Commentary: Include men in conversations about menopause

Approximately 1 million women experience the start of menopause every year, yet many are surprised and bewildered by its arrival, so much so that they can’t even help themselves. According to a 2021 survey of 1,000 U.S. women, more than 70% of women don’t treat their menopausal symptoms because they don’t even understand what’s happening to their own bodies.

It sneaks up on even the most well-resourced people. Oprah Winfrey and her longtime buddy, journalist Maria Shriver, spoke out about the silence surrounding menopause during a conversation in the Paramount+ series “The Checkup With Dr. David Agus.” Both women described being unprepared for the “change of life.”

The fact that people with resources like Winfrey and Shriver didn’t know what was happening to them shows just how little we talk about menopause. To combat this lack of knowledge, experts argue that we should “normalize” it; Australian obstetrician Martha Hickey and three women’s health professors from the United Kingdom, United States and Australia advocated doing just that in the British Medical Journal. Winfrey and Shriver also used that word.

They’re wrong. If there were any normalizing to do, women would be discussing this now, but we’re not. Only 9% of those surveyed in 2021 reported that they had a conversation about menopause with their mother.

Instead, we need to start these discussions about menopause. And the best way to do that is to include men in these talks.

One of the reasons why menopause remains culturally shrouded is that it’s been identified as an exclusively female problem.

It’s not. Andropause, also known as male menopause, is characterized by an age-related decrease in testosterone levels. The sex hormone changes occur gradually in men unlike women, who experience a more dramatic plunge during menopause. Still, about 50% of men will experience symptoms, and it’s attracted the attention of the medical community; there’s significant research into male menopause, or climacterium, that gets spun into a new conversation about virility but never enters the discussion as an analog of women’s menopause.

It should. Not only do middle-age and elderly men experience a decline in testosterone production and plasma concentrations, but they also encounter mood swings, occasional night sweats, weight gain in the upper body and irritability.

It’s significant enough that researchers have examined how pharmacists, the health professionals people interact with the most often, can help men who are experiencing these problems. Pharmacists are ultimately more effective in managing men’s symptoms than primary care providers. As a result of these findings, guidelines on how pharmacists can screen men appeared in 2021.

This same idea was proposed for women as early as 2005, but it’s not gained as much traction. Indeed, treatment for menopause has dropped off considerably since the 1990s, largely because the side effects of hormone treatment were published and scared women away. As a result, effective treatment that’s available to women has been kept from them, and they’ve been required to suffer when it hasn’t been necessary.

That men can get more relief for similar yet less significant problems should have been expected and not just because society can be sexist. However, that’s not the entire explanation for the abandonment of women undergoing menopause. It’s because we as women have intentionally left men out of the conversation about women’s reproductive symptoms.

Menopause is just the far end of menstruation, and we keep boys and men out of discussions of reproductive health from an early age. Health and sexual education classes are often gender-segregated. Boys learn more about menstruation from parents, siblings and classmates than they do from sex education.

This extends into adulthood, when men report being aware of their partners’ menopausal symptoms but unaware of how to access treatment for symptom management.

But there’s potential here. In a 2019 study to assess men’s perceptions and attitudes toward menopause, 75% of subjects reported perceiving themselves as largely influential in their partners’ lifestyle and medical choices. If they knew more about accessing medical management for menopause, there might be fewer surprises for women.

Of course, there’s another reason why we don’t talk about menopause, and it isn’t medical. It’s about how women’s value is determined by their ability to bear children. Men don’t experience that type of devaluation; they can impregnate a woman throughout their lives.

That conversation involves reversing misogyny, a much taller order than getting women the help they need and deserve when menopause hits. That’s something we can begin now.

We need to start the conversation about menopause by extending explicit invitations to men to join in.

Margena Christian, Ed.D., is a former health and wellness editor with Ebony magazine. She is currently a senior lecturer of English and professional writing at the University of Illinois at Chicago and is a Public Voices fellow of the OpEd Project.