Reversing the damage of menopause awareness

I’m writing this post at the end of menopause awareness month.

“Menopause is having a moment,” we’ve been told across multiple media outlets, as if menopause moments have never happened before.

In every generation, women can become curious about the changes they experience in their body and soul come midlife. Sadly, women’s curiosity alone, even when paired with a typewriter, or computer and the internet, has never been enough to power national or global menopause moments. Instead, menopause awareness only spreads like wildfire to create “a moment” when it’s part of a business plan to sell more pharmaceutical products.

In the US, in the late 1980s and 1990s, almost 45% of postmenopausal women were taking or had taken HRT. Whether in discussions with their doctors or each other, women were talking about menopause.

Back then, menopause was definitely having a moment!

I’m not the only one in the menopause space familiar with the history of HRT and shifting attitudes to midlife change. Yet, so many meno influencers want women to believe that developments in recent years have created a groundbreaking menopause moment or even menopause revolution. As this narrative is accepted, women are more likely to believe that medicine can finally “save us from our biology” with brand new products – products that just happen to be woefully under tested.

Decades ago, the US was able to lead the world in HRT sales because pharmaceutical ads were permitted, as they still are.  

Today, instead of relying on the mainstream media and women’s magazines to convince women that they are hormonally deficient and about to suffer a terrible disease if they don’t medicate their menopause transition, we also have social media algorithms pushing out pharmaceutical messaging into digital devices.

The familiar faces of useful celebs behaving as pharma reps has strangely managed to circumvent the ban on advertising prescription-only medicines in countries where such advertising is not permitted. Even in the US, a celeb isn’t allowed to show you how she uses a testosterone cream on an Instagram reel, for example, but in the US and elsewhere, few seem to care.

HRT is a fast-growing multibillion dollar business. The fuel to power the business is fear.

“I can't think of anything worse than hot flushes and night sweats,” said Sally Farmiloe, a 49-year-old actress, presenter and writer, quoted in the Daily Mail. Not yet in menopause, she claimed she’s “absolutely dreading it.”

In recent years, I’ve observed similar feelings of dread expressed by women in their 30s and 40s on social media. The fear of menopause is not innate and it’s not something that I heard a decade ago, when I first started supporting women in perimenopause and menopause.

In the current wave of menopause (HRT) awareness, the fear was manufactured, just as it was manufactured decades ago. Previous waves of fear followed the same playbook, only to collapse in scandal, when research showed hormone therapies to be not as safe and effective as promised.

Dreading menopause is incredibly unhelpful. Fear and health don’t mix. Fear can create a nocebo effect – the opposite of the better-known placebo effect.

If second year medical students can spontaneously develop symptoms of terrible diseases they happen to be studying (a phenomenon known second year syndrome), women who have been taught to dread menopause are setting themselves up for more symptoms and a worse experience of them.

By contrast, the nocebo effect is great for pharma corporations. Through creating a heightened negative experience of symptoms, women are more likely to seek out the prescribed medical solution.

In 2022 in the UK, women were thrown into a tizzy around fears of declining cognitive function, following a Channel 4 menopause documentary. The documentary, hosted by Davina McCall, promoted the idea that HRT could protect women’s brains through the menopause transition and beyond, and help women avoid dementia. Women were led to believe that if they didn’t take HRT, they were hurting their brain.

McCall had openly discussed her own experience with brain fog during perimenopause, which with her busy career as a media personality, had terrified her. As McCall raved about HRT, viewers would surely assume that her brain fog had improved with the treatment.

But in March 2025, an article in The Times described the surgery that McCall had to undergo to remove a colloid cyst that sat between the right and left hemispheres of her brain. Happily, the operation was successful.

The Times article stated, “Symptoms [McCall] had attributed to the menopause – fogginess, an inability to remember – she now thinks were symptoms of the cyst sitting on her short-term memory pathway.”  McCall shared, “A week after the operation, it was like, ‘Wow. My mind feels more active.’”

With influence, comes responsibility. Many menopause influencers have misled women about brain fog and dementia. There are still women taking HRT, exposing themselves to unnecessary risks, believing it will protect their brain.

Professor Susan Davis points out that many women these days appear to be most concerned about impaired cognitive function, whereas in the past, women’s major complaint was around hot flushes. Of course, this doesn’t mean that all her patients who complain of mental fogginess have cysts in their brain.

