#11: Sex, Meaning and the Menopause

Simply Hormones Podcast

As seen in the Daily Mail, here is the interview: It was a privilege to interview Sue Brayne on her book: Sex, Meaning and the Menopause. Written for men and women, this book describes the pain and anguish, the broken relationships through misunderstanding menopause. A highly recommended read, now listen to the interview.

Interview with Sue Brayne, author of Sex, Meaning and the Menopause

KC: Hello everybody it's Kathryn Colas here from Simply Hormones.com, and I'm here today to talk to Sue Brayne. Sue has written a super book that's just come out called Sex Meaning and the Menopause. I'm going to just say a bit about that before we start talking to Sue.

I've had a preview, and I like it very much. The book tackles taboos around sexual changes, looks at the grief of saying goodbye to youth and fertility, explores deeper spiritual significance of the ageing process, provides a different perspective on medical treatments and alternative approaches, and hears from men about what it's like to live with a menopausal woman. I know my husband would like some input on that one. Anyway, hello Sue, nice to talk to you at last.

SB: Hi Kathryn.

KC: If we can just plunge straight into your book, I'd like to ask you what thoughts ultimately led you to wanting to write this book?

SB: I got really fed up trying to find information that worked for me personally, and being told that I ought to have my menopause fixed through hormone treatment. I felt angry about that. I was certainly having some changes, but I was lucky with my menopause – I only had a few tepid glows, as I call them, and some headaches – but I noticed huge sexual changes. That was the big thing. I didn't understand what was going on, but all the information I read about it was that I should get it fixed. If I didn't, there was something wrong with me. I found that really distressing.

KC: Yes, and it's that dreaded ‘M' word, nobody wants to mention it do they? So is it a dysfunction in need of treatment? What's your view on this?

SB: Well, I don't necessarily think it is [dreaded]. Some women have a lot of symptoms that I didn't, which are very distressing. When it is extremely distressing, we do have modern medicine that can help. Certainly to contain it, or to re-balance what's going on. Everybody has every right to that treatment if it is available.

But I think there's an awful lot of women like me who aren't necessarily distressed about what is happening to them, except there is a confusion about the sexual changes which are happening. Certainly my libido took a major plummet. [At the time] I didn't understand this. [Most information] talks about the body beginning to malfunction. I thought, ‘No, it's not. I'm 52. I'm just normally going through what my body should be going through at this age.'

KC: I read recently research on how it's now being accepted that menopause is a major health event in a woman's life. There's so much information out there if you want to become pregnant, if you are pregnant, and if you're a new parent, but there is still so little on the menopause itself.

SB: My big issue is that the menopause is much more than a medical event. It's much much more complex than that. [It's also] a profound spiritual deepening. You're called to the deepest part of yourself. You have to say goodbye to the woman that you were. You have to say goodbye to your fertility. You have to say goodbye to the fact that men don't fancy you particularly any more – or certainly find you attractive in a different way – and you have to face the fact that you are now ageing. For me, it was a confusing time. I couldn't find anything out there to help me. That's why I ended up writing the book. So, the book is not about medical symptoms. It's about deeper, complex issues that we face as individuals, and collectively, as we go through the menopause.

KC: Yes, that's right, because it is an emotional rollercoaster. You do feel as if you're all over the place, and you can't cope. This can be quite scary. It was certainly scary for me. In many instances – I hear from so many women, and it's in your book too – that they think they've got Alzheimer's.

SB: Well, I think a lot of women get very confused and concerned about the fact that they start forgetting everything, or they find themselves saying “What am I up here for.” I think [what happens] isn't explained properly.

Basically, it's to do with the drop in oestrogen levels. As soon as your ovaries start turning off, or the menopause happens in other ways, that plummet [in hormone levels] affects every single part of you. Of course, it affects your brain [too]. These things aren't spoken about, but I don't want to stay with the medicalisation of the menopause.

For me, it's such a profound experience. But, most information says that once you stopped having periods for 12 months you're through the menopause. That's rubbish! The menopause is huge life change. It takes years, sometimes up to 10 years, to really feel your way through to the other side of post-menopause.

KC: That's right. I think it's not until you are post-menopausal (unless you've had a better understanding earlier on in your life) that you understand it so much better. You start to have more energy again. You want to take things in a different direction, do different things, and, in effect, have a new life.

