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April 26, 2021 23 mins

If you think you’re too young to learn about menopause, you’re wrong. Prepare to be both surprised and entertained — and maybe even become a kinder son or daughter.

 

Our understanding of menopause has changed dramatically, and it’s our distant relatives the whales that may help explain what it’s for. And Dessa has a heart-to-heart with her dad about her grandmother, exploring the parts of our lives we should share more, generation to generation. 


Deeply Human is a BBC World Service and American Public Media coproduction with iHeartMedia.

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Episode Transcript

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Speaker 1 (00:03):
You have great taste in podcasts. This is deeply human
and I am your host, Tessa. Our topic of the
day is menopause. And before you run off thinking I'm
too young for this one or I'm too dude for this,
I can almost guarantee that you will be both surprised
and entertained, maybe even rendered a kinder son or daughter.

(00:30):
Menopause is actually a really rare condition in the animal world.
The only mammals will go through it are us and
some species of whales. Okay, sidebar for a quick story.
Many years ago, when I was twenty three, my doctor
found a tumor in my right ovary, and in a
blur of a few weeks, a surgery was scheduled. The
ovary was taken out, and I moved into my dad's

(00:50):
basement to recuperate. My doctor said I'd still be fertile.
My left ovary would essentially pull double shifts for the
next couple of decades, ovulating every month and releasing enough
hormones to keep my system balanced. But there was a
slight lag in my hormone production before my left ovary
realized it was the only one left at the party,
and I got a sneak peak of pre menopause. I

(01:13):
remember lying awake one night with never before experienced sort
of insomnia, not the familiar toss in turn routine, but
a razor sharp alertness, and this feverish heat. The nighttime
sounds gave way to the first morning traffic, then the
footfalls of my family walking on the floor above me,
and I registered all of it in this unrelenting, high

(01:35):
definition consciousness, and eventually I decided, I guess it's time
to get up and put some clothes on. And when
I rose, I saw the outline of my body on
the bedsheets. My sweat had traced the edges of me
in salt like police chalk on cotton. Most mammals remained
fertile all the way to the end of their lives,

(01:56):
and intuitively, that would seem like a strategic advantage the
whole get your genes out there board game of evolution.
So why is menopause only a thing for whales and women,
and on the human side of that equation, why do
we have such trouble talking to one another about the experience. Okay, first,
let's review basics paging. Dr Rosalind Jackson, an obstetrician, gynecologist

(02:19):
in Ohio. The average age for women going through menopause
is fifty one plus or minus three years, but ten
years prior to that is called the perimenal pausal time
of a woman's life, and during that time hormones start
to decrease. But it's when you become truly menopausal. It's
not to say that you've totally stopped making hormones at all,

(02:41):
but it's a very very small amount that you're producing,
quick and painless biochem refresher. The major sex hormones are estrogen, progesterone,
and testosterone, and all three hormones are found in both
men and women, but in different concentrations. Yes, ladies have
distosterone and guys have estrogen. During menopause, levels of these
hormones drop, and that change in body chemistry can affect

(03:04):
women in all sorts of ways. For some menopause isn't
really that big a deal. For others meaningfully alters what
it feels like to be alive in their own bodies,
with effects on mood and memory, they're thinking, and even
their sense of self. A lot of times they don't
associate some of the symptoms that they're having with menopause,
or that the fact that their hormones are decreasing, such

(03:26):
as um fatigue or insomnia. That's a really big one.
But commonly a lot of people do not associate the
inability to sleep with the fact that they're losing their
hormones or their hormones are decreasing. So there's fatigue, there's
I can't sleep, I can't lose weight. That's a big one.
Hot flashes, a nice sweat seems common, but it's not

(03:48):
the main thing that women come to see me for
regarding their hormones. Also, a decrease in libido, the integrity
of their skin, if they're losing hair. You have to
pull back all the layers to help a woman under
dan what's really going on with her body. You know,
it's it's very deep. How long does this part of
a woman's life last? You know, from the moment that
she starts to experience symptoms, like how much of her

(04:11):
life are we talking about now you are menopause or
you have no hormones, and so it's not like, oh,
for ten years, I'm gonna be bothered with this and
then I'm done with it. Right, So, yeah, it may
be true that you're not always bothered with hot flashes
or night swets, But what about the chemistry that's going
on your body? What about the fact that your metabolism
is different. You can't lose the weight that you could

(04:32):
when you were in your twenties or thirties. So those
kinds of metabolic changes are ongoing. Because menopause it's not
just a phase that you go through. It is like
this time in your life. It's like the woman you become.

