The Menopause Script

The cultural account of menopause is a story about ending. The reproductive chapter closes. The body undergoes a transition that the culture has assembled into a narrative of loss—the hot flushes, the mood disruptions, the declining oestrogen, the changed relationship to a body that was previously, in the culture’s account, defined primarily by its reproductive capacity.

The story is told in the language of deficiency. The hormone levels fall. The fertility concludes. The woman enters the post-menopausal phase, which the medical literature sometimes calls the climacteric and which the culture treats as a kind of arrival at the end of something significant, the beginning of the long concluding section.

The women who live through menopause frequently report something more complicated.

Not uniformly. The experience is varied in ways the script does not accommodate. For some women, the transition is genuinely difficult—the physical symptoms are significant, the mood changes are real, the disruption to sleep and to daily functioning is substantial and prolonged. These experiences are real and their reality does not need to be minimised in the service of a counter-narrative.

The script’s error is not in acknowledging that menopause involves change. The script’s error is in treating the change as loss rather than as transition, and in treating the transition as uniform when the actual experience is distributed across a range that the script cannot render.

 

The reduction of female identity to reproductive capacity is so embedded in the cultural framework that it is often invisible as a reduction. The woman is understood, within this framework, as someone whose primary biological significance is the possibility of reproduction, and the life stages through which she moves are narrated in relation to this significance.

The menarche initiates the reproductive phase. The menopause concludes it. The phase between is the phase of full female identity, and what comes after is, in the script’s logic, a kind of remainder—the person who continues after the defining capacity has withdrawn.

This is an extraordinarily narrow account of what a person is, and it produces extraordinary distortions when it is applied to actual women living actual lives across the full span of those lives. The woman who has spent her adult life not particularly defined by her reproductive capacity—who has had children or not had children, who has built her sense of self around the full range of what persons are built around—encounters at menopause a cultural script that tells her the central chapter is closing. The script does not correspond to how she has understood her life. It corresponds to how the framework has understood her life, which is not the same thing.

 

The lived variation across menopause is substantial and the research is beginning to catch up with what the variation actually involves. The hormonal changes are real and their effects are real, but the effects are not identical across individuals.

The age of onset varies by a decade or more across populations. The duration of the transition varies. The severity of the symptoms varies enormously. The relationship between hormonal changes and cognitive function is more complicated than the cultural narrative of menopausal fog suggests—some women report no change, some report temporary disruption that resolves, some report a shift in the kind of thinking they do rather than a decline in the quality of it. The research is inconsistent and the inconsistency reflects the genuine variation in the experience rather than the inadequacy of the research methods alone.

What is more consistent in the literature, and what the cultural script does not contain, is the account of what women report about the experience of the post-menopausal decades. The reduced anxiety around reproduction—for women who experienced it as background anxiety, which many did without necessarily naming it as such—produces something that several researchers have described as a psychological spaciousness. The attention and energy that were organised around fertility, around pregnancy risk, around the monthly cycle and its implications, become available for other things. The things they become available for are as varied as the women themselves.

The sexuality that emerges in this space is not the sexuality the script predicts. The script predicts diminishment—the declining hormones, the physical changes, the reduced interest. Some women experience this. Many women report the opposite, or something that the category of diminishment does not adequately describe.

The increased self-knowledge that comes from having lived in a body for five or six decades, the reduced performance anxiety that came with the end of the reproductive script, the greater clarity about what intimacy actually means and what it requires—these can produce a sexuality that is different from what came before without being less than it.

 

The self-knowledge point deserves more space than it typically receives in discussions of women’s later-life sexuality, because it represents something that the script’s logic of declining hormones cannot account for. Knowledge of one’s own body, of what produces genuine pleasure rather than performed pleasure, of what intimacy requires and what it does not require, accumulates over time in ways that the young body with its high hormone levels does not have access to.

The young woman navigating sexuality within a culture that has organised the performance of female sexuality primarily around male desire has less access to her own experience of it than the woman who has had decades to examine and understand what her own experience actually is.

This is not a romantic claim about ageing as wisdom. It is an observation about a specific kind of knowledge that is acquired through sustained experience and that is directly relevant to the quality of sexual and intimate life. The woman who knows what she wants, who has developed the confidence to ask for it and to decline what she does not want, who is no longer navigating the performance requirements of the reproductive script, has resources that the script’s account of post-menopausal sexuality does not include.

The cultural script has not included them because the cultural script was not written from inside women’s experience of their own sexuality. It was written from the outside, from the perspective of the culture that defined female sexuality in terms of its reproductive function and its relationship to male desire, and that therefore understood the end of the reproductive phase as the end of the sexually significant phase. The women whose experience does not match this account have not had their experience well represented in the script, because the script was not designed to receive it.

 

The age taboo operates on women’s sexuality with particular force, because it sits at the intersection of the ageism that applies to everyone and the specific cultural investment in female sexuality as youth-bound. The older woman who claims an ongoing erotic life encounters a cultural response that ranges from disbelief to discomfort to the specific condescension that the culture reserves for the older woman who does not behave in the ways that older women are supposed to behave.

The invisibility of older women’s sexuality in mainstream cultural representation is so thorough that the older woman who experiences herself as sexual may find that her experience exists outside the available language for talking about it publicly.

The consequence is the same survivorship bias that distorts the male account of later-life sexuality. The women who experience diminishment speak about it, because the diminishment matches the script and the script provides the vocabulary. The women who do not experience diminishment, or who experience transformation rather than diminishment, are less visible in the public discourse. Their experience does not match the dominant narrative and the dominant narrative does not provide good ways of talking about it. The invisibility is then taken as further evidence that the script is accurate, which reinforces the script for the next generation of women approaching menopause.

 

The medications that are frequently prescribed at menopause are worth examining briefly for what their design reveals about the framework within which menopause has been medically understood. Hormone replacement therapy addresses the hormonal changes of menopause as a deficiency—the hormones that have declined are replaced, the deficiency is corrected. This framing is not irrational. For women whose symptoms are significant and whose quality of life is genuinely impaired, hormone therapy can provide genuine relief and the framing of it as deficiency correction is defensible within the clinical logic of managing symptoms.

The framing also, however, reproduces the script’s logic of menopause as a deficiency state—a condition in which something has been lost that should be restored rather than a transition in which something has changed that requires adaptation. The medical response to the transition as deficiency does not contain an account of adaptation as an alternative to replacement. It contains correction. The assumption embedded in the correction is that the post-menopausal state is inferior to the pre-menopausal state and that the goal of medical intervention is to approximate the pre-menopausal condition as closely as possible.

This is one account of what menopause is and what the appropriate response to it looks like. It is not the only account. It is the account that the medical framework, built around Norm and Norma and the population averages that produce them, has centred. The women whose experience of the transition is not primarily deficiency—who are navigating change rather than managing loss—are less well represented within this framework. Their experience is not well served by the language of correction.

 

The women I know who are sexually and erotically active in their seventies, eighties, and beyond are not exceptional in the sense of being biologically unusual. They are exceptional in the sense that their experience is not visible in the dominant cultural account of what women’s sexuality looks like at those ages. The account does not contain them. It contains the script, which ends the story earlier than they have ended it.

The story continues for as long as the person continues to be a person. The person continues to be a person regardless of where the hormones are. The sexuality continues to be a dimension of the person’s experience regardless of what the script says it should be doing at this age.

The script was assembled from the dominant experience of a specific population.

The population was not everyone.

The everyone that it was not includes the women the script has not been able to see.

They are there.

The script is not looking.