Buck up, ladies of a certain vintage! There is marvellous news. “Women told hormone replacement therapy does not lead to early death,” reads the headline in the Times. That’s women “told”, you see. I do not know why any women were worried about the increased risk of breast cancer, heart disease and stroke except that, well, we were told to be. Now scientists more or less agree that the benefits – protection against fracture for lower bone-density, against diabetes and endometrial cancer – cancel out the risks. So pump it up, if that’s your bag.
When I got to the age where I was offered HRT I was completely mystified by the conversations around it. It’s terrible! It’s wonderful! It saves your life and your skin. Suddenly, there was a world of women handing round the names of private doctors like dealers; doctors who offered bioidenticals said to be better than the bog-standard HRT on the NHS.
It wasn’t for me, though now I wonder. What bothered me at the time was the idea that ageing is an illness that must be treated; that our depleted oestrogen has to be restored in order for us to function properly as feminine. Clearly I did not suffer in the way I have seen some women suffer. The insomnia was bad but I quite liked feeling angry all the time, alongside the sense of dropping out of the part of life where one’s drive is seen as inherently about mating.
I wondered what I was becoming, for menopause is a form of transition, an everyday one. Still it’s embarrassing to talk about it all, because age is embarrassing and women’s bodies are frankly weird. We live in a culture where the highest compliments are not “Well done on that Nobel prize”, but, “You’ve lost weight”, and, “You don’t look your age”. This is an unfortunate thing for the middle-aged bon viveur.
But that women’s lives may be put at risk – or that as individuals we may assess those risks, while a medical establishment addresses us as entirely passive – is par for the course. It starts in puberty when girls go to the doctors and are told that the solution to their pain (cysts, fibroids, endometriosis) is either pregnancy or the pill. Thus begins a life on a combination of artificial hormones. Pills for ever until you hit the HRT jackpot.
Along the way, women who do not feel OK may be going to doctors for years complaining of pain before being diagnosed. The new advice on endometriosis is: “Listen to women”. Yes, really. And if you do listen to women you will hear story after story of women not getting the right treatment for years and then women beating themselves up for not giving birth the right way or not finding breast-feeding easy and feeling both that their bodies were all wrong but that nobody was listening to them.
I used to think one of the successes of feminism was in encouraging women to make active choices around contraception and childbirth. My mother, after all, was sterilised against her will while under general anaesthetic, the permission given by her then-husband. He was very much “then” after that, I can tell you.
By the time I had my first child, more than 30 years ago, I still had to fight not to have labour induced, but I had a sense that my generation would demand that the rights of individual women be taken into consideration.
This was because the body was firmly at the centre of feminist debate and many women benefitted from that debate whether they considered themselves feminist or not. The proverbial birthplan did not come about by accident.
But what has gone on in the meantime? Sure, progress has been made, but I do not know a woman who hasn’t been patronised by a doctor or been made to feel that she should not complain.
At the same time I was being offered HRT or antidepressants, I was in A&E with one of my daughters, then 19 and in terrible pain. My entire reproductive life flashed before me as she was having an internal scan and the consultant said: “Mummy, come behind the curtain and see your daughter’s lovely eggs. Don’t worry, you will be a grandma after all.” Yes, my daughter gave me permission to tell you this story as we were both mortified by it. Her value was that she could reproduce; mine was that I had done so.
This is still the way much of the medical establishment addresses us; the reality of having a female body with its periods and malfunctions and fluctuating hormones, its hair and its blood and its pain.
From young women brushed off in doctors’ surgeries to women in their 50s being “told” whether we can have HRT or not, it never stops. Listen to women: such a simple thing to do. I can’t wait for it to start.