Blog of the Society for Menstrual Cycle Research

Feeling Uncertainty, Confusion, and Frustration about Menopause

November 10th, 2011 by Heather Dillaway

Last Friday I attended a conference on autoethnography and was privileged enough to listen to Carolyn Ellis give the keynote speech on this new and upcoming qualitative methodology.  Sitting there and listening to Ellis talk about the need for all of us to be reflexive and put ourselves into our research projects, I realized that I probably do need to acknowledge my own feelings of uncertainty and frustration as I study menopause and midlife. Therefore, this blog entry is for you, Carolyn Ellis, as I am inspired by you to be better from now on about acknowledging the connections between me and my work and trying to understand myself as a research instrument as I seek to understand menopause and midlife better.

The reasons I really started studying menopause are the very reasons why I’m still studying it but also frustrated by it. In the mid to late 1990s, my experiences as a birth control counselor at Planned Parenthood in Delaware and Michigan led me to realize that plenty of middle-aged women don’t understand what’s happening to them when they start to have irregular periods in perimenopause. I also watched my mother begin perimenopause in the mid 1990s and be confused and embarrassed to talk about the experience when she had always been the first one who always wanted to talk about pregnancy, childbirth, breastfeeding, and birth control (“What was so confusing about menopause?,” I thought).  I’ve now formally studied and written about women’s thoughts and experiences of menopause since 1999. All along, the terminology and definitions of menopause have been as problematic for me as for the women I’ve studied. I’ve listened to menopausal women who tell me that they are completely confused about biomedical terminology for their life stage and completely baffled about what they’re going through.  I’ve heard them talk about how doctors and other women they talk to are just as confused as they are. What is this thing they’re going through? I’ve talked to other feminist social scientists and humanities scholars who think we should call menopause “reproductive aging” or “the menopause transition” to signify that variation over time is really the only guaranteed experience at this time of life. Endocrinologists and biologists turn around and tell me that the term “reproductive aging” is faulty because all that term signifies is that we are all maturing from birth on – that it is an empty term signifying nothing. I listen to endocrinologists, epidemiologists, public health educators, women’s health advocates, menstrual activist researchers, biologists, and clinical/biomedical researchers who are all ready with their own take on what terminology and definition is “best” for describing this time of life. Some argue that there is a strict three-phase model of perimenopause, menopause, and postmenopause that we should follow. Some argue for a five or even seven stage model for “menopause,” parsing out pre, post, early and late stages of the menstrual life course (such as early and late  premenopause, early and late perimenopause, menopause, early and late postmenopause, etc.). Some argue that perimenopause is really the only “stage” of “menopause” or late reproductive life that women really want to know about because that is when all the (negative) symptoms come. I hear others argue that “menopause” and “postmenopause” are the same thing, or are that these are conflated terms that mean nothing, and that both of these terms should be scrapped. (Yet then I hear individual women I interview tell me that postmenopause is as frustrating as perimenopause.) I hear other researchers say that EVERY term associated with menopause or reproductive aging is faulty. If I listen to individual menopausal women, they tell me the same. Two months ago, I did a presentation on midlife in general, and a feminist humanities scholar (whom I respect quite a bit) told me I shouldn’t be using the term “midlife” at all, because it is a non-term itself, defined by nothing. If I think about all of the terms I associate with menopause – menopause, the climacteric, the change, the change of life, perimenopause, postmenopause, the late reproductive years, the menopause transition, women’s midlife transition, reproductive aging, etc. – I don’t even know what terms I should be using. Over time I have thought that the best case scenario is just to use the term that women themselves use (therefore I used the word “menopause” a lot to describe a whole transition, or adopted the term “reproductive aging” when urged by feminist scholars to do so in order to define a broader transition). But, now, I’ve been critiqued recently for not correcting individual women when they use the “wrong” term to describe what they’re going through.

I find myself at a loss for what to do next, and how to describe the very thing I study. One thing I’ve definitely realized is that I am as confused and frustrated about how to talk about menopause sometimes as the women who are actually going through this transition. I’ve also realized that researchers, educators, and health care providers who often have the same goals (i.e., promoting a better understanding of women’s health experiences and health concerns) cannot agree on how to term or define the very things they study. We come to stalemates and standstills and haven’t gotten very far. So far we’ve had trouble making compromises amongst each other about how to study the topic together, and can’t always talk across disciplinary or applied/research lines. I’ve seen frustration, confusion, and uncertainty among the very researchers that are supposed to be the experts on these topics.

