Midlife women in the UK are very riled up right now, after the government decided not to make menopause “a protected characteristic”.
For analysis, I’m going to turn this over to the extremely reasonable and very credible Rachel Lankester, founder of Magnificent Midlife, who breaks it down better than I ever could.
There have been a lot of indignant women in the UK this week. The government rejected suggestions from the Women and Equalities Committee, including to introduce 'menopause leave' and make menopause a protected characteristic under the Equality Act.
A lot of women feel very let down and I get that.
The wording used for rejecting menopause as a protected characteristic was unfortunate. The government said such a move could have "unintended consequences which may inadvertently create new forms of discrimination, for example, discrimination risks towards men suffering from long term medical conditions or eroding existing protections."
So of course the headlines were all about the protected characteristic proposal being rejected because it could hurt men. Not good. In fact, we can still fight menopause discrimination under three other protected characteristics - age, sex and disability. So there are ways around any such discrimination. We can fight it! All is not lost.
While I don't like this government, I looked at their report and it's very comprehensive. There were actually 12 recommendations and the government rejected 5. That means they accepted 7 wholly or in part. That doesn't get covered in the media though.
The cost of HRT is set to plummet and doctors are getting better informed, even if ongoing training is not being made compulsory. It is already a part of the UK medical curriculum - perhaps it is the older doctors who are less well informed? There are already lots of initiatives to raise awareness including making menopause part of the curriculum at school and encouraging employers to be more supportive.
There's going to be a Menopause Employment Champion appointed and the NHS England National Menopause Care Improvement Programme, launched in 2021, is working to improve clinical care for menopause in England (shame that's devolved). The campaigners have done great work to get things to change. Women are speaking up and being heard more.
The government wording I quoted above, highlights for me that menopause is viewed as a medical condition, when it is in fact a natural transition in a woman’s life, puberty in reverse. Medical conditions need medication, hence why all we hear about with menopause is HRT, when in reality it is lifestyle factors that often influence how bad natural (non surgical or illness related) menopause can be.
I just hope with all this awareness-raising and championing, that the focus isn't solely on HRT, but on how we can use menopause symptoms as the impetus to sort out our lifestyle, to give us great midlife health and set us up well for the long term.
I personally can't see how menopause leave could work. Menopause isn't like pregnancy with a fixed time limit. It can go on for years. If a woman is still having hot flushes in her 60s, having had them in her 40s, would she still be entitled to meno leave? It would be very difficult to manage. I also don't want another easy reason for organisations not to want to employ older women.
But we could definitely benefit from more workplace understanding and flexible working! And that recommendation was accepted too — to make flexible working an option from day 1 of employment.
If you're interested in the detail of this, I really recommend reading the actual government report rather than relying on the sensationalist media.
Rachel is a real good person to follow on this and anything else midlife. I highly recommend her book. She is also organizing a very important initiative in the UK and beyond to counter some of the narratives we are seeing, and I will be a part of it. Stay tuned – I’ll have more to announce soon!
It’s not all about the HRT: Dementia edition
Why are people breathlessly waiting for research to confirm HRT will help lower dementia risks when we know physical activity, a Mediterranean diet, challenging your brain regularly and a few other simple hallmarks of a “healthy lifestyle” will definitely reduce risks massively, right now? As I wrote to my paid subscribers earlier this week, there are so many other contributing factors to dementia that I don’t think anyone can rely on estrogen to save them – even though estrogen might very likely help.
Two new studies to that end that got little in the way of media coverage in recent weeks:
• Nine additional minutes a day of moderate physical activity improves cognition, according to a new research published in the Journal of Epidemiology and Community Health.
The study involved 4,481 people born in 1970 who participated in the British Cohort Study. We often make this all very complicated, but as researcher John J Mitchell told Medscape Medical News, “even minor differences in daily behavior appeared meaningful for cognition”.
• A 10-year study looking into cognitive decline found that a healthy lifestyle – defined as whole-food-based diet, regular physical activity, active social contact and cognitive activity and zero smoking or alcohol – and found that it was associated with slower memory decline. Those findings extended to participants who had the gene with the strongest risk factor for Alzheimer’s, APOE4.
