Speaker 1: You have great taste in podcasts. This is deeply human
Speaker 1: and I am your host, Tessa. Our topic of the
Speaker 1: day is menopause. And before you run off thinking I'm
Speaker 1: too young for this one or I'm too dude for this,
Speaker 1: I can almost guarantee that you will be both surprised
Speaker 1: and entertained, maybe even rendered a kinder son or daughter.
Speaker 1: Menopause is actually a really rare condition in the animal world.
Speaker 1: The only mammals will go through it are us and
Speaker 1: some species of whales. Okay, sidebar for a quick story.
Speaker 1: Many years ago, when I was twenty three, my doctor
Speaker 1: found a tumor in my right ovary, and in a
Speaker 1: blur of a few weeks, a surgery was scheduled. The
Speaker 1: ovary was taken out, and I moved into my dad's
Speaker 1: basement to recuperate. My doctor said I'd still be fertile.
Speaker 1: My left ovary would essentially pull double shifts for the
Speaker 1: next couple of decades, ovulating every month and releasing enough
Speaker 1: hormones to keep my system balanced. But there was a
Speaker 1: slight lag in my hormone production before my left ovary
Speaker 1: realized it was the only one left at the party,
Speaker 1: and I got a sneak peak of pre menopause. I
Speaker 1: remember lying awake one night with never before experienced sort
Speaker 1: of insomnia, not the familiar toss in turn routine, but
Speaker 1: a razor sharp alertness, and this feverish heat. The nighttime
Speaker 1: sounds gave way to the first morning traffic, then the
Speaker 1: footfalls of my family walking on the floor above me,
Speaker 1: and I registered all of it in this unrelenting, high
Speaker 1: definition consciousness, and eventually I decided, I guess it's time
Speaker 1: to get up and put some clothes on. And when
Speaker 1: I rose, I saw the outline of my body on
Speaker 1: the bedsheets. My sweat had traced the edges of me
Speaker 1: in salt like police chalk on cotton. Most mammals remained
Speaker 1: fertile all the way to the end of their lives,
Speaker 1: and intuitively, that would seem like a strategic advantage the
Speaker 1: whole get your genes out there board game of evolution.
Speaker 1: So why is menopause only a thing for whales and women,
Speaker 1: and on the human side of that equation, why do
Speaker 1: we have such trouble talking to one another about the experience. Okay, first,
Speaker 1: let's review basics paging. Dr Rosalind Jackson, an obstetrician, gynecologist
Speaker 1: in Ohio. The average age for women going through menopause
Speaker 1: is fifty one plus or minus three years, but ten
Speaker 1: years prior to that is called the perimenal pausal time
Speaker 1: of a woman's life, and during that time hormones start
Speaker 1: to decrease. But it's when you become truly menopausal. It's
Speaker 1: not to say that you've totally stopped making hormones at all,
Speaker 1: but it's a very very small amount that you're producing,
Speaker 1: quick and painless biochem refresher. The major sex hormones are estrogen, progesterone,
Speaker 1: and testosterone, and all three hormones are found in both
Speaker 1: men and women, but in different concentrations. Yes, ladies have
Speaker 1: distosterone and guys have estrogen. During menopause, levels of these
Speaker 1: hormones drop, and that change in body chemistry can affect
Speaker 1: women in all sorts of ways. For some menopause isn't
Speaker 1: really that big a deal. For others meaningfully alters what
Speaker 1: it feels like to be alive in their own bodies,
Speaker 1: with effects on mood and memory, they're thinking, and even
Speaker 1: their sense of self. A lot of times they don't
Speaker 1: associate some of the symptoms that they're having with menopause,
Speaker 1: or that the fact that their hormones are decreasing, such
Speaker 1: as um fatigue or insomnia. That's a really big one.
Speaker 1: But commonly a lot of people do not associate the
Speaker 1: inability to sleep with the fact that they're losing their
Speaker 1: hormones or their hormones are decreasing. So there's fatigue, there's
Speaker 1: I can't sleep, I can't lose weight. That's a big one.