(04:58):
Our cultural attitudes towards menopau eyes, along with the words
we use for it, have changed a lot over time.
Climate terek, the crisis, time of life, change of life,
the change and the gateway to death. My name is
Louise Foxcroft and I'm a historian and writer. I work
mainly in the history of medicine and I've written a

(05:18):
book called Hot Flush is called science the History of
the Modern Menopause. Louise has sifted through all sorts of
historical documents, diaries, old recipes, medical treatises, adds to get
a picture of how are thinking on menopause is evolved
earlier records, a early modern records. So it's seen fifty

(05:39):
and I'm talking you know British at this point, it's
mainly management, but it's tinged with this idea of what
women are and what women are is perceived through the
male I and one of the ideas that it's a
during the early modern time is that when you stop bleeding,

(06:01):
so when you hit menopause and you stop bleeding, the
blood has nowhere to go, so it stays in the
body and it corrupts the body because because we know
that the history of menstrual blood is that you know,
with his babies in the cradle, and mirrors cloud and
storms gather and flowers dye, milk, curdles, all that sort
of stuff. Monsters come out of dung heaps where your
rags are thrown. Okay, that warrants a restatement. People used

(06:26):
to think that women on their periods could curdle milk
and wilt flowers. Plenty of the elders said that menstrual
blood would take the edge of steel. Luise says that
our understanding of women's health is filtered through a medical
tradition that regards femaleness itself as a sort of affliction.
Just a heads up. The next few minutes include some

(06:46):
adult conversation that might not be appropriate for little listeners.
We are sort of physically unpleasant and emotionally unstable and
prone to vanity, and all sorts of indulgences and what
to our bodies is predicated upon those ideas of how
we are on the way that we behave, and so

(07:07):
generally you find you are treated in response to those ideas.
Can you list some of the most dramatic treatments that
have been administered to metopausal women? Yeah, so in the
nineteenth century, when it really kicks off, you might have
acetate of lead pumped into the vagina. You might have

(07:28):
a vaginal plug that well that's I mean, rags and
moss and various things have been used to instead of tampons,
just sort of early tampons. You might have an anal
injection of opium, so that some sort of narcotic which
was just not you for six you know, so, but
narcotic is a sort of every day analgesic first for everything.

(07:50):
Am I correct in thinking that in our most regrettable eras?
There were also surgical interventions? Yes, there were. There was cliterodectomy,
which is excision of the clitterers. Do you think that
women are less afraid of menopausean they used to be.

(08:13):
If you've placed your self worth in terms of how
you look and how you're perceived by men, mainly by men,
then I think women might dread menopause as they might
dread old age or the effects of aging. If you're
not worried about that, then I think you're happier. I
think the more women know about menopause, the less they'll

(08:33):
dread it. Marie Stops, the feminist and eugenicist who founded
the first birth control clinic in Britain in the nine twenties.
So there was also a gender power dynamic at play
that the menopause or the crisis of menopause, is a
manufactured crisis, and it's been created by male doctors. At

(08:55):
least as early as the nineteen thirties, pharmaceutical abs were
making hormone replacement therapies, pills, and creams that delivered sex
hormones back into a woman's body in order to reduce
menopausal symptoms. Some of the manufacturers of these products had
absolutely no qualms about taking the lowest of all available
low roads. The good one is endo Creme or endocream,

(09:18):
which was advertised in medical journals but also in women's magazines.
And that's the most glamorous photograph of a blonde and
she's staring up at her sort of clock gable lesque husband,
and he's looking down at her, and she's obviously applied
the endocream, rubbed it well in because you can't see it.
But the tagline is how long is it since he
said I love you? The thing is, ladies don't get

(09:42):
older and don't have a menopause because men will no
longer love you. In the US, the number one prescription
in the eighties and nineties was a hormone pill called Premarin.
Since then, there's been a lot of controversy about hormone
replacement therapy. Some studies have associated it within creased rates
of cancer and other serious health risks. Okay, let's leave

(10:04):
the chemistry and horrifying marketing copy behind for a moment
and head instead for open water. It's time to talk whales.
I'm Darren Croft. I work at the University of extra
and I'm a professor in animal behavior. Your specialty technically
is behavioral ecology. Yes, it's the study of behavior in

(10:29):
an ecological setting, so understanding how the environment has shaped
the behavior of animals. Does that essentially mean that you're
also studying the way that animals interact with each other
and with their larger environment as opposed to an individual. Yes, definitely.

