’t the doctor mention this?
In data from England and Wales, we see that men aged 50–54 have the highest age-specific rate while women peak at 45–49. Men at midlife are also approximately three times more likely to commit suicide than women at midlife.
In the US, the data is similar but there’s an additional peak in suicides for men aged 75+, which is attributed to cultural factors.
So, is it menopause?
Or is it a lack of mental health understanding combined with a collapse in traditional social support systems that make it challenging for men and women to cope with the massive life changes that often occur at midlife?
Blaming menopause for suicide rates or indeed increased rates of mental health disorders is reductionist and dangerous – it fosters a belief that women are broken by design and it can become a self-fulfilling prophecy. Women in perimenopause and menopause go through a sensitive time but we have innate resilience that we should be shining a light on more often.
In Western societies, we often fail to understand the brilliance of midlife change. From what I’ve seen from my research and from supporting women in perimenopause and menopause over the last 10 years, I’m convinced that promoting the menopause transition as a health crisis is unhelpful indeed. As I mentioned earlier, this time in our lives is a rite of passage. It may feel uncomfortable at times, but it’s designed to encourage us to return to a path of good health when we are running on empty – depleted physically, emotionally and spiritually.
We can turn to a supposed quick “fix” when our body is talking to us through symptoms, but that defeats the purpose of these sensitive years.
By slowing down and learning to listen to the body, we can make changes and walk a sovereign path back to harmony and well-being. Improving lifestyles will protect us from disease. Offering women a false sense of security by promoting HRT as a panacea isn’t going to serve women in the long-term. Suggesting that HRT protects us (when for women in natural menopause, the most robust studies show that it doesn’t) might convince us that we can ignore the need to clean up our diet, move more, spend time outside and prioritize healthy social connections.
AI is usually good at finding research that can be the source of a data point. However, it could not find research that could be the source of the doctor’s claim that HRT can reduce the risk of chronic heart disease by 50% every year.
If we ignore the “every year” part of the claim, perhaps the doctor was referencing The Danish Osteoporosis Prevention Study (DOPS), published in 2012. This was a trial of just over 1,000 women with no placebo group. In addition, no differentiation was made between the data from women post hysterectomy and women with a uterus intact.
Alternatively, the doctor might have referenced a study entitled Estrogen and Coronary Heart Disease in Women, published in 1991. This research (not a large randomized controlled trial) looked at the impact of estrogen-only therapy given to women with a pre-existing condition that led to a hysterectomy. We cannot draw conclusions for most women based on the results of either study.
The North American Menopause Society policy document on menopause hormone therapy does not recommend using HRT to protect the heart because when considering the benefits and risks from the most robust large randomized controlled trials, an overall advantage for disease prevention has not been found.
When Mayim’s co-host on the podcast, Jonathan Cohen, asked about gut health, the doctor claimed: “The female gut microbiome completely changes to that of a man’s after menopause.”
It’s incredible how the doctor has merged old misogynistic ideas that a woman’s identity can only be defined through menstruation and reproduction, but is lost post menopause.
The doctor referred to ZOE, a leading company in gut microbiome research. According to a recent article on menopause on ZOE’s website, only three out of 10 small studies that researched menopause, hormones and gut bacteria found that "after menopause, women’s gut microbiomes were more similar to men's than premenopausal women's.”
That’s a big difference. Perhaps we can just conclude that postmenopausal women have postmenopausal gut microbiomes.
The doctor also claimed that in early research, ZOE compared the health of women on HRT with women who didn't take it, and saw that women are “maintaining the health of the gut microbiome with HRT.”
ZOE’s website actually states: “Overall, we simply don’t know how HRT influences the gut microbiome yet.”
Mayim Bialik has a PhD degree in neuroscience and is a woman of faith. It is stunning how in the swirls of a discussion on menopause with one of the most vocal advocates of HRT, a platform is given to unproven hypotheses that chop up any notion of divine intelligence stored in the female body during the menopause transition and beyond.
On the scientific side, the average listener may not understand the subtleties of statements about early research into pharmaceutical products. The doctor is probably aware that small studies were undertaken examining women who had a pre-existing condition that led to premature ovarian insufficiency (POI), and rats, which were injured in a lab by being forced into unnatural menopause.
Over the years, many hypotheses have been promoted about supposed benefits of HRT. Doctors made them up because they viewed the female body as prone to malfunction, weak and even dangerous.
What would a discussion on perimenopause and menopause look like if we started from the premise that the female body is brilliant and divinely designed?
Mayim was right to bring up how medicine can mislead us with regards to pregnancy and birth – the comparison is a good one. Imagine if we could embrace the idea that women’s bodies KNOW. Our bodies know how to give birth, how to create optimal nutrition for our babies, and our bodies know what hormones we need and when, post menopause.
It takes a special kind of doctor to see the divine intelligence in our design and to realize that no matter how far medicine has developed, it cannot overtake the brilliance of the body.
Close to the end of the podcast, the doctor, while discussing dietary choices for women said, “It turns out that things that contain sugar from God – fruits and vegetables – are not bad for you.” She continued to explain that when we add sugar to food, then we see disruptions to health.
So, the doctor sees God in fruits and vegetables and their sugars, but not in WOMAN and her hormones.
Fascinating.
Mayim is in a much better place to see the truth of WOMAN. She’s conscious of miracles that the body performs in birth. Would she not like to be open to the miracle of menopause. Would she not like to discover how menopause is a superpower?
