An utter dearth of peri+menopause research
So beware The Certain (+ your free roundup of hopefully helpful things)
The longer I am on this earth, the more I am suspicious of The Certain.
You may have met them at the start of the pandemic, which was a fertile time for The Certain, even as the time itself was the very definition of complete and total uncertainty.
The Certain believe in things like “science” as immoveable and unchanging; as dependable and reliable, rather than an ever-evolving iteration. As if they haven’t changed somewhere in the world since the word itself was uttered.
Any woman with a wrinkle on her face, or who has opened herself to at least the start of the midlife awakening, knows this is true of almost nothing.
Even a rock changes over time. But in the peri/menopause space, specifically, The Certain slay me. Here is why:
We have slightly over 1 million studies on pregnancy since studies were recorded (you can do a search on Pubmed, the US National Institute of Health’s database of clinical research) something that happens to some – and increasingly, less and less – women. We have less than 94,000 on menopause, which happens to all of us, and less than 6,000 studies on perimenopause, which also happens to all of us. 1.1 billion of us by 2025, the most ever.
No time like the present to support independent journalism, especially with a discount!
Hat tip to Texas ob-gyn, The Galveston diet author and DMG (Doctor Menopause Guru; 2 million+ TikTok followers) Dr Mary Claire Haver, who pointed this out on social media. Here’s what she had to say about it when I had her on the Hotflash inc podcast.
“And I was like, okay, well what about the last 10 years? Of course, a hundred years ago, 50 years ago, okay, but what about just the last 10 years? Exactly the same 10 percent ratio held. Ten percent of the brain power, 10 percent of the money, 10 percent of the research funding.”
Dr Haver pointed out that the good news about all this is that we have a real conversation going about menopause now, something that has broken open in the last two years.
But that conversation is still based on this dearth of research, which might change, but very, very slowly.
“When you look at how research is done, bench research, you know,” she said, “it is a financial and political rigamarole to get anything done.”
And then, of course, there are the general problems within the paltry amount of peri/menopause research: for starters, most of it is has been done on animals, or in women who are too old, the field is tiny and the work itself is looked down on, because it’s not considered life-threatening, all points the new Nature article How menopause reshapes the brain lays out. There’s also how most of the research doesn’t differentiate between synthetic and bioidentical hormones, and has mostly been done on synthetic, and how few people seem to understand the difference between progestin and progesterone, or care.
And of course the problems with clinical research in general, all things I’ll get into in future editions.
As for certainty, one of my favorite relevant modern-day feuds is between Goop and America’s menopause doctor, Jen Gunter. On their website Goop calls Gunter, a noted Goop antagonist, “oddly confident”. Gunter has on her Twitter profile: “Appropriately confident”. Only time will tell.
I do know that some day I’d like to see a book or watch a documentary called The Certain: A history of how that all turned out.
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New book alert
“When I started going through perimenopause at age 45, sex with my husband began to hurt— a lot. It felt like I was being exfoliated from the inside. My cringing and grimacing were not exactly an aphrodisiac for Tom, either. I began to actively avoid him.”
New York Times Well columnist Jancee Dunn doesn’t pull any punches in talking about some of the genitourinary syndrome of menopause symptoms that can happen during the transition in her new book Hot and Bothered: What No One Tells You About Menopause and How to Feel Like Yourself Again. Read an excerpt on the sex stuff (a piece that is titled How I Got My Sex Life Back After Menopause, but could also be called Vaginal estrogen: A love story), in Oprah Daily.
Click, read, listen, watch + follow
• Roll your eyes if you must, but there is something powerful going on this weekend and if you at all want to understand, this is a start: MAY 2023’S SCORPIO FLOWER MOON LUNAR ECLIPSE IS A REBIRTH Nylon
• A great explainer about mast cell activation syndrome, histamines, and the perimenopause/hormone connection. You might find yourself saying “yes, yes, and yes, that’s me!” like my friend, nutritionist and Morphus founder Andrea Donsky Menopause Reimagined podcast
• What a sensitive, balanced, hopeful, helpful documentary this is: From an Australian announcer and TV personality going through it, The Truth About Menopause with Myf Warhurst. (Sign up to watch for free) ABC
• Growing Use of ADHD Label Risks ‘Medicalising Human Experience’: Experts Epoch Times
• I agree with a lot ob-gyn and The Menopause Manifesto author Dr Jen Gunter says (not the bullying, obviously). One thing that troubles me is how she is loathe to acknowledge that some things may be possible even if they aren’t evident in her reading of the scientific literature. I hope to interview her some day and ask this myself, but obviously I’m terrified: Can the Mirena IUD cause Menopause-like Symptoms in the Vagina? The Vagenda
• This is a great article, so it’s a shame that it starts out with the “menopause is only 100 years old” illusory truth. Meet the women embracing menopause—and those hoping to end it Fast Company
Editor’s note
“Any village cursed by the werewolf knows what to do on the night of the full moon: lock the doors and hide your livestock. Don’t put yourself in the way of lunacy. Similarly, eclipses aren’t the time for action, intervention or manifestation: Our calling is to step back and witness what has gone, what is being born, and what has transformed irrevocably.” Thank you Nylon, for helping me decide how to spend my Friday night.