SB: [Speaking] as a post-menopausal woman, I actually think there is a gift to be found in the death of fertility. The death of being a young woman is a very painful experience to go through, for me anyway. But now I'm out the other side, I feel much more peaceful with who I am. I can see – I witness this through the lives of younger women who I work with in my psychotherapy practice, when they talk about their midlife crises at 40, 45, maybe, even 50 – I can actually see the archetypal journey that we're all on. I understand that being in a post-menopausal state means I've been freed up. It's such a cliché to talk about ‘the wise woman', but I do feel I have a much more objective viewpoint, and a much clearer view about how life plays itself out. I'm deeply grateful for that.

KC: Do you feel that if you'd had some of this information at the beginning of the journey it might have been an easier one?

SB: I asked quite a lot of people about that. Some interviewees said, ‘I don't think you can ever prepare for it.' In a sense, I agree because menopause is such a personal journey. You can't really compare yours with anybody else's. It's like dealing with a death. It's such a personal thing, yet, at the same time, it's also collective.

I think I would have liked to have been told that the sexual changes I went through were normal. They were not abnormal. It's what happens to a woman as she gets to a certain age.

Some women carry on being just a sexual as they were. Fantastic. But a lot of women, in fact, one in two women, experience something called vaginal atrophy, where it's very painful to have sex. I wish had I understood that more. I wish I had understood what it was going to mean to me, what it was going to mean to my husband and my relationship, and how much pressure it put on my relationship. My husband certainly wasn't prepared for it.

We went through quite an interesting experience. That was one of the reasons I wrote the book. I wanted to say, ‘Look, these changes that happen are normal, except we're sold [the notion] that they are a dysfunction. That's not true.' [Unfortunately] I think that's very much down to what happens, the fact that our sexuality is so medicalised now. You go on the pill when you're a girl. You go on HRT as an older woman. Hang on a second, who are we in between?

KC: And if you don't look good at the same time, then there's something else to throw at you.

SB: I've chosen to go grey, because I wanted to make a statement. ‘Actually, yes, I am an older woman, who in 18 months time is going to be 60.' That doesn't mean to say I don't feel alive. In fact, I feel more alive than I did as a younger woman. But, personally, and I can only talk for myself, I don't want to deny the fact that I'm getting older, I actually want to celebrate it. There's no reason why I can't look good with grey hair. But I think it's about what works for you inside. However, I don't want to chase youth, because youth is not part of who I am any more, although I do feel incredibly young inside!

KC: Yes, it's not the book. It's what inside the book that's better. I think also talking about the confusion that goes on. I don't think women understand that hormones are messengers. The brain is sending messages all round the body to do x, y and z, and because the hormones aren't the ‘right quantity or quality' any more, then strange things happen. I liken it to being re-wired. Having a new IT system installed, if you like. Some of the wires aren't joining up properly, which is why you get sparks going off in different directions. Things aren't working too well.

SB: I think the word ‘atrophy' is quite relevant here. Things do start to dry up after the menopause. You're just not a juicy fertile woman any more, and I think [the message] we're sold – the image in the media that we're sold – is that we should be this juicy young woman age 60. Well, sorry, the reality of evolution means that at a certain point in our lives, this is what happens. The trouble is that, in a way, we've gone beyond evolution. Now, of course, we're living maybe 30 years after our menopause.

KC: And working longer.

SB: But, the whole sexually-obsessed culture that we live in saying, ‘Oh God, you shouldn't look that old. You should look like a 20 year-old.' Look what happened to Joan Collins, the classic example, trying to get into a dress (for an Oscar party this year) fit for a 22 year-old, and she ends up in hospital having fainted. Come on!

The problem is the baby boomers are growing up with media that is completely youth-obsessed. This is the first generation this has ever happened to. So, we're straddling these two worlds of growing older, but still being thumped every day with the message, 'You shouldn't look that old.'

KC: Yes, do something about it. You're supposed to have plastic surgery, and all the other stuff.

SB: Get the Botox out!

KC: Going back to your book Sue, was there any one interview that particularly struck you?

SB: Yes. It was, without question, talking to the men. I found this a most enlightening, encouraging, heart-warming experience. I interviewed [most of] them on Skype, or on the phone. I suppose because I was this kind of disembodied voice, they opened up. Virtually none of them had spoken about this before. They were so confused about their wives. [Some] were [also] feeling rejected because their wife suddenly didn't want sex. They took it personally, and were struggling to make sense of it. But they didn't want to leave, they loved their wives.

