The Study
Introduction
Studies show that diet, genetics, cultural beliefs, and environmental factors influence menopause experiences. Yet, in the UK the discourse is predominantly homogenous i.e there is one generic way to experience the menopause. But that ignores the complexities of social and cultural diversity. The invisibility of the Black menopause experience is very profound.
We have visited, engaged in discussions, actively participated in activities, and hosted conversations with individuals/groups from health and social care, community organisations, and academia relating to all contestations of menopause - kinship networks, support, legislature, workplace policy and practice, pathology, and research, and strive to share that knowledge as widely as possible.
Why This Is Important
We belong to two underrepresented minority groups and given that menopause mostly occurs as we get older, it gives rise to the added dimension of ageism.
The prejudice needs addressing especially because it is a universal life course experience affecting approximately half of the population.
Sadly, there are so many factors that adversely and disproportionately affects our physical, mental and emotional state of being. Yet, there is still so little research carried out around the interventions and support structures that can holistically promote our optimum biological and psychological health and wellness.
There is a distinct imbalance in the knowledge available when it comes to gender and ethnicity in relation to health, and though in many respects the disequilibrium is being addressed, there is still a considered gap in the knowledge on the black embodiment of menopause.
Hence, why we set out to gain an understanding of local theoretical models and narratives, of the culturally implicit and explicit notions, and practical healing methodology and treatments in the countries we visited. We will continue to visit groups, organisations and institutions to get better understanding of the explanations, experiences, consequences, and interventions from the black perspective.
What We Are Doing
For us, this is not only an academic exercise. We will continue to engage with others on a grassroots level to discover activities and interventions that help treat with menopausal symptoms, and where possible we have been using them to treat with our own reproductive wellness.
The knowledge gained including practical examples, good practice guidelines, resources etc. will be used to further enhance and enrich the group discussions we attend encouraging others to be better positioned to be a voice for those championing change in the approaches to menopause.
Any useful and practical information we get is disseminated to a number of relevant organisations so it can be used in the development of frameworks to aid policy and service delivery.
The Challenges
The social construction of menopause is that it is the gateway to old age with decreased physical attractiveness, and declining mental and physical functionality, but research done in South Africa provides a counter-narrative.
We have found that even though the menopause can represent a challenging and difficult time in the life of many, some considered post- menopause to be a liberating - embracing their life with renewed energy and youthfulness.
According to the World Health Organisation’s Women, Ageing and Health: A framework for Action, focus on gender report, a study mapping existing research and knowledge gaps in older women in Europe found a lack of research relating to women aged 50 to 60 which is the more likely age bracket for menopause. It is therefore safe to deduce that there is even less research on Black experiences within that age group.
We know that there are tensions in the black menopause experience, the support received, engagements with health care professionals, and the way that we are perceived in terms of our psychological and functional selves. But one of the things we consider to be useful is the locating of black experiences in historical, social, political and cultural contexts. In doing so, it makes it easier to understand and challenge particular areas of policy, practice and interventions and be less reliant on the uncritical transfer of knowledge and experiences of menopause in non-black bodies.
The invisibility of blackness in menopause scholarship is evident – we found limited academic papers via the British Library and Google scholar, and a quick search on amazon for ‘menopause books’ flagged up over 5000 results and by far the vast majority (roughly 90%) had white faces on the cover, similarly a scan of Podcasts and Ted Talks produced limited results, thought we are pleased to say that it is getting much better – Finally Our experiences are becoming more visible.
On perusing the British Menopause Society website, we came upon The Menopause Management Workbook which has male co-authors but none were visibly Black women. We do however wish to acknowledge those who have written academically on the subject of menopause, and to those who are speaking openly about their own experiences and those have written very helpful books on the subject. The tide is slowly turning.
The Aim
We want to continue to hear the voices of those with differing experiences - those for whom it is not just a condition attributable to old age, but those who may see it as a time of enlightenment, those for whom it is considered a spiritual renaissance, or a time of sexual liberation, those for whom traditional healing methods have helped them to cope, or those who have resorted to seeking spiritual womb wellness sessions, worn waist beads, taken herbs and baths, altered their diet, taken up exercise routines.
We have been doing this work since 2014 and over the past 12 months we have done over 20 workshops, conversations, and discussion groups and it is this type of information that we want to understand and share. We know that differences in social constructs, symptomology and severity means that there will be variations in perceptions, coping strategies, and treatment utilisation, but knowledge is power – if we have the knowledge, we have to power to help ourselves.
Our ultimate aim is to identify and bridge a gaps and signpost to practical solutions in this very important yet under-researched area. We want to add to existing scholarship on topics such as Workplace Presenteeism and Menopause which is of itself another under-researched area. Generally, when employers think of the impact of health in the workplace it is more often than not thought of in terms of the cost of absenteeism i.e. employees who are not at work.
Yet, the cost of presenteeism is greater than that of absenteeism, but a culture of presenteeism is generally promoted. We know that those who are experiencing menopause will for the most part turn up for work even though they may be grappling with symptoms that are impacting their productivity. According to the Menopause at Work – Guide for Unison Safety Reps, ‘the menopause is an occupational health issue, and one that is growing in importance’, but many organisations are still unaware of the adaptations or support that they can put in place.
Workplaces have a duty via the Health and Safety at Work Act to ensure the health safety and welfare of their employees, and in that regard under the Management Regulations they are required to undertake risk assessments. Health and safety does not only apply to physical wellbeing, but also to mental and emotion. Additionally, employers have a duty under the Equalities Act to address potential discrimination. But many do not realise their responsibilities under these Acts also include those within their employ who are experiencing the menopause.
A survey of 500 safety reps found that ‘45% said their managers did not recognise problems associated with the menopause. Almost one in three of those surveyed reported management criticism of menopause-related sick leave, over a third cited embarrassment or difficulties in discussing the menopause with their employers, and one in five spoke of criticism, ridicule and even harassment from their managers when the subject was broached’.
This space is about promoting better health outcomes, sharing practical advice, and support, offering a listening ear, and spreading knowledge, and talking about our experiences.
We are advocating to be Menopause Champions and want others to join. Remember, “If you want to go fast, go alone. If you want to go far, go together.” African Proverb.
Benefits
The benefits would be the practical ways in which we can manage our symptoms, and on a wider level how we can enhance our awareness and increase understanding more widely.
On a practical level it will help us to openly name the experience and ask for support - breaking the silence and uncovering our invisibility in mainstream conversations, and providing a space for social scientists and health professions to carry out further studies and research.
Our own experience and that of many others in the UK points to the fact that our clinical engagements do not take account of our differing symptoms. This is not a condemnation of medical professions, but highlights why this space is needed.