(10:52):
As a high school student, I spent most of my
time wandering around in streams and fields and just studying animals.
And fast forward around twenty years or something to hanging
around in boats and looking at killer whales, trying to
understand how the world works. In the mammalian world, it's

(11:17):
pretty much just us and a handful of toothed whale
species that go through menopause, including orcas a k a.
Killer whales and Norwall's arguably the A Listers of the
whale world. Darren and his student Emma Foster studied more
than forty years of all the birth and death records
for two groups of killer whales off the western coast
of North America. Emma had a suspicion that there might

(11:40):
be some patterns in these birth and death records that
could explain whale menopause, so she and Darren dove into
the data. I swear on my honor that was an
accidental dive plan and it will not happen again. One
important point about these animals, and it's absolutely key to

(12:01):
understanding why menopause is evolved in this system, is that
in most animals, one of the sex will disperse from
from the family group, and in this species, sons and
daughters stay with their mother, and that's absolutely crucial to
understanding why menopause is evolved. Okay, so whales are special
and weird because the kids stay with ma even after

(12:23):
they're grown up. Not a crystal clear connection with menopause yet,
but I'm tracking. But that means that you've got adult
sons hanging around with their mothers. So we were able
to look at what the effects of a mother death
was on her son's survival, and we found a huge effect.
The data showed that if an adult males mom died,
his chance of dying shut up to his hazard of

(12:44):
mortality increases by more than eight times. So they really
are keeping their sons alive. So how exactly are older
moms keeping their adult sons alive. One of the ways
they're doing is by feeding them. Amazingly, say you've got
the sixty plus year old females catching salmon and actually

(13:04):
sharing that fish, you know, ripping that fish in half
and directly feeding these fully grown, huge male offspring. These
adults male killer whales sound like the least datable people. Well,
they only go one very short dates because then they
returned back to their mothers. They literally are swimming by

(13:25):
their mum's side most of their life. While dude whales
typically die in their thirties, lady whales stop having calves
in their thirties or forties, but live for decades longer.
They spend this post reproductive stage of their lives helping
their grown children and their grandchildren. And because old females

(13:48):
have been around the water block so many times, they're
particularly formidable when it comes to the hunt. One of
the things that we know is that they are really
important in finding the food in the first place. I mean,
if you think about these whiles swimming around in this ocean,
and these salmon are locally abundant, coming to the rivers
in their masses to spawn, but not all rivers have

(14:11):
fish at the same time, So it's a case of
knowing when and where to look for food. And it's
these old post reproductive females that are guiding their family
group around to find the fish. So it's that knowledge
that they've accumulated through their life is one of the
ways that they're helping to keep their family group alive.
So here's the crucial bit. For whales, a grandmother's energy

(14:33):
is better spent on existing offspring than on mating to
make more offspring. Her jeans have the best chance of
carrying on into the future if she devotes her attention,
her knowledge, and her resources to her adult descendants and
their young rude rather than getting pregnant again herself. A
lot of anthropologists and evolutionary scientists are trying to find

(14:53):
out if human behavior can be explained in the same way,
if menopause is an evolved adaptation that direct our time
and attention to our adult kids and their families. In
a fit of literalism, scientists call this the grandmother hypothesis.

(15:16):
If grand offspring really benefit in killer whale populations and
potentially in human populations um from having their grandmother around
even when she's postfertile, then why don't we see it
in a lot of other species that live together in
social groups. Yeah, So, I mean, it's a really good
question because we know that there are these grandmother effects

(15:37):
in other species. So elephant societies for example, the grandmothers
are really important in keeping their grand offspring alive and
their offspring alive and similar mechanisms. You know, they know
how to respond to predators or they know where to
find water. With elephants, an old female can help out
as grandmother while still having new babies of our own.

(15:59):
But for way as their social structure and ecological conditions
mean that younger and older generations would be competing for resources.
The key thing is with these resident killer whales is
that when the females are reaching and that they've got
their adult offspring around, there is a real opportunity there
for them to help. Whereas you know, it'd be hard
to imagine a way that an elephant or another long

(16:21):
lived social mammal might be able to do that in
the same way because of diet, because the herbivores, because
I can't catch a tree, right, the trees just actually
the trees, they're they're grazing, they're browsing. And you know,
if we look at other long lived mammals such as elephants,
for example, they're not sharing food in the in the
same way that the killer whales are, and indeed, ancestral

(16:45):
humans were sharing and helping to prepare food. So it
really is the ecology, the environment that diet their life.
That's It's all a combination of factors and it is
very unusual that you get these effects coming together, which
is why menopause is so rare in the animal kingdom. Okay,

(17:07):
a quick aside before moving on. Fertility functions in different
ways in humans and whales. For women, menopause is signaled
by the cessation of a woman's menstrual cycle, but whales
don't have periods, and so researchers can only tell if
they're post fertile by measuring the hormonal levels in their pooh,
which they locate floating on the surface of the water

