Dear Friend, 

Thank you for loving the women in your life enough to read this missive. At the very least, thank you for being curious about its contents.

If you know me, you probably have a good understanding that I am (for the most part) an open book. I understand deeply that talking about our personal struggles is the key to our own inner freedom as well as someone else’s relief. Anxiety—a diagnosis that I, like most sufferers, am adept at masking—has been a fairly constant companion of mine across many years. I have also struggled (forever) with unhealthy eating habits. This one, for obvious reasons, is a bit harder to hide. I have readily shared it all. And I have worked hard across the years to process the origins of my obstacles, to rewrite the limiting beliefs that fuel them and to enact the changes that serve the health of my body, mind and spirit. I’m a work in progress but I am getting there.

Recently, it became evident to me that it was time to share the experience of another hat I am getting acclimated to wearing—that of a post-menopausal woman. As much as I’m not afraid of sharing my personal experience, it didn’t feel authentic for me to simply share my own story and so I tossed the request out on social media. Seventeen women in the very same boat—some having gone through surgically-induced menopause at a younger age than is typical for menopause, some having gone through natural menopause fairly recently and some that are decades in—stepped forward. Thirteen of us met in group format and five were interviewed privately. Each volunteered their story generously and with great passion. One breezed easily through menopause and the rest had much to say about the experience and its aftermath. I bow deeply to each one and I pray I do everyone’s words justice. All were promised anonymity.

To each of these women (myself included), I posed these questions.

1. What would you like your first-tier people (spouses, partners, parents, siblings, children, best friends, co-workers, etc.) to know about your experience as a post-menopausal woman?

2. What would you like to say to the medical community about the care you receive as a post-menopausal woman?

3. What would you like to say to the world-at-large (i.e. society) about your experience of being a post-menopausal woman?

A hearty conversation ensued. I learned quickly that these three questions were actually just one question with interweaving and inextricably connected parts. Looking closely at the answers often revealed similar familial, workplace and medical institution experiences. A bird’s-eye view told the tale of something more ubiquitous—the perception of a systemic, societal dismissal of women and the female experience, in general. 

Truth be told, you cannot talk about menopause without turning the clock way back. Many of us learned about the inner workings of the female reproductive system from our school nurses, our older sisters, our friends’ older sisters and, of course, Judy Blume. A good chunk of our moms didn’t know what to do with this information (because, I’m sure, their moms didn’t know what to do with this information) which led to the misguided sense that what was soon to take place in our bodies was something to be ashamed of. And feared. And definitely not talked about. 

Think about what happened when you heard these words: ‘This is Kathy Rigby for Stayfree Maxi Pads.’ The room cleared and the brave few that remained filled the air with nervous coughs, snickers and ‘Who wants chips? Anyone want chips?’ The collective breath held until the next commercial. Many of us recount the ongoing walk of shame at the pharmacy and the way that all evidence of our monthly ‘visitors’ was to be hidden in our homes. If half (HALF!) of the population goes through these beautiful, biological changes (the very ones that make bringing life into the world remotely possible), why were we so afraid to look at this topic then and why are we still so squeamish about it now when we talk so openly about everything else?

So, here we are, decades later making sense of the cessation of this monthly biological function which, we find, is accompanied with equally dramatic changes and much less information than we received heading into puberty. The overarching experience for every one of us going through or coming out of the transition of menopause was characterized by little to no acknowledgement, preparation or information from our medical team which included both male and female professionals. Our questions and concerns about the tectonic shifts we would experience (and continue to experience) in our bodies and minds, across the board, were (are) often minimized, dismissed and met with very abrupt sessions that, for several of us, missed important, potentially life-threatening diagnoses. Symptoms of discomfort that are typical during or after the menopausal transition are often met with a quick, patronizing Band-Aid, no deep dive (or any dive at all) into causation and no plan in place for follow-up.

Let’s talk for a moment about mammograms.