KC: And wanted to support them, but the woman is saying ‘go away, and leave me alone.'

SB: Absolutely. That's why I wrote the book for men as well. They can read about other men's experiences, and not feel so utterly alone with it. [Some] told me that they'd been going on the internet and all they can find out [about the menopause] is, ‘You need to go on HRT.' So they would say to their wives, ‘You need to go on HRT.' But the wife says, ‘I don't want to.' And, then there's a huge row.

I interviewed two sex therapists about the psychological aspect of what happens when sexual changes occur in a relationship later in life, and how hard it is. The men [interviewees] were graphic when they talked about how they cope when they don't have sex with their wives.

KC: I get a lot of men emailing me too, and talking to me on the phone, in great distress in some cases. But, what I have noticed over a period of time is that the men seem to notice these physiological changes before their wives do. Or, perhaps, women don't want to recognise it, and don't want to acknowledge it. But the men do see those changes, and they want to do something about it. But don't know how.

SB: Yes, I think that's absolutely right. But, I think that a woman goes through such a deep, profound change in who she is. A man, yes, he does have a midlife crisis, that's scientifically proven now, but [he] doesn't have this almighty fall in hormones that a woman does when she goes through the menopause. First, she has to go through the 40's midlife crisis, which is more about ‘who am I', and then, ‘Wham!' She goes straight into the menopause, without much of a breath in between.

So, the [inner] changes that she experiences, [which prompt her to ask] ‘Who am I?' ‘What am I here for?' How can I find my place in the world without the role of mother and wife?' I think are much more profound than a man's experience. Normally, but I don't want to categorise all men as this, when they [men] are unhappy, they will often leave to go to another woman. A woman tends to leave to be on her own to find out who she is. That's a very different experience.

It can be a very frightening for men who've been married for ever, when their wives, who've been looking after the cleaning and washing, and so on, suddenly say, ‘Hang on a second, I don't want to do this any more.' Husbands end up asking, ‘Where's my wife gone?'

KC: Yes, ‘I just want my wife back', is very common.

SB: Well, a wife isn't going to come back as she was. She's going to be a different person. Unless, of course, she chooses the role of carer, and steps into being the grandmother. But, again, we're not talking sexual here. We're not talking about sexual identity.

KC: I think none of that is really covered in magazines or newspapers. They may make a few ripples, but they don't really get into the depths of it.

SB: The other thing I found really interesting was interviewing women who had chosen to take HRT. There are plenty of women that don't need this [HRT] by the way. They don't experience these sexual changes. But a lot of woman do. [HRT] enables older women to continue to be sexually active. There's a huge issue now, of older men and women getting sexually transmitted diseases because there's no sex education for older couples who are changing partners. They think nothing happens to them. HIV is one of the biggest dangers of sexually transmitted diseases in older couples. So there's a major health warning about that in the book. Take responsibility, and put a condom in your pocket!

KC: Yes, just when you think you don't need that [sexual protection] any more you've got to be vigilant once again, haven't you? It comes up time and time again.

SB: I think there's a huge lack of general information and understanding about sex for an older person.

KC: Yes, because it has never been spoken about. I keep hearing time and time again that to enjoy an intimate relationship it isn't necessary to have penetration.

SB: Absolutely, I hate to say it, but we are now riding on the back of the porn industry. That comes from what's happened on the internet. It is driven by the porn industry, I can't remember, but something like 500 million pages on the internet are to do with pornography.

And, pornography is about penetration.

For a guy who looks at pornography on the internet, he's going to see that it is all about penetration. [It's difficult for] a man to understand there's other ways to be intimate. There's a big, big problem here. A lot of older women don't want to be penetrated any more. It doesn't mean to say they don't love their husband, they can actually have a different kind of intimacy. But for a man, there's an almost evolutionary need to have penetration to feel fulfilled [sexually]. It's a big issue, and it doesn't match necessarily with a woman who's growing older on a sexual level.

KC: That's right. And, of course, men are being prescribed Viagra, but the poor woman on the other side has vaginal atrophy. So, all hell breaks loose. But I don't think it's necessarily the internet either, I think it's just men's upbringing, and how men talk to each other. That it's all about penetrative sex.

SB: About having a good bang. Are you getting it?!

KC: It's all about that, isn't it? Yes.