Speaker 1: Hot flashes, a nice sweat seems common, but it's not
Speaker 1: the main thing that women come to see me for
Speaker 1: regarding their hormones. Also, a decrease in libido, the integrity
Speaker 1: of their skin, if they're losing hair. You have to
Speaker 1: pull back all the layers to help a woman under
Speaker 1: dan what's really going on with her body. You know,
Speaker 1: it's it's very deep. How long does this part of
Speaker 1: a woman's life last? You know, from the moment that
Speaker 1: she starts to experience symptoms, like how much of her
Speaker 1: life are we talking about now you are menopause or
Speaker 1: you have no hormones, and so it's not like, oh,
Speaker 1: for ten years, I'm gonna be bothered with this and
Speaker 1: then I'm done with it. Right, So, yeah, it may
Speaker 1: be true that you're not always bothered with hot flashes
Speaker 1: or night swets, But what about the chemistry that's going
Speaker 1: on your body? What about the fact that your metabolism
Speaker 1: is different. You can't lose the weight that you could
Speaker 1: when you were in your twenties or thirties. So those
Speaker 1: kinds of metabolic changes are ongoing. Because menopause it's not
Speaker 1: just a phase that you go through. It is like
Speaker 1: this time in your life. It's like the woman you become.
Speaker 1: Our cultural attitudes towards menopau eyes, along with the words
Speaker 1: we use for it, have changed a lot over time.
Speaker 1: Climate terek, the crisis, time of life, change of life,
Speaker 1: the change and the gateway to death. My name is
Speaker 1: Louise Foxcroft and I'm a historian and writer. I work
Speaker 1: mainly in the history of medicine and I've written a
Speaker 1: book called Hot Flush is called science the History of
Speaker 1: the Modern Menopause. Louise has sifted through all sorts of
Speaker 1: historical documents, diaries, old recipes, medical treatises, adds to get
Speaker 1: a picture of how are thinking on menopause is evolved
Speaker 1: earlier records, a early modern records. So it's seen fifty
Speaker 1: and I'm talking you know British at this point, it's
Speaker 1: mainly management, but it's tinged with this idea of what
Speaker 1: women are and what women are is perceived through the
Speaker 1: male I and one of the ideas that it's a
Speaker 1: during the early modern time is that when you stop bleeding,
Speaker 1: so when you hit menopause and you stop bleeding, the
Speaker 1: blood has nowhere to go, so it stays in the
Speaker 1: body and it corrupts the body because because we know
Speaker 1: that the history of menstrual blood is that you know,
Speaker 1: with his babies in the cradle, and mirrors cloud and
Speaker 1: storms gather and flowers dye, milk, curdles, all that sort
Speaker 1: of stuff. Monsters come out of dung heaps where your
Speaker 1: rags are thrown. Okay, that warrants a restatement. People used
Speaker 1: to think that women on their periods could curdle milk
Speaker 1: and wilt flowers. Plenty of the elders said that menstrual
Speaker 1: blood would take the edge of steel. Luise says that
Speaker 1: our understanding of women's health is filtered through a medical
Speaker 1: tradition that regards femaleness itself as a sort of affliction.
Speaker 1: Just a heads up. The next few minutes include some
Speaker 1: adult conversation that might not be appropriate for little listeners.
Speaker 1: We are sort of physically unpleasant and emotionally unstable and
Speaker 1: prone to vanity, and all sorts of indulgences and what
Speaker 1: to our bodies is predicated upon those ideas of how
Speaker 1: we are on the way that we behave, and so
Speaker 1: generally you find you are treated in response to those ideas.