And then, back to HRT:
• A small study published this week in Nature revealed menopausal women who took menopause hormone therapy had more gray matter in the same age range, and those scans are something.
OMG oat milk is not good for you!
I cracked up this week when I saw British biohacker Tim Gray start a video with “OH MY GOD oat milk is not good for you!” I get his frustration; why do people think oat milk is good for them? (I guess because the companies that make it, trainers, influencers and even doctors tell us it is. And when you google “is oat milk good for you?” the odd-sounding, over-the-top endorsement you get, from the Vegan Food and Living website, is this: “Oat milk is certainly a healthy option and it's good for you. It's an easy-to-digest, low-fat, low-sugar drink that supplies healthy fibre and contains nothing that could be bad for you. There's literally no downside to oat milk!”)
The truth is, and I don’t want to be that person but I guess I am, there are literally multiple downsides to oat milk: just flip most boxes over and see for yourself that they contain additives including inflammatory canola or rapeseed oils, sugar and preservatives; they may have also been contaminated with the herbicide Glyphosate, which has been shown to alter the gut microbiome and urine. Many of us cannot really digest oats properly. Then there is the questionable impact of the stabilizers and emulsifiers needed to make oat milk creamy and palatable – and stay that way.
Naturopath Lara Briden just shared a study on Twitter investigating the “troubling possibility” that emulsifiers could be driving the current epidemic rates of metabolic dysfunction. (Not all of them, as the review of literature published in the August 2022 issue of Foods concludes. But some.) Meanwhile when I recently interviewed Ali Hashemi, a doctor and founder of Dubai-based GluCare and Zone.Health, he told me he and his wife both found out they were pre-diabetic after the pandemic. He was 45 pounds overweight. His slim-and-fit wife? One of the big culprits upon investigation via continuous glucose monitoring was her daily breakfast: oat milk and All Bran.
Gerianne DiPiano is chairman and CEO of FemmePharma, which produces a range of solutions for women going through menopause including vaginal moisturizers aimed at minimizing the mess women have to deal with. (One of my favorite quotes from this episode is “we're talking about like four or five mls of material”) Geri has had a three-decade career in women's health, working at the top levels of the pharmaceutical industry as well as founding her own companies. The insight she has from those experiences is unparalleled. We talk about everything from clinical trials to saying no to hormones to letting your hair go gray; it’s a really good discussion from a very reasonable person with skin in every game. (I am trying to figure out how to get new podcasts here on Substack without sending them out to everyone in a separate email by the way, and… I’m still working on it)
Click, watch, listen, follow, read...
• Police exhibits officer who blamed the menopause after she stole £15,000 of seized cash from evidence store to fund her online shopping addiction is jailed for two years Daily Mail
• Forget the hot flashes, here's the upside of menopause - Women say it's a superpower of ageing News24.com
• I love that younger women are learning about perimenopause so they won’t be surprised, but I’m starting to get worried about self-fulfilling prophecies… What Every 35-Year-Old Should Know About Perimenopause: Feeling off lately? You might be entering puberty 2.0. Oprah Daily
• I’m going to take a closer look at this review, hopefully next week, and I hope to have Makeba Williams on the podcast : New menopause research centers on Black women KSDK.com
• British Vogue editor Alexandra Shulman won’t be predictably outraged by the British government’s menopause move: Playing the menopause card won’t work Mail on Sunday
Editor’s note
This newsletter was the target of some sort of bot campaign I don’t understand this week and it was just about the most stressful thing I’ve dealt with on this platform so far. (I was unprepared for the solo level of despair that hits whenever an IT problem without an IT team appears; it turns me into a four-year-old). Literally every five minutes for days someone was signing up. It just kept going like that, on and on and on and on, some sort of silent, robotic horror show with no way to fix it and no response from Substack. It finally stopped yesterday, and I have no way of knowing who is real and who is someone who had their email address compromised and is wondering why they are getting this issue of Hotflash inc, probably along with 60,000 other emails. I can’t help but think I got the lucky end of this stick, so I’m counting my blessings.
All that to say, if you don’t want Hotflash inc now and you never did, that’s okay. You can unsubscribe. And if you like it and want another one, that’s even better. AMx