During sensitive times of hormonal change, the body wants us to slow down, yet, in this modern age, many of us carry unprecedented mental load and are squeezed between family responsibilities and busy careers. Could this be impacting our memory and could the relentless fear of brain function during menopause and beyond make women’s symptoms worse?

Professor Davis notes that when women move beyond menopause and our hormones settle to new lower levels, brain fog tends to disappear. In other words, brain fog is not caused by low levels of hormones. Furthermore, as Professor Davis explains, there are no large randomized controlled trials that have found HRT to directly improve cognitive function at midlife and beyond.

Many doctors and influencers believe the myth that in natural menopause, women need HRT not only to protect their brain, but also their heart and bones.

Gloria Hunniford, a 62-year-old TV and radio presenter who had a relatively smooth menopause transition shared in the Daily Mail, “My GP was absolutely determined to get me on HRT and put me under an inordinate amount of pressure, literally saying I had to take it.”

Hunniford ultimately resisted and embraced the proven benefits of a healthy lifestyle instead.

Lucy, who recently commented on my work, shared: “I have resisted taking any forms of medication throughout my menopause years and am keen to keep it that way. It feels like there is a lot of pressure to take medicine and I don’t want to.”

Another woman who has started coming off HRT shared: “I realise how sucked into the media story I (we) have been. The pharma industry wants us to buy into this story - literally! My symptoms weren’t that bad yet I felt I should be on HRT!”

The BBC, with a recent history of promoting unproven supposed benefits of HRT through news stories, used a new TV series to ramp up HRT-linked FOMO:

“It probably is the HRT…I’ve started to feel about a hundred years younger in the last few weeks,” says Beth, a character in the series, Riot Women.

Riot Women could have empowered midlife women viewers without pretending that HRT will help you feel younger. Lifestyle shifts (including finally embracing your long-forgotten passions) will help you feel more vibrant again.

The BBC’s promotion of HRT violates UK advertising law. HRT is not a lifestyle choice. It’s a prescription-only medicine that comes with side-effects, which is why any woman’s decision to take it should involve informed consent, not brainwashing.

Sally Wainwright, the creator, executive producer and lead director of Riot Woman, is open about why HRT plays a role in the series. In an interview with the BBC, she said:

“You can [enter] menopause at any age and for a lot of women HRT can help you at any age, it shouldn’t just be for two years when you’re absolutely at the end of your tether.”

Why on earth is Wainwright giving out medical advice? And why is her advice not edited out of the article?

Wait! Don’t tell me. It’s menopause awareness.

These days, many women find the choice to journey through the menopause transition naturally to be a lonely one. I’ve heard women’s shock when they realize all their friends have bought into the myth that HRT is a panacea.

But maybe we're witnessing the beginnings of a new shift. After the placebo effect wore off and the HRT didn’t appear so effective after all, women are realizing that their health is actually in their hands. Many women never wanted to spend years using patches, gels or pills, and they don’t want to feel dependent on a corporate supply chain. They want to feel sovereign on their path through midlife and beyond. They want to reconnect and trust their body once more, rather than believing that there is a bug in the design of WOMAN.

Over the last 10 years, our bodies have not changed the way they journey through menopause. Just as our bodies always knew how to develop from a baby, to a girl, to a woman and in many cases a mother, our bodies know how to help us move beyond our reproductive years, naturally. What has changed is how women perceive menopause.

In the podcast, The Things I Want My Daughters to Know, Rachel Lankester aptly describes how menopause is now positioned as “the gateway to ill health.”

In this open letter to the head of the FDA, I explain in detail why menopause is not the cause of disease and why HRT is not the preventative cure.

It’s incredible when one considers that throughout history and across all societies where data is available, women have outlived men. How could menopause be to blame for ill-health?

If you want to step away from the current fear-ridden flavor of menopause awareness, you can start trusting your body. Listen to how it guides you. How can you slow down? How can you remove stress from your life? How can you clean up your diet, even a bit? How can you move in a way that feels good for you? How can you reconnect with what you feel passionate about?

By tapping into the innate intelligence of the body, it’s much easier to create a loving and healthy path through perimenopause, menopause and beyond.

If you have found this article helpful, feel free to share it with your friends!

---