Speaker 1: Can you list some of the most dramatic treatments that
Speaker 1: have been administered to metopausal women? Yeah, so in the
Speaker 1: nineteenth century, when it really kicks off, you might have
Speaker 1: acetate of lead pumped into the vagina. You might have
Speaker 1: a vaginal plug that well that's I mean, rags and
Speaker 1: moss and various things have been used to instead of tampons,
Speaker 1: just sort of early tampons. You might have an anal
Speaker 1: injection of opium, so that some sort of narcotic which
Speaker 1: was just not you for six you know, so, but
Speaker 1: narcotic is a sort of every day analgesic first for everything.
Speaker 1: Am I correct in thinking that in our most regrettable eras?
Speaker 1: There were also surgical interventions? Yes, there were. There was cliterodectomy,
Speaker 1: which is excision of the clitterers. Do you think that
Speaker 1: women are less afraid of menopausean they used to be.
Speaker 1: If you've placed your self worth in terms of how
Speaker 1: you look and how you're perceived by men, mainly by men,
Speaker 1: then I think women might dread menopause as they might
Speaker 1: dread old age or the effects of aging. If you're
Speaker 1: not worried about that, then I think you're happier. I
Speaker 1: think the more women know about menopause, the less they'll
Speaker 1: dread it. Marie Stops, the feminist and eugenicist who founded
Speaker 1: the first birth control clinic in Britain in the nine twenties.
Speaker 1: So there was also a gender power dynamic at play
Speaker 1: that the menopause or the crisis of menopause, is a
Speaker 1: manufactured crisis, and it's been created by male doctors. At
Speaker 1: least as early as the nineteen thirties, pharmaceutical abs were
Speaker 1: making hormone replacement therapies, pills, and creams that delivered sex
Speaker 1: hormones back into a woman's body in order to reduce
Speaker 1: menopausal symptoms. Some of the manufacturers of these products had
Speaker 1: absolutely no qualms about taking the lowest of all available
Speaker 1: low roads. The good one is endo Creme or endocream,
Speaker 1: which was advertised in medical journals but also in women's magazines.
Speaker 1: And that's the most glamorous photograph of a blonde and
Speaker 1: she's staring up at her sort of clock gable lesque husband,
Speaker 1: and he's looking down at her, and she's obviously applied
Speaker 1: the endocream, rubbed it well in because you can't see it.
Speaker 1: But the tagline is how long is it since he
Speaker 1: said I love you? The thing is, ladies don't get
Speaker 1: older and don't have a menopause because men will no
Speaker 1: longer love you. In the US, the number one prescription
Speaker 1: in the eighties and nineties was a hormone pill called Premarin.
Speaker 1: Since then, there's been a lot of controversy about hormone
Speaker 1: replacement therapy. Some studies have associated it within creased rates
Speaker 1: of cancer and other serious health risks. Okay, let's leave
Speaker 1: the chemistry and horrifying marketing copy behind for a moment
Speaker 1: and head instead for open water. It's time to talk whales.
Speaker 1: I'm Darren Croft. I work at the University of extra
Speaker 1: and I'm a professor in animal behavior. Your specialty technically
Speaker 1: is behavioral ecology. Yes, it's the study of behavior in
Speaker 1: an ecological setting, so understanding how the environment has shaped
Speaker 1: the behavior of animals. Does that essentially mean that you're
Speaker 1: also studying the way that animals interact with each other
Speaker 1: and with their larger environment as opposed to an individual. Yes, definitely.
Speaker 1: As a high school student, I spent most of my
Speaker 1: time wandering around in streams and fields and just studying animals.
Speaker 1: And fast forward around twenty years or something to hanging
Speaker 1: around in boats and looking at killer whales, trying to
Speaker 1: understand how the world works. In the mammalian world, it's
Speaker 1: pretty much just us and a handful of toothed whale
Speaker 1: species that go through menopause, including orcas a k a.
Speaker 1: Killer whales and Norwall's arguably the A Listers of the
Speaker 1: whale world. Darren and his student Emma Foster studied more
Speaker 1: than forty years of all the birth and death records
Speaker 1: for two groups of killer whales off the western coast
Speaker 1: of North America. Emma had a suspicion that there might
Speaker 1: be some patterns in these birth and death records that
Speaker 1: could explain whale menopause, so she and Darren dove into
Speaker 1: the data. I swear on my honor that was an
Speaker 1: accidental dive plan and it will not happen again. One
Speaker 1: important point about these animals, and it's absolutely key to
Speaker 1: understanding why menopause is evolved in this system, is that
Speaker 1: in most animals, one of the sex will disperse from
Speaker 1: from the family group, and in this species, sons and
Speaker 1: daughters stay with their mother, and that's absolutely crucial to
Speaker 1: understanding why menopause is evolved. Okay, so whales are special
Speaker 1: and weird because the kids stay with ma even after
Speaker 1: they're grown up. Not a crystal clear connection with menopause yet,
Speaker 1: but I'm tracking. But that means that you've got adult
Speaker 1: sons hanging around with their mothers. So we were able
Speaker 1: to look at what the effects of a mother death
Speaker 1: was on her son's survival, and we found a huge effect.
Speaker 1: The data showed that if an adult males mom died,
Speaker 1: his chance of dying shut up to his hazard of
Speaker 1: mortality increases by more than eight times. So they really
Speaker 1: are keeping their sons alive. So how exactly are older
Speaker 1: moms keeping their adult sons alive. One of the ways
Speaker 1: they're doing is by feeding them. Amazingly, say you've got
Speaker 1: the sixty plus year old females catching salmon and actually
Speaker 1: sharing that fish, you know, ripping that fish in half
Speaker 1: and directly feeding these fully grown, huge male offspring. These
Speaker 1: adults male killer whales sound like the least datable people. Well,
Speaker 1: they only go one very short dates because then they
Speaker 1: returned back to their mothers. They literally are swimming by
Speaker 1: their mum's side most of their life. While dude whales
Speaker 1: typically die in their thirties, lady whales stop having calves
Speaker 1: in their thirties or forties, but live for decades longer.
Speaker 1: They spend this post reproductive stage of their lives helping
Speaker 1: their grown children and their grandchildren. And because old females
Speaker 1: have been around the water block so many times, they're
Speaker 1: particularly formidable when it comes to the hunt. One of
Speaker 1: the things that we know is that they are really
Speaker 1: important in finding the food in the first place. I mean,
Speaker 1: if you think about these whiles swimming around in this ocean,
Speaker 1: and these salmon are locally abundant, coming to the rivers
Speaker 1: in their masses to spawn, but not all rivers have
Speaker 1: fish at the same time, So it's a case of
Speaker 1: knowing when and where to look for food. And it's
Speaker 1: these old post reproductive females that are guiding their family
Speaker 1: group around to find the fish. So it's that knowledge
Speaker 1: that they've accumulated through their life is one of the
Speaker 1: ways that they're helping to keep their family group alive.
Speaker 1: So here's the crucial bit. For whales, a grandmother's energy
Speaker 1: is better spent on existing offspring than on mating to
Speaker 1: make more offspring. Her jeans have the best chance of
Speaker 1: carrying on into the future if she devotes her attention,
Speaker 1: her knowledge, and her resources to her adult descendants and
Speaker 1: their young rude rather than getting pregnant again herself. A
Speaker 1: lot of anthropologists and evolutionary scientists are trying to find
Speaker 1: out if human behavior can be explained in the same way,
Speaker 1: if menopause is an evolved adaptation that direct our time
Speaker 1: and attention to our adult kids and their families. In
Speaker 1: a fit of literalism, scientists call this the grandmother hypothesis.
Speaker 1: If grand offspring really benefit in killer whale populations and
Speaker 1: potentially in human populations um from having their grandmother around
Speaker 1: even when she's postfertile, then why don't we see it
Speaker 1: in a lot of other species that live together in
Speaker 1: social groups. Yeah, So, I mean, it's a really good
Speaker 1: question because we know that there are these grandmother effects
Speaker 1: in other species. So elephant societies for example, the grandmothers
Speaker 1: are really important in keeping their grand offspring alive and
Speaker 1: their offspring alive and similar mechanisms. You know, they know
Speaker 1: how to respond to predators or they know where to
Speaker 1: find water. With elephants, an old female can help out
Speaker 1: as grandmother while still having new babies of our own.
Speaker 1: But for way as their social structure and ecological conditions
Speaker 1: mean that younger and older generations would be competing for resources.
Speaker 1: The key thing is with these resident killer whales is
Speaker 1: that when the females are reaching and that they've got
Speaker 1: their adult offspring around, there is a real opportunity there
Speaker 1: for them to help. Whereas you know, it'd be hard
Speaker 1: to imagine a way that an elephant or another long
Speaker 1: lived social mammal might be able to do that in
Speaker 1: the same way because of diet, because the herbivores, because
Speaker 1: I can't catch a tree, right, the trees just actually
Speaker 1: the trees, they're they're grazing, they're browsing. And you know,
Speaker 1: if we look at other long lived mammals such as elephants,
Speaker 1: for example, they're not sharing food in the in the
Speaker 1: same way that the killer whales are, and indeed, ancestral
Speaker 1: humans were sharing and helping to prepare food. So it
Speaker 1: really is the ecology, the environment that diet their life.
Speaker 1: That's It's all a combination of factors and it is
Speaker 1: very unusual that you get these effects coming together, which
Speaker 1: is why menopause is so rare in the animal kingdom. Okay,
Speaker 1: a quick aside before moving on. Fertility functions in different
Speaker 1: ways in humans and whales. For women, menopause is signaled
Speaker 1: by the cessation of a woman's menstrual cycle, but whales
Speaker 1: don't have periods, and so researchers can only tell if
Speaker 1: they're post fertile by measuring the hormonal levels in their pooh,
Speaker 1: which they locate floating on the surface of the water
Speaker 1: with sniffer dogs, the most famous one of which is
Speaker 1: a Labrador Retriever named Tucker. Listener the World is Wide,
Speaker 1: Louis Foxcroft, our menopause historian, says, it's important that all
Speaker 1: of us boys and girls know more about this stuff,
Speaker 1: more about our own bodies. Is not about Tucker the labrador.
Speaker 1: In schools where they have sex education, they need to
Speaker 1: talk about menopause thenteen year old, they need to know
Speaker 1: about the whole of their reproductive lives. Wow. That has
Speaker 1: not occurred to me until this moment, but I wish
Speaker 1: that in my it like junior high in high school,
Speaker 1: sex said, which was so profoundly uncomfortable for so many reasons. Right,
Speaker 1: it's a weird class. I wish they had talked about
Speaker 1: the menopause, not necessarily because I would have been in
Speaker 1: a position that it's going to better equip me for
Speaker 1: my own menopause, but because I would have loved, like
Speaker 1: a very swift jab to the ribs to like think
Speaker 1: about my mother in a more compassionate way. And in
Speaker 1: researching this podcast, I texted her like, I am so
Speaker 1: sorry that I was totally tone deaf to like a
Speaker 1: really big part of your life when you have not
Speaker 1: been even when we fought, like you've not been tone
Speaker 1: deaf and completely oblivious, right, like these big things that
Speaker 1: are happening to mind. Well, I lost my mother when
Speaker 1: I was thirty five, so I never got to have
Speaker 1: that conversation with her, and I would really like to
Speaker 1: have that conversation. And I remember her having the menopause,
Speaker 1: and I remember her struggling with it, and I didn't
Speaker 1: really you know, I had no conception of what was
Speaker 1: going on. And we didn't talk about it because I
Speaker 1: think that generation of women she was born in didn't
Speaker 1: discuss it. With that note on the importance of intergenerational conversation,
Speaker 1: I'll usher in our final guest. My name is Bob Wander,
Speaker 1: and how did we meet? I am the father of
Speaker 1: the interviewer. Actually we met in the hospital during your
Speaker 1: birthing process. I remember the day very clearly. Reading scientists
Speaker 1: arguments for and against the grandmother hypothesis made me think
Speaker 1: about my own grandma. When I was very small. She
Speaker 1: took care of me a few nights a week. When
Speaker 1: I got big, we ate lunch together at a dumb
Speaker 1: sports bar. Why drank coffee, and she ordered a Manhattan
Speaker 1: and always picked up the tab, which incidentally is pretty
Speaker 1: much exactly what the grandmother hypothesis would predict, both the
Speaker 1: childcare and the resource sharing. I still sometimes wear Jeanette's
Speaker 1: wedding ring on a chain around my neck. She and
Speaker 1: I were close, but she and my dad were really close.
Speaker 1: Do you feel like you understood her? I do. Did
Speaker 1: you feel understood by her? Probably better by her than
Speaker 1: just about anybody else on earth, To be honest, do
Speaker 1: you know what her experience of menopause was like, that's
Speaker 1: a good question. I really don't know. I was too
Speaker 1: young to know much biology when she was menopausal, and
Speaker 1: I was also kind of on my way out of
Speaker 1: the household at a relatively young age to be on
Speaker 1: my own. Okay, I'm going to do a quick fact
Speaker 1: check with your dad. Are you saying that when you
Speaker 1: went up to college you didn't know the biology of menopause.
Speaker 1: I knew a little bit about it, but the only
Speaker 1: female in the household where I grew up was my mother.
Speaker 1: I had four brothers, so I knew very little about
Speaker 1: what was going down. To be perfectly honest, my dad
Speaker 1: and his mom shared secrets. They confided in one another
Speaker 1: about their marriages, the sweet stuff and the lousy and
Speaker 1: only stuff too. So it struck me as a little
Speaker 1: strange that what might have been a really important experience
Speaker 1: for her was never really mentioned between them. Even in
Speaker 1: passing years later, when my ovary had to come out,
Speaker 1: my dad got really involved with the science of the
Speaker 1: female reproductive system, Like, in order to understand my experience,
Speaker 1: he wanted to understand the biology of me. I remember
Speaker 1: your diagnosis and treatment very well. These subjects for public
Speaker 1: discussion were really kind of taboo when I was a
Speaker 1: very young person, at least in Central North America, and
Speaker 1: they're not now. So I think the level of knowledge
Speaker 1: that everybody has about the number of as I said,
Speaker 1: gender identity issues and female biological issues, the level of
Speaker 1: general education is much higher now than it was when
Speaker 1: I was a very young person. That is better, I do. Yeah,
Speaker 1: I think sunlight is the best disinfectant. I didn't invent
Speaker 1: that phrase, but if I had invented it, I would
Speaker 1: be proud of it. Net was a pretty stellar mother,
Speaker 1: loving but also shrewd and quick. If she were a
Speaker 1: killer whale, she would have been the ferocious hunter to
Speaker 1: stuff all her sons with fish. And if menopause is
Speaker 1: partly to thank for the way that human children are raised,
Speaker 1: then it's a huge factor that shaped a lot of
Speaker 1: our families in a mostly unrecognized way. On my next
Speaker 1: visit with my dad, I've already made plans to have
Speaker 1: a salmon dinner in Jeanette's honor salmon, and maybe a
Speaker 1: Manhattan too. On the next Deeply Human, why do you
Speaker 1: listen to sad music? Like? If we're generally trying to
Speaker 1: lead happy lives, how come we subject ourselves. Two songs
Speaker 1: that choke us up. The song can feel like you're
Speaker 1: communing with an artist who understands and has been through
Speaker 1: what you've gone through, and so it's not necessarily hopeless
Speaker 1: because here's somebody who clearly went through some of the
Speaker 1: same things that I did and came out on the
Speaker 1: other side and wrote a song about it. Deeply Human
Speaker 1: is a co production of the BBC World Service in
Speaker 1: America in Public Media with I Heart Media, and it's
Speaker 1: hosted by me Deessa. Til next time, Stay Curious,