The History of Menopause

{Alternate title: Why Women Are Mad}. When it comes to menopausal attitudes, we tend to think that they have always been overwhelmingly negative, painting women as crazy, withered grandmas or bitter harpies clinging to youth — but actually, if we go back far enough, older women were once matriarchal pillars, providing a font of wisdom that is now lost, as well as strong family support systems.

Historically, until the 1900s, the average lifespan for women was around 50, which means life after menopause is a relatively modern concept. So, what changed? After the industrial and medical revolutions, women started living a lot longer, and menopause (like pregnancy) became less a stage of life and more of a "condition" — except, as it turned out, no one was really helping to address this condition…

Women were stuck between modernist (i.e., post-industrial) socially negative views held of older women and the fact that these changes were left largely unaddressed. Synthetic hormones were introduced as a replacement for traditional remedies — some of which held actual merit and didn't have side effects — and thus the "curing menopause" cycle was born.

Women could choose to use synthetic hormone replacement therapy (HRT) or grin and bear it. The mood swings and emotional shifts became a common "joke" about women of a certain age.

There was more to come. The rapidly growing advertising industry promoted a wide range of products focused on beauty, maintaining a youthful appearance, and promoting the importance of looks for women. Both men and women were "taught" to value youth over age. Elder women's wisdom became an afterthought, and the cult of chasing youth led women to feel "less than" as they got older. Add the changes associated with shifting hormones in peri and post-menopause and, well, women felt even worse about themselves — and so did society.

It's a grim history, with older women caught in the crosshairs of having lost what society said they needed, and having been stripped of what they could have inhabited instead. And through it all, one thing remained crystal clear: still, no one really understood what was actually happening to women in menopause, or how to help them navigate it.

Understanding Menopause

Many of us grew up with mothers who were prescribed synthetic hormones. Some made it out unscathed, but for many women these hormone substitutes led to a wide range of unwanted changes, including increased cardiovascular concerns. These hormones — made from pregnant mares' urine — contained compounds that don't occur naturally in human women, and didn't always play well in human bodies. Long-term studies helped refine the understanding of which formulations and which combinations posed the greatest concerns, and why.

But they did seem to catch a budding idea — that hormones were at the crux of many changes related to menopause. In 2024, thankfully, there is a growing (if sometimes slowly growing) understanding of the intricacies of menopause, starting with hormone changes and how these affect women from their brains and bodies, to their sex lives and daily energy.

Hormones and their changes are topics we write about at length in our articles, detailing how hormones like progesterone, estrogen, DHEA, and testosterone all play a crucial role in our bodies — from weight to neurotransmitters — and in how they interact with other hormones like cortisol, insulin, and melatonin.

Hormones play a critical role in brain chemistry, a fact that is consistently overlooked by many practitioners. Many people today are noticing the impact that daily environmental stressors may have on how they feel — hormonally and emotionally. Add the changes in hormones associated with the menopausal transition and women are understandably navigating a lot at once. And yet this is still portrayed as a comedic meme. If you're not frustrated because of hormone fluctuations, we think you should be frustrated because women's health is so poorly understood.

Mental Health & Menopause

The mental well-being of women in menopause is no secret. Many women in menopause report feeling mentally foggy, less rested, or more emotionally reactive — experiences that can meaningfully affect daily life and well-being. Sleep changes and difficulty concentrating are among the most commonly shared.

Some research suggests that the hormonal shifts of menopause may intensify emotional experiences for women who are already prone to mood changes. Additional research has linked pre-existing tendencies toward emotional reactivity with a greater likelihood of navigating mood-related changes during menopause — in a nutshell, women who already noticed more variation in their moods tended to feel the shifts of menopause more acutely.

Is it all hormones? Probably not. After all, menopause often marks other key shifts: children leaving home, becoming a grandparent, retiring, loss of loved ones, and of course — there is often an imperceptible change in how you are viewed in society. We may not experience all these things, and some of them may have more or less of an effect on us, but like becoming a new parent, changing careers, or getting married — significant life changes are likely to affect our emotional lives, and many aspects of menopause are connected to transition and change.

Retiring and children leaving home can offer cause for sadness, or space for travel, hobbies, or reinvention — sadly, it is often framed as the former, with little time or energy being directed towards the joys that women can have as grandparents, new business owners, aspiring senior pickleball pros, or late-life learners enrolling in college. Let's face it, sometimes we feel both loss AND excitement.

The other puzzle piece, aside from socioemotional changes, is changes in our brain chemistry.

Hormones & The Brain

Estrogen, progesterone, and DHEA are all linked to the production of key neurotransmitters that help regulate our emotions — notably serotonin, dopamine, and GABA. You can read more about each of those neurotransmitters and the role they have in brain function and mood in our other articles, but the bottom line is that a healthy balance of our sex hormones (estrogen, progesterone, testosterone) is directly connected to the brain's ability to produce important neurochemicals — and thus, to our mood and emotional well-being.

When we look at the data, we see many women in menopause being prescribed anti-anxiety medications, prescription mood support medications, and sleep aid medications. These medications sidestep the more pressing question — are women really experiencing emotional changes, or is the medical community giving out prescriptions to avoid delving into the underlying issues…

Research suggests that, for many women, supporting hormonal balance has been associated with feeling more emotionally even, better rested, and more like themselves — and without the side effects that often come with prescription mood medications, including weight changes, low libido, headaches, and disrupted sleep — issues many of us are already navigating in menopause.

Doctor, Help!

Many doctors are wary of prescribing bioidentical hormones to women in menopause. This may be due to lack of training, a lack of familiarity with current research, or because protocols provided by health systems limit practitioners' options for providing individualized care. Sadly, for many women, the response from their doctor isn't great. Women often hear things like:

Deal with it. Use more lube. Try this anti-anxiety med. Try this synthetic hormone pill. Stay away from all hormones. Give up sex. Try this antidepressant.

Even as research does begin to catch up — as in the 2022 North American Menopause Society updates — many women are still left scratching their heads, finding naturopathic doctors, or using their wits to find information on their own.

I Am Woman… (Hear Me Out)

Older women are everywhere in TV and advertising, but not in the places that matter.

Where is the representation of women's health in medical research and training? Where is the representation of women in business? Where is the lost wisdom of the women who have raised children, worked, and managed their menopause as best they could while society told them to shuffle off into the corner and be old quietly and out of sight?

Is it any wonder women's emotional well-being has taken a hit?

In our latest Ask Dr. Robyn, one client asked how women could fight back against insurance companies and medical providers who refused to listen to them, look at their packet of research, or pay for their treatments. Her response? Keep going. Keep advocating.

Once upon a time, older women held a place of power — the matriarchs who ruled with wit, wisdom, and often the steely fortitude of having birthed eight children. Who said modern women can't have that too? In the era of negative menopause representation in the media, maybe it's time we get to be the ones who decide what menopause looks like.

After all, we are older and wiser than everyone else… 😉

This article is for educational and general wellness purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease. If you are noticing changes in your body or have questions about your health, please consult a knowledgeable healthcare provider.