The ‘Gold Standard' of breast diagnostics, we are told, is the mammogram. A very shallow dive into the literature (starting with the American Cancer Society) reveals what we are up against—the confounding fact that mammograms will most assuredly save some lives, hurt others (via false positive results and potentially life-altering/threatening side-effects of surgery/chemo/radiation for pre-cancers and cancers that would never have progressed or posed a threat) and miss a good chunk of cancers (15-20% in general and 20-50% for those with dense breasts). In the end, respectfully, our body, our choice, BUT, we ask, is contorting our spines, placing the most beautiful glandular tissue of our bodies between two cold hard plates, applying 20 to 45 pounds of pressure to each respective breast (the equivalent of two to three bowling balls) and radiating said beautiful tissue in the face of such mixed results really the ‘Gold Standard’ of what we can offer women today? Would this be an appropriate diagnostic tool for, say, a penis? We hardly think so. 

And that’s just one confusing, painful and humiliating aspect of women’s health care.

Several spoke of the trauma of rushed, poorly-explained procedures at or around menopause that included vaginal ultrasounds, repeated endometrial biopsies and contraceptive (IUD) extractions performed without proper pain management in place. For those going down the path of HRT (hormone replacement therapy), its prescription often came with almost no strategy, information, game plan or follow-up despite the fact that some felt unwell on the protocol and had to discontinue use. Making sense of the scant information around menopause (and the entirety of the female lifecycle, actually) leaves us mining for our own information and scratching our heads and other dry parts, to be quite frank. And speaking of dry parts, one of our OB/GYNS told us to apply ‘the ointment that farmers use on the underside of a cow’ to address genital dryness and atrophy. What?? Can you imagine how humiliating that advice is? Does cow ointment also go under the heading of ‘Gold Standard’ offering for women?  

All things considered (and there is a lot to consider), we are mostly looking for all of our medical professionals (not just our OB/GYNs) to be educated in the biological changes of menopause—you know, the natural transition that half of the population will go through. Shouldn’t each have a good understanding of how menopause considerations will affect the care provided from their respective disciplines? (As a licensed physical therapist, I speak from experience that my education did not remotely broach the topic of menopause even though the majority of patients I treated were post-menopausal women. Understanding the role of changing hormones, the tendency toward inflammation and the fragility of post-menopausal soft tissue structures would’ve gone a long way in the care I provided.) At a time where we are feeling increasingly invisible, we ask all medical team members to listen to us and to listen well, to not look down on us, to give us the time we deserve and to treat us as though we matter and that women’s health issues matter. Less robotic, more human, and maybe a medical specialty dedicated to menopause (someone who can let us know that beyond the vaginal dryness, hot flashes, insomnia, mental fog, diminished libido, painful intercourse and weight gain of menopause, the weird skin things and random hip pain and itchy ears and burning tongue are also part of it…and maybe this person could help us do something about it), please and thank you. 

If you’re paying attention, it’s pretty obvious that so much of our collective experience with the Western medical model as post-menopausal women appears to be a reflection of how society views aging women (or, perhaps, all women) in general. So, let’s broaden the conversation. Consider indigenous, tribal communities where every person has their highly regarded role and in which female elders are revered for their wisdom and spiritual insights. They function as healers, caregivers to elders/children and keepers of heritage values. Superficial standards of beauty do not exist for these women who are cherished for the gifts they bring to the table including their beautiful wrinkles, laugh lines, etc. With emphasis, we assure you that this is not the experience we are having. Not even close.

Have you seen The Golden Bachelorette? Reality TV is a terrible litmus test of actual reality but this is the ideal we are often held up against; unnaturally and ultra-processed (hey, no judgment, you do you) post-menopausal women. Thanks to shows such as this, social media, astute marketing campaigns and life, generally, in the year 2025, menopause gets added to the list of things that have been commodified and we pay a price for it. Go grey but do it in a flattering way, like this woman with perfect hair did. These beige highlights will help. Lose your 'meno' belly and look like this ideal woman. Erase your crepe-y skin and firm your turkey-waddle neck. You guessed it, just like this ideal woman did. Believe us, we hear and see the underlying message loud and clear: We are broken. We are not enough. We need to be fixed. Shame on us. 

Shame on a society that would do this to us now or any women ever. 

Why isn't it okay for us to be our glorious, beautiful selves just as we are and without the fix you are selling? In case you haven’t noticed, we ARE trying (and, to be clear, we actually have been trying since the elevation of the stick-figure ideal of the 1970s!) At this stage of the game, maintaining our health and keeping up with the sweeping physical changes of menopause (which often make our bodies unrecognizable to us) are quite the uphill battle. Those of us who feared turning into our mothers, found our dear grandmothers staring back in the mirror seemingly overnight and that truly takes our breath away.

