Research suggests that currently, menopausal women may experience worse symptoms than older generations. But are symptoms really changing, or are women becoming more vocal about them?
Menopause is among the most significant events in a woman's life, bringing permanent physiological changes and hugely impacting the quality of life: more than 75% of women experience symptoms like hot flashes and night sweats, reduced sex drive, and poor cognition.
Despite menopause affecting about 50% of the population, there is still a lack of public awareness about something that is a natural part of the aging process. As scientists point out in the commentary for Lancet, many women are either suffering in silence or being over-medicalized.
Unsurprisingly, menopause is widely discussed in anonymous online spaces like Reddit. This is where users have recently raised a question of whether menopause symptoms were milder in the generations of their mothers and grandmothers. Some wondered if environmental factors like processed foods or microplastics are to blame.
Others suggested that women used to keep their struggles with menopause for themselves.
I'm sure my mom suffered silently. She was one of those people who lived by the 'if you don't have anything nice to say, you don't say anything at all.' There were years when she just seemed like a zombie and didn't take any joy in the things she used to.
A Redditor
What does science say about menopause?
There is some data suggesting that women in today's world may indeed have more severe menopause symptoms than their mothers or grandmothers.
A study from Sweden compared the frequency of self-reported hot flashes in 50-year-old women born in 1918 and 1930 to women of younger generations born in 1954 and 1966.
Among younger generations, 35% of women reported experiencing daily hot flashes, compared to 24% of women from prior generations. The difference remained even after accounting for factors associated with more severe menopause symptoms, such as smoking, stress, and high body mass index (BMI).
Nanette Santoro, M.D., a professor of obstetrics and gynecology at the University of Colorado, says it's difficult to tell if menopause symptoms are getting more severe because most of them are measured using surveys.
It would be like trying to determine if labor pains are worse in 2024 than they were in 1950. Different women in different environments would be reporting something that they have only experienced.
Santoro
Although more recent studies include better definitions for symptoms like hot flashes, validated scales have only been widely used over the past 20-30 years, Santoro explains.
Women no longer want to suffer in silence
Jewel M. Kling, M.D., MPH, a professor of medicine at Mayo Clinic, says increasing awareness and reduced stigma surrounding menopause could help explain reports of increasing symptoms, especially when they are self-reported rather than physiologically monitored.
However, the stigma seems to be alive and well: a 2023 survey of American women found that 37.4% felt shame over their menopause-related symptoms, and 82.7% reported feeling stigma associated with symptoms. Younger women who were entering perimenopause with higher education levels were more likely to experience these negative feelings.
Nevertheless, Santoro says there is also a sense of entitlement among currently menopausal women that they do not feel that they should suffer through this.
Experts don't rule out generational changes
Although it is nearly impossible to know if menopause symptoms are becoming more severe with younger generations, doctors tell Healthnews that significant population changes that occurred over the past generations may play a role in how women experience menopause.
"The obesity epidemic is one intriguing possibility of a change in the overall population that could be driving hot flashes. There is some evidence that hot flashes are worse in perimenopausal women with obesity, and then, after menopause, they are less severe," Santoro tells Healthnews.
About 40% of Americans currently have obesity, compared to 15% in 1976–1980. The obesity epidemic had a significant impact on health, driving the rates of diabetes, cardiovascular disease, and cancer.
However, Kling says multiple factors may impact the likelihood and severity of symptoms like hot flashes, night sweats, and heart palpitations during menopause. They include race and ethnicity and history of abuse, including adverse childhood experiences.
The authors of the Swedish study also called for further research that takes into account factors like the impact of endocrine-disrupting chemicals and diet.
Kling adds, "Hopefully, women are also more aware of the many options available to them to treat their quality of life-impacting symptoms, including hormone therapy if they are less than age 60 or within 10 years from their last menstrual period."
4 resources
- National Library of Medicine. Perception of higher frequency of daily hot flashes in 50-year-old women today: a study of trends over time during 48 years in the Population Study of Women in Gothenburg, Sweden.
- The Lancet. Attitudes towards menopause: time for change.
- Journal of Women’s Health. Identifying variables associated with menopause-related shame and stigma: results from a National Survey Study.
- National Library of Medicine. The origins of the obesity epidemic in the USA–lessons for today.
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