There seems an ever-present assumption that menopause is a downward spiral that seriously reduces a woman's quality of life in the long term.
But two major new studies suggest that during the menopause women's quality of life gets better, and this improvement becomes even more dramatic after the change of life. Contrary to popular belief, this is not necessarily related to hormone replacement therapy.
Switch on the television or open a magazine and there is a seemingly endless array of fabulous fifties - think of Goldie Hawn, Helen Mirren, Joanna Lumley and Susan Sarandon: Though they may not have gone through the menopause themselves, they are all around the age at which it commonly occurs, and appear to be having a better time than ever.
Last year Sarandon won an Oscar; Mirren has picked up an Emmy for her role as the detective Jane Tennison in Prime Suspect and has been photographed naked on the front of the Radio Times; and, in the past few years, Joanna Lumley has scored her most remarkable hit with her portrayal of the coke- sniffing, permanently sozzled Patsy in Absolutely Fabulous. As Ms Fox, in the same age bracket as these stars, affirms, "Life's the best it's ever been." She does not mourn the loss of her fertility but rather sees it as a relief: "It's nice to be free of all that. I was having very heavy bleeding. Every month I would end up feeling like a wrung out old dish-rag."
Ms Fox went through her menopause in her forties after a hysterectomy. She is now, she says, a "different woman". "Since I reached my middle years, life has really taken off. I write technical articles and fiction, I'm very involved in the church and I drive a lot. I feel I'm more outgoing and a lot more relaxed in company."
According to research, she is not the only one feeling this way. The reports, unveiled at the Royal College of Psychiatrists annual conference and the British Psychological Society's women's conference this month, found significant benefits for women in post-menopausal years. The RCP study, backed by the Department of Health, surveyed almost 10,000 people and found that depression in fact decreased in women after the menopause.
The "change of life" occurs normally around the age of 50. The ovaries cease egg production and the resultant hormonal changes alter the inner lining of the womb; periods become more scanty and then stop. Among the most common symptoms are hot flushes, night sweats, insomnia, headaches and irritability.
It is well documented that women are more prone to depressive disorders than men, but this latest study from the RCP shows that a large random sample of women over the age of 55 unexpectedly displayed lower levels of depression than men. The change is thought to be because of a reduction in the female level of depression rather than an increase in its prevalence in men.
Paul Bebbington, professor of social and community psychiatry at University College London, who conducted the study, says: "We found that the ratio of depression in females to males is usually two to one but, after the age of 55 [by which time most women have gone through the menopause], this has been reversed in cases of severe depression, with more men being depressed than women."
In the past, Professor Bebbington says, there was an assumption that involutional melancholia - depression after the menopause - was a given. "But there was never any good evidence for this ... and the menopause ended up getting a bad press. In our study, after the age of 55 the suggestion is that for women life has not got worse, it has got better."
Professor Bebbington says that the findings cannot be explained away in terms of social variables - such as whether a woman is married or has children. He thinks that the improved scores for women could be directly connected with the menopause. This could be hormonal, but Professor Bebbington thinks it more likely to be changes in a woman's role at this time of life. "After the menopause you are not so involved with child care and you can get rid of a man if you don't like him," he says.
In the BPS survey, nearly 1,200 women aged between 40 and 63 were assessed to identify the psychological impact of the menopause on their lives. Researchers measured factors such as sleep patterns, mood changes, appetite, energy levels, memory, ability to concentrate and social exchanges.
The results were startling, with most women reporting feeling better at 60 than they had done at 40, according to Pam Jacobs, psychologist at Plymouth University and author of the report.
"For women, life just might begin at 60," says Ms Jacobs.
Hormone replacement therapy (HRT) has been linked to these feelings of renewal and optimism but, interestingly enough, the women who took HRT (23 per cent of the sample) found their quality of life "was no better than the people who didn't take it", according to Ms Jacobs.
The women who fared worst were those who had tried HRT but given it up. "I think HRT helps women who take it, but not having it seems to make no difference in terms of quality of life," she says. "Those women who start having problems at the beginning of the menopause should know that life does get better. There are significant improvements."
In areas such as concentration and memory, women of 63 reported improvements on those of 52. "In focus groups, women of 63 said their quality of life was better than at the age of 40," Ms Jacobs adds. "Their cognitive function was better, and their memory, and their overall quality of life.
"We did ask about empty nest syndrome - whether women get depressed when their children leave home - but there was no evidence for this whatsoever.
"As women's lives changed, they were not just concerned with the home but had responsibilities outside the home, which was very positive," she says. "Older women are taking up other opportunities. They find their children leaving home quite liberating. They often take up jobs or start studying again."
As for losing reproductive power: "Women have had to come to terms with that, but once they do, they see how good their lives are and that there is a lot more to life than being fertile."
Josephine Fox cannot agree more. "As an occupational therapy nurse, I occasionally counsel women in this situation," she says. "And I do say to them that the menopause is a liberation. They don't have the trouble of periods - it's such a relief, and you do have this sense of well-being. I think it's wonderful!"Reuse content