To boot, we find ourselves caring for our elderly parents, our aging siblings/partners/relatives, our homes, our children (who might’ve come along later or who might be having a hard time launching into the world or who might be returning to the nest for a re-grouping) and our children’s children AND we are among the first generation of women doing all of these things while holding down full-time jobs and/or part-time jobs with a sprinkling of side-gigs thrown in for good measure—well into our golden years. Without question, we are faced with layer upon layer of responsibility. One of those interviewed said, ‘If we are the sandwich generation, I am a burnt panini.’ Indigenous female elders contribute in meaningful ways to tribal culture but they do few things and they do them well. The hats we juggle and the burden we bear make us feel like Atlas—responsible for holding up the world—and WE ARE TIRED. 

To top it all off, the ever-increasing list of dearly departed loved ones, the empty nest, our changing bodies, our waning energy levels, fractured relationships, unrealized dreams, deep regret for pushing ourselves too damn hard for too damn long and, of course, our impending irrelevance (which, by the way, is so palpable, you could cut it with a knife) all make for a hearty dollop of GRIEF to go with our burnt panini. Some of us were coerced out of work we loved. Some of us were talked over or told to ‘Let the younger ones handle that.’ One was treated differently the moment she stopped coloring her hair. (Maybe those beige highlights would’ve come in handy, after all?) How unfair, how unnatural and how un-tribal all of this is. At a time where people are living longer, we realize that many of us still have a third or up to half of our lives left. That’s an awful long time to be so uncomfortable in our physical bodies and to feel irrelevant in a society that unequivocally reveres youthfulness.

Our intention with this missive is straightforward: To share the experience we had with menopause, to share the experience we are having as post-menopausal women and to share the way that all of this makes us feel—with anyone open-hearted enough to listen. Apparently, that is you. Thank you for that. Trust us, this isn’t about that one person doing that one thing badly. This is about a society that is missing the mark in casting aside one of its richest resources. We feel for those who paved the way for this conversation with less support than we currently have. We know they are cheering us on. Our hope is to shed a little light on our situations and improve awareness/strategies for our up and coming pre-menopausal sisters. 

If the family unit is the bedrock of society, it would seem that improving the valuation of aging women within our families would be a good place to start. There are a few things we would like to reiterate and state clearly for the record to our families and first-tier folk.

• By and large, menopause isn’t an easy transition. We simply want to be on your radar in the way that you are on ours. Be curious about what we are going through, check in with us and follow-up with what we share. This is a high form of love and would be a priceless effort on our behalf.

• We don’t need fixing. Please don’t tell us what you think we should or shouldn’t be doing (including losing weight). 

• Along with all of the shifts and all of the changes, there comes a lot of second-guessing. Understand that our self-confidence is wavering. Be the thing that bolsters it.

• Share the load. If you haven’t heard it already, we are ‘burnt-panini’ tired and cannot keep up with what we used to be able to do. We need help. Please, ask how you can help us.

• Choose your words kindly and carefully. Maybe even consider doing some research on your own to gain understanding on the topic.

• We are more than our menopausal status. Please don’t plop us in that bucket and please see us for all that we are and all that we bring to the table.

• Be patient with us. We are recalibrating to sweeping changes in our bodies and minds.

Despite the fact that the world may not know what to do with us and often suggests that we are a burden, we want everyone to know that we aren’t done living, learning and contributing. Not by a longshot. Menopause is a natural process, uniquely different for every woman. It is neither a sign of weakness nor a liability. Ultimately, we see it as part of an ongoing invitation in our lives to accept our bodies and the experience we are having in them—a process that, we are sure, will continue until our last breath.

So what’s next?

Well, we are figuring that out. What is clear is that we would like to be done with trying to be what the world needs us to be and done trying to be all things to all people. As we struggle to make sense of a life that is flying faster than the speed of sound and changing by the second, we plan to continue being the joy-seeking, connection-loving, work-in-progress/ever-arriving women that you know and love. We are still us. We remain committed to championing you as you claim your esteemed place in the community and we hope you will support us as we claim ours. 

We are grateful to anyone who has taken the time to see this missive through and even more grateful for any change it persuades.