Loss and gain

• Menopause means the end of the possibility of childbearing. This can feel like a loss, and some women will want to grieve for their physical fertility. However, since many women in their 40s and early 50s have already decided that they do not want to have babies at this stage in their lives, it can also feel like a liberation.

• Menopause also means the end of menstruation; for some women this can seem like pure gain, with the end of the management of heavy bleeding, cramps, or other menstrual distress. Others miss the familiarity of their monthly cycle, and have to get to know their body again as it responds to changing hormone levels. Menopausal women need to learn to deal with hot flushes, as they had to learn to deal with unpredictable bleeding as teenagers.

It is less obvious what we gain at menopause. Whatever we thought as teenagers, in Western society no-one is old at 35, at 45 or even 55! Even if we like and value old women, to them we are still quite young – we are not ready to join them at menopause, and it could well be a long time before we are. So what are women while they are waiting to become old?

• Menopause can help us to cultivate wisdom, and to learn how to make the best use of our energy, for our own benefit as well as for others. Sara Maitland suggested that a useful model was the fairy godmother. In pantomimes she can be shown as a rather clueless lady in unsuitable pink frills, but in fairy stories she has the power to rescue and transform others – and uses it only when she thinks there is an emergency. The rest of the time, she does whatever fairy godmothers do when they are off duty.

• Women at menopause may be far too busy, or not busy enough. Some are drowning in commitments and desperate for some time to themselves. They need to find ways to make this time and hang on to it. See Time for Yourself. Others find that their lives are emptying under pressure of other people’s choices, or their own waning enthusiasm for what used to feel important. They need to seek more rewarding roles. Neither task is easy.

• Many women find the change of life an opportunity to start new things. Interests which have been submerged under the pressures of family or work emerge into the light of day. Women may find new roles, in the community, in new paid work, or in the family, finding different ways to hand on what they have learnt. Physical fertility can be replaced by different kinds of creativity – gardening, arts and crafts, working to help people change themselves or their neighbourhood, developing a small business. Becoming a granny, rewarding though it can be, is not the only role for menopausal women – indeed, some would like to delay it. Taking stock of past and present skills and interests may help both the over-burdened and the under-appreciated to find a new focus for their lives.