I think that the frustration I feel right now is an indication of the culture surrounding menopause more generally and the culture of menopause research as well. As much as we know, we are stuck in the process of finding better terms and definitions and explanations of the process.  In the face of the frustration, confusion, and uncertainty we face, we tend to go back into our disciplinary and professional holes and just keep on doing what we’re doing and avoid talking across boundaries or beyond walls. It’s easier for me to just keep publishing in my gender journals than go beyond those safe walls and deal with people who don’t use the same terms as me. It’s easier for individual menopausal women to buy into whatever biomedical terminology they confront at the moment or to keep their menopause transition under wraps and not talk about it, rather than deal with the discrepancies between their own feelings and others’. BUT these actions and “choices” (if they are indeed choices) don’t challenge the very frustrations, uncertainties, and confusion we face. And those feelings remain. I don’t know what to do at this point about the terms I use.

This entry is somewhat freeing to write but also it makes me even more frustrated when I think about the uncertainty and confusion that everyone seems to facing in thinking about the menopause transition. My hope is that we can figure out a way to come to some agreement on terms and definitions, if only to promote social justice for menopausal women and to lessen power relationships in the long run (between women and doctors/health care providers, and between or among different types of menopause researchers) because power relationships are a part of this situation as well.

I know this is a hard blog entry to comment on, but I’d love to hear from others on this. Are you experiencing the same frustration as me? Today is a day that I can’t quite get past this frustration.

  

8 Responses to “Feeling Uncertainty, Confusion, and Frustration about Menopause”

  1. [...] Society for Menstrual Cycle Research : » Feeling Uncertainty … [...]

    • Heather D says:

      If you’re inferring that no word or phrase referring to menopause makes reference to the fact that it is also a change in identity and/or has a spiritual component, I agree! None of the words/phrases/ways of talking about menopause do the breadth and depth of the transition justice at all. Spirituality is definitely part of the process and perhaps we should name it more often.

  2. Elizabeth Kissling says:

    I hope to come back to this post later with something more substantial to say, but for now, Heather, I just want to thank you for writing about this, and opening the discussion. I can’t help but think it’s part of the larger cultural taboos about talking about menstruation at all, and I’m sure you’ve had that same thought, but that doesn’t really advance the dialogue.

    • Heather D says:

      Yeah, I think we are all frustrated and stifled and stifle each other right now. I agree that it is definitely related to the silence and negativity and ways we’ve been forced/encouraged to think about these processes. And we’ve spent so much time trying to deny the “bad” or “negative” ways of talking about women’s health processes that we haven’t done any positive work to redefine or rephrase or rethink on our own terms. This goes right back to Randi Koeske’s idea that we have let ourselves become sidelined on our very own topics and we cannot think of ourselves as unable to come up with our own terms and own ways of thinking about things.

      • Heather D says:

        And maybe we’re also afraid to say to others, “you know what? I think I am using the correct term and this is why…”

  3. Laura Wershler says:

    Wow. Heather, you have instinctively, with this post, done exactly what I’ve just learned in my Blogging Bootcamp we bloggers should be doing. Expressing vulnerability, acknowledging what we don’t know and sharing what we are learning today about our areas of expertise. You’ve just shared an “a ha” moment. Your post points out the importance of testing our assumptions about the language we and others use in talking about the menopausal experience. Key Point that you made in the comment section: “And maybe we’re also afraid to say to others, “you know what? I think I am using the correct term and this is why…” This is how we will acknowledge our assumptions and perhaps find common ground. Great post topic.

    • HeatherD says:

      Cool, didn’t know I was doing that but thanks for letting me know, Laura! This is just something that I’ve been feeling forever that I finally just needed to get out. Of course, your comment inspires me to keep going on these kinds of blog topics. For instance, I had a misunderstanding in a conversation with another researcher the other day just because we were defining “reproductive health” differently. Maybe that will be my next blog topic!

  4. [...] Heather Dillaway blogged about the challenges and frustrations of naming, and this blog continues with that theme, looking at a recent article about increased rates [...]

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