SB: [Message is:] ‘No? Oh, well, then you couldn't have had sex.' A lot of the men are ashamed about the fact that they aren't having sex. They feel embarrassed, and find it very difficult to admit. Or, if they do, they kind of say, ‘Oh God, I didn't get it again this weekend.' There was nothing about intimate connection. It is all about the physical penetration that goes on. I can understand, having talked to these guys [interviewees], how frustrating it must be. The trouble is so many woman are having, it seems to me, penetrative sex just to keep their husbands quiet, to shut them up. That's no way to have a relationship.

KC: No, it isn't.

SB: [Sex] isn't spoken about. It's made fun of. It's highly distressing for a woman to feel that she has to have sex just to keep [her husband] quiet. And, it's highly distressing for a guy to feel he's having sex with his wife, and he knows she doesn't want it any more.

KC: Yes, they must know that.

SB: I've got a lot of interviews in the book with women talking about this. The solution is that you have to communicate, and find a way which works for you both.

KC: It's very embarrassing – just like vaginal atrophy is very embarrassing to talk about. Sexual problems are difficult to discuss, aren't they? And so they avoid them like the plague, and just carry on pretending there's nothing's wrong.

SB: Research that has been done into this say that women who are in happy relationships and want to continue sexual intimacy, find it much more stressful and upsetting to have these sexual problems as they go through the menopause, than women who think, ‘I don't really care, levitra' or, ‘Thank God I don't have to do that any more'.

So there's quite an interesting psychological difference. The trouble is that a lot of academic research doesn't come out into the public domain. Academics normally just end up talking to other academics.

KC: That's right. Yes. There's always a conclusion at the end, and what should be achieved from here on in. But that's rarely taken up by anybody, is it?

SB: [And usually] impenetrable to read, excuse the pun. The layman in the street doesn't want to trawl through academic journals. They just want to know what's going on in plain English. That's what I hope I have achieved [in the book].

KC: Yes, I think you have. I think it's a lovely book to read. I think we've just about covered everything, although I think we could talk ad-infinitum about this subject of menopause and sexuality.

SB: I just wanted to add – and I know you're very involved yourself, with women in the work industry – just how many women, struggling with the menopause, are in positions of authority, or in management. They really do need a huge amount of support. I spoke to several [business] women facing these issues, and then I spoke to a whole bunch of women in their fifties, academics or working for themselves, who said they felt as if they were just beginning to hit their stride. So again, it's quite a complex area. You can't just say this is what the menopause does for everybody. It's a very individual journey that we're all on.

KC: Generally speaking 50% of menopausal women do not declare the real reason why they're taking time off work. This is usually it's to do with line managers. The average age of a line manager is 43, and they are either disinterested or embarrassed. Again, if they [menopausal woman] are a senior executive, they've got nobody else to confide in.

SB: One interviewee for the book told me how she now found herself working in a very youth orientated business. She realised that she couldn't work in that industry any more because clients ‘don't want to be buying from their mothers.'

KC: Oh dear, how awful, yes!

SB: That's a really hard thing to come to terms with. It wouldn't happen for men. That's why the menopause is such a different experience for women than it is for men at the same age. They don't age the same way that we do.

KC: That's why I think there needs to be a whole programme for men and a whole programme for women.

SB: Education.

KC: They'll start talking, hopefully.

SB: Well, at least everybody can understand more. I think if you understand more, then you're actually more allowing.

KC: If you are a little better informed, you have a better understanding of where you can go from here can't you, and make better decisions. So let me just remind everybody the name of your book Sue. It's called Sex, meaning and the Menopause.

SB: Yes, it's due to be published on June 9^th, by Continuum Books, and it's out already on Amazon: www.amazon.co.uk. More information is on my website www.suebrayne.co.uk, where I also blog about issues to do with end of life, menopause and ageing.

KC: That's excellent. Of course, this book is for men and women. I found it very good. Thank you so much for that Sue. I'm sure we'll talk again soon because you've got another book that I'm very interested in called the D-Word, which is about dying.

SB: Different ways to talk about dying, yes.

KC: I've just bought that myself. We'll get back together on that one. Thank you once again Sue, lovely to talk to you.

SB: And you, Kathryn.

Will Your Marriage Survive the Menopause, was adapted from Sex, Meaning and the Menopause, and published by the Daily Mail on 2^nd June, 2011.

For more information on menopause do take a look at my website: http://www.simplyhormones.com and you can see more about what Sue Brayne is up to at http://www.suebrayne.co.uk

Until the next time…

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