Life

What Do Menopausal Women Want?

Entrepreneurs (and Naomi Watts!) suggest creams, cooling sprays, and conferences.

Collage of words and shapes related to menopause with Naomi Watts.
Photo illustration by Natalie Matthews-Ramo/Slate. Photo by Dimitrios Kambouris/Getty Images.

I’m going through menopause. Well, that’s not quite true. I’m in the midst of perimenopause, which leads to menopause, which, unlike perimenopause, is less a process than it is a marker.

Let me explain. Perimenopause is a period of time typically beginning in a woman’s 40s and lasting anywhere from a year to a decade. It’s when a woman’s reproductive system starts to get signals (or give signals) that it’s time to switch everything off; in other words, that she’s reaching the end of her fertile years. Perimenopause is often accompanied by moodiness and irregular periods. This can make life for some women, like me, a confusing, distracting, irritable occasional hellscape.

Menopause, on the other hand, is an end. There’s no specific “moment” when menopause happens. A woman is said to be in it when a year has passed without a menstrual period. In that sense, a 50-year-old woman who has not had a period is in menopause. So is a 70-year-old woman who’s been without a period for 15 years.

Soon I’ll be that woman, too.

A few years ago, I began to suffer from symptoms that I didn’t think much about, at first. There was irritability, and my tendency to cry at the littlest provocation. My periods happened more often; usually every 3 weeks instead of every 4. There were night sweats so horrible that I’d wake up having soaked one side of the bed so thoroughly that I’d have to scoot over to find a warm, dry patch. The sheets were easy to launder; the mattress less so. I wondered what the woman who comes to clean my apartment thought of me.

Earlier this month, journalist and writer Susan Dominus published a cover story in the New York Times Magazine about menopause and the ways that the medical establishment is failing women. It was a much-needed, deeply reported, substantial feature and was shared back and forth by a not-insignificant number of my female peers, all of us Gen Xers in our late 40s and early 50s. In addition to outlining the ways in which this phase of a woman’s life has been misunderstood and “misdiagnosed,” it touched on menopause marketing, which is to say the companies that are capitalizing on current conversations about menopause to sell products and services to an underserved audience.

There are, in fact, a lot companies getting into the menopause space. Friends my age (I’m 50) report ads for supplements and exercise regimens targeted to menopausal women dominating their Instagram feeds. There are also at least half a dozen new, VC-funded companies being founded—usually by entrepreneurial women of menopausal age—that are looking to help peri- and menopausal women navigate the confusing labyrinth of medical advice around things like hormone replacement therapy, and to connect users with medical professionals who can help.

And then there are conferences. This past weekend, I attended a $200-a-head event on the west side of Los Angeles called “The New Pause,” a sort of one-day symposium-slash-conference marketed to women who are facing, or going through, perimenopause and menopause. (I didn’t quite get the “new” part—I still don’t—but, oh well.)

Sponsored by Swell, a membership-driven “first of its kind midlife community,” and Stripes, actress Naomi Watts’ middle-aged answer to Goop, the all-day event, the second of its kind (the first was in New York last October), was held at a fancy hotel in Santa Monica and attended by a few hundred of the sorts of women you might find in the conference room of a fancy hotel in Santa Monica. In other words, a bunch of rich-looking white ladies, many of them blond, wearing neutral colors in soft fabrics like cashmere and brushed cotton. There were some leather pants, too.

Before I go any further, I want to acknowledge the elephant in the room. I am neither rich, rich-looking, nor white, nor a lady who carries a Kate Spade bag. Meaning: This is the place in the story where it would be the most natural, and easiest, for me to launch into an overly judgmental, snarky recounting of a gathering of middle-aged women with whom I have nothing in common.

Except: I think I might.

In fact, if I’m honest, I’m not necessarily that dissimilar to the women with whom I sat for six-plus hours (with breaks!) on a cloudy Saturday afternoon, listening to a series of talks and panels about everything from “female sexual medicine” (a term I’d never heard before) to “energetic joy” and raising one’s “vibration,” to proper nutrition. I, too, am a woman of a certain age who worries about skin hydration, thinning hair, emotional ups and downs, and any number of other things that I am, quite frankly, ashamed to admit I worry about at all. (Vaginal dryness isn’t one of them. Yet.)

Still, I’m also terribly suspicious of anything that is marketed to me as a woman; more so when it’s marketed as some sort of solution or respite to living as a middle-aged menopausal woman. I saw a lot of this marketing in action at the event, where, in an anteroom/space off to the side of the conference room, a dozen or so tables were piled high with products for inspection and for sale. Included among them was Nutrafol, a supplement that purports to help thicken and strengthen thinning hair. There was also some sort of protein bar that calls itself “power food for the pause.” (It’s … a protein bar. With kale in it.)

So here’s what happened inside the room: A bunch of us, myself included, sat upright on a bunch of upholstered, straight-backed chairs and listened to over a dozen women—therapists, scientists, doctors, advocates—sit and stand on a stage and talk about navigating menopause both mentally and emotionally. Some of it was a bit off-the-wall. One woman simply stood on stage, directed us to close our eyes and put our hands on our hearts, and then asked us, again and again (and again), “What makes you happy?” (Eventually I settled into her prompt and came up with a few ideas: my friends, food, animals, travel, hikes, Maine.) Another speaker, the writer Joel Stein, got up on stage to make jokes about blowjobs and his menopausal wife’s recurrent urinary tract infections. (“I knew there would be a room full of vibrant, beautiful women that I don’t have to use a condom with,” was his opening line.) This was pretty mortifying, and not at all funny.

But what else? Well, there was a lot else and not all of it was cringe-inducing. One panel, which featured an OB-GYN I know socially, discussed the controversies around hormone therapy. (At one point, the lone male on the panel mansplained something to one of the female speakers.) There were speakers who discussed heart health and happiness. And while I wasn’t on board with the fashion designer who got up on stage to talk about “joy rockets” and how to feel “juicy and amazing,” I, and, it seemed, most of the audience, was rapt during that aforementioned panel’s interrogation of a Women’s Health Initiative report from 2002 that suggested a higher incidence of reproductive cancers with use of hormone replacement therapy … and sent a generation of women throwing their pills into the wastebasket. (The report has since been debunked.)

All of this is to say that there were both highlights and lowlights in that room, and I don’t just mean expensive hair-coloring jobs. But I’d be lying if I said that the message of the symposium was about aging with grace: It was more about aging with intent … and perhaps a few vaginal suppositories containing CBD. (And yes, that is a real thing.) Which is another way of saying that, along with the marketing and advertising opportunity that The New Pause presented for its promoters, the conference did try to address some of the serious health and medical issues and risks that come with being an aging woman.

In that respect, The New Pause was successful. But I wondered, after having spent those six-plus hours in that fancy conference room, what the women in that room, myself included, really are in need of. Is it creams and gels and cooling face mists to combat hot flushes? (One of the panelists claims that the correct word to use is “flushes,” not “flashes.”) Is it community and conversation? The latter existed at The New Pause, but there are certainly better, more equitable (and affordable) ways to jump-start and sustain conversations than fancy conferences in Santa Monica. Or membership-only online groups.

I think a big part of the reason that the New York Times cover story struck such a nerve is that not only did it unapologetically lean into an issue that has been whispered about and tiptoed around for decades, it educated its readers about options to treat perimenopausal symptoms … and empowered them to advocate for themselves among medical professionals and researchers who have overlooked their issues for so long. Readers felt seen, and heard. This, in some respects, felt like a “New Pause” of its own.

And they didn’t have to pay $200 for it.