(17:27):
with sniffer dogs, the most famous one of which is
a Labrador Retriever named Tucker. Listener the World is Wide,
Louis Foxcroft, our menopause historian, says, it's important that all
of us boys and girls know more about this stuff,
more about our own bodies. Is not about Tucker the labrador.
In schools where they have sex education, they need to

(17:49):
talk about menopause thenteen year old, they need to know
about the whole of their reproductive lives. Wow. That has
not occurred to me until this moment, but I wish
that in my it like junior high in high school,
sex said, which was so profoundly uncomfortable for so many reasons. Right,
it's a weird class. I wish they had talked about
the menopause, not necessarily because I would have been in

(18:11):
a position that it's going to better equip me for
my own menopause, but because I would have loved, like
a very swift jab to the ribs to like think
about my mother in a more compassionate way. And in
researching this podcast, I texted her like, I am so
sorry that I was totally tone deaf to like a

(18:33):
really big part of your life when you have not
been even when we fought, like you've not been tone
deaf and completely oblivious, right, like these big things that
are happening to mind. Well, I lost my mother when
I was thirty five, so I never got to have
that conversation with her, and I would really like to
have that conversation. And I remember her having the menopause,
and I remember her struggling with it, and I didn't

(18:53):
really you know, I had no conception of what was
going on. And we didn't talk about it because I
think that generation of women she was born in didn't
discuss it. With that note on the importance of intergenerational conversation,
I'll usher in our final guest. My name is Bob Wander,

(19:15):
and how did we meet? I am the father of
the interviewer. Actually we met in the hospital during your
birthing process. I remember the day very clearly. Reading scientists
arguments for and against the grandmother hypothesis made me think

(19:36):
about my own grandma. When I was very small. She
took care of me a few nights a week. When
I got big, we ate lunch together at a dumb
sports bar. Why drank coffee, and she ordered a Manhattan
and always picked up the tab, which incidentally is pretty
much exactly what the grandmother hypothesis would predict, both the
childcare and the resource sharing. I still sometimes wear Jeanette's

(19:57):
wedding ring on a chain around my neck. She and
I were close, but she and my dad were really close.
Do you feel like you understood her? I do. Did
you feel understood by her? Probably better by her than
just about anybody else on earth, To be honest, do
you know what her experience of menopause was like, that's

(20:20):
a good question. I really don't know. I was too
young to know much biology when she was menopausal, and
I was also kind of on my way out of
the household at a relatively young age to be on
my own. Okay, I'm going to do a quick fact
check with your dad. Are you saying that when you
went up to college you didn't know the biology of menopause.

(20:41):
I knew a little bit about it, but the only
female in the household where I grew up was my mother.
I had four brothers, so I knew very little about
what was going down. To be perfectly honest, my dad
and his mom shared secrets. They confided in one another
about their marriages, the sweet stuff and the lousy and
only stuff too. So it struck me as a little

(21:02):
strange that what might have been a really important experience
for her was never really mentioned between them. Even in
passing years later, when my ovary had to come out,
my dad got really involved with the science of the
female reproductive system, Like, in order to understand my experience,
he wanted to understand the biology of me. I remember
your diagnosis and treatment very well. These subjects for public

(21:26):
discussion were really kind of taboo when I was a
very young person, at least in Central North America, and
they're not now. So I think the level of knowledge
that everybody has about the number of as I said,
gender identity issues and female biological issues, the level of
general education is much higher now than it was when
I was a very young person. That is better, I do. Yeah,

(21:50):
I think sunlight is the best disinfectant. I didn't invent
that phrase, but if I had invented it, I would
be proud of it. Net was a pretty stellar mother,
loving but also shrewd and quick. If she were a
killer whale, she would have been the ferocious hunter to
stuff all her sons with fish. And if menopause is

(22:11):
partly to thank for the way that human children are raised,
then it's a huge factor that shaped a lot of
our families in a mostly unrecognized way. On my next
visit with my dad, I've already made plans to have
a salmon dinner in Jeanette's honor salmon, and maybe a
Manhattan too. On the next Deeply Human, why do you

(22:32):
listen to sad music? Like? If we're generally trying to
lead happy lives, how come we subject ourselves. Two songs
that choke us up. The song can feel like you're
communing with an artist who understands and has been through
what you've gone through, and so it's not necessarily hopeless
because here's somebody who clearly went through some of the
same things that I did and came out on the

(22:52):
other side and wrote a song about it. Deeply Human
is a co production of the BBC World Service in
America in Public Media with I Heart Media, and it's
hosted by me Deessa. Til next time, Stay Curious,
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