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The last taboo: menopause and the oestrogen patch shortage

By Evelyn Tsitas - posted Thursday, 28 September 2017


Just as in Gilead, women's fertility is privileged. As standard practice, the media has an ongoing fetishization of pregnant celebrities.

The spectre of Gilead is one all women live under. We can view the lack of interest in the HRT shortage as a disregard for women's health now that their reproductive days are over. Atwood argues that under Trump, women have been put on notice that hard-won rights may be only provisional. "It's the return to patriarchy," she said, warning that whenever tyranny is exercised, "it is wise to ask, "Cui bono? Who profits by it?"

This obsessive and misogynistic link between female worth and reproduction is also at the heart of the medical profession's patronising conspiracy of silence about the long term health risks associated with vaginal birth.

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Mavis King breaks this taboo, writing about 'the things that can last a lifetime after a vaginal delivery, such as a weak bladder, reduced feeling or even pain during sex, a heavy feeling in the vagina where your insides feel like they are falling out (and quite literally can be)…If I had been presented with some clear and simple possibilities, which every obstetrician would know, then I feel I could have made a more informed decision and been better prepared for the recovery.'

Cui bono? In the UK, there are claims that women are being pressured not to have caesareans as part of an NHS culture of 'policing pregnancy' – this is because it costs the government money. The surgical procedure costs the NHS more than double a vaginal delivery. No wonder the alarm at the rise in caesareans worldwide. Of course, there are very good medical reasons for having a caesarean birth, and good reasons for not, but it is interesting, and not widely publicised, that there is a financial incentive in the worldwide campaign to stop women accessing this option. Women are pressured into vaginal delivery even when they will end up with life changing consequences.

Last week, recipients of vaginal mesh implants gave personal accounts of their suffering to a Senate committee in Sydney. The women received the mesh in a bid to correct urinary incontinence and pelvic organ prolapseas a result of damage to their pelvic floor after childbirth. The hearings come as 800 women fight in a class action lawsuit against Johnson & Johnson, claiming their vaginal mesh implants have left them in pain.

Throughout their lives, women are silenced about speaking about their embodied experiences as women. We are shamed about frank and open discussion regarding birth trauma, the long term impact of vaginal birth, and caesarean birth (I was accused of being 'too posh to push' after my book on high risk pregnancy came out). Once the reproductive years are behind us, we find that the taboo shifts to silencing, dismissing or trivialising women about the menopause.

Research has found women find it hard to talk about experiences of menopause at work because they fear aged-based discrimination.

UK broadcaster Lorraine Kelly who went public with her struggle with menopause said that it is still the last taboo. "We still don't talk about it, even with our own girlfriends…. It's natural! As a woman you get periods, you have your child-bearing years, and then you have the menopause."

Indeed, we haven't come that far in the past 70 years when it comes to discussing menopause in the media. In 1948, when obstetrician Dame Josephine Barnes gave a series of talks on women's health on BBC radio covering bleeding, hot flushes and hormonal changes, there was uproar.

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The trouble with all this silence about women's bodies is that the many varied narratives and nuances around the different stages of women's reproductive lives are lost. Only the most 'sensational' and 'news worthy' see the light of day. But just as not all women experience life changing birth trauma after vaginal delivery, not all women suffer from debilitating menopause symptoms. Just as not all men after a certain age need chemical assistance from the little blue pill to maintain their sex lives.

Let's flip it around to see what applying a women-centric narrative to men's health issues looks like. If menopausal women's need for HRT to resolve complaints like hot flushes and insomnia isn't considered important enough for the government to put pressure on the manufactures to come through with reliable drug production, then it seems only fair that impotent men's desire for erections should be deemed similarly inconsequential.

Something however tells me that the reliable supply of Viagra will never dry up.

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About the Author

Dr Evelyn Tsitas works at RMIT University and has an extensive background in journalism (10 years at the Herald Sun) and communications. As well as crime fiction and horror, she writes about media, popular culture, parenting and Gothic horror and the arts and society in general. She likes to take her academic research to the mass media and to provoke debate.

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