There are now one billion women in perimenopause, menopause, or post-menopause around the world in 2025. And that’s why we need a cultural and health revolution. A new conversation, new attitudes to menopause, and immediate action will make a difference to those billion lives – and the lives of families and colleagues that women so often support. Menopause is a massive feminist issue. So is later-life power.
So welcome to my @katemuir Substack, which will address this new world demographic, and its hunger for stories and scientific knowledge, mostly in a local and funny way. To my surprise, I’ve become an expert on the menopause, midlife and its madnesses over the last five years, making documentaries, writing a book on the menopause (more) and, out this month, writing about the effect of hormonal change on mind, body and spirit in How to Have a Magnificent Midlife Crisis (more). (Book launch pic below with Dr Bill Robertson Smith a.k.a. @drbillbones on Insta, and she’s in the Pumping Up Your Muscle and Bone chapter.)
I’ll be talking about the wider midlife picture over the coming weeks here, from whether you should join a commune, start a digital detox, take a psychedelic trip, tackle the male-female orgasm gap, or vanquish your midlife muffin top, but first I’m going to get you to put your hormonal glasses on, and remember that hormones are chemical messengers in your body and brain (think of the Pixar film Inside Out) and when the hormones estrogen and progesterone leave the building half a century through life, that has a profound effect which sometimes only comes to light as health problems surface years later.
I am a massive proponent of the new safer, cheap body-identical hormone replacement therapy or HRT, and the life-changing science coming out as we speak on its effect on longevity: preventing brittle bones and osteoporosis, oiling our joints like WD40, clearing our arteries like a Dyson, lowering rates of vascular dementia and Alzheimer’s, and keeping our brains firing on all cylinders, and well as lubricating our vulvas for comfort - and, of course, joy. (Great podcast here from Dr Louise Newson and Kaye Adams explaining the decades of misinformation on HRT, and happily bringing us up to date.)
And I’m also very aware of the inequalities of the distribution of this knowledge locally, and around the world. Access to healthspan-extending HRT is mostly restricted to rich countries, and even in the UK, with free body-identical hormones available on the NHS, their figures show 23% of white women are on HRT, 6% Asian, and 5% Black. Yet Asian women are at high risk for osteoporosis, and Black women have more hot flushes and a higher risk of Alzheimer’s. So spreading this conversation far and wide is essential for health equality too. Keeping calm and carrying on is not an option, and we can all play a part.
My friend and menopause expert Dr Radhika Vohra has written extensively and powerfully on this. Here she is when we were campaigning together with Betty Bones, our skeleton, on the #giveyourbonesabreak campaign last year.
‘South Asian women have a higher risk of cardiovascular disease, and many don’t know about the bone-building benefits of HRT,’ Radhika told me. ‘Diabetes is also higher in Black ethnic and South Asian groups. There could be huge benefits for women and improved health outcomes could save the NHS billions.’ And billions more lives round the world.
By 2030, there will be 500 million women worldwide aged between 45 and 55, the biggest growing demographic in the workplace (at least until AI absorbs us all). We know in the UK that 1 in 10 women leave the workplace due to menopause symptoms. And if there’s one thing we could do with in the world, it’s having older and wiser women in power in the boardroom and in politics. We need to be in good health to take that power. Why is a 79-year-old orange man running a massive nation, again? Where are all the women of that age? We need to wake up.
Look out for my FREE Substack every Friday and subscribe here to get it emailed to you. Also, it would be great if you can pledge support for my work and spread the word. (I’m also on @menoscandal Instagram.)
*I’m saving the full analysis of Miranda July and the perimenopausal sex surge for next week’s Substack…