Dare I Say It: Everything I Wish I'd Known About Menopause

Watts tells a story about a “friend,” before admitting it is about herself. She had a conversation with her boyfriend in which she mentioned wanting plastic surgery, which he strongly disagreed with. She writes that whether or not to employ cosmetic interventions is an individual choice—“Where you fall on the continuum has everything to do with your personal taste, your level of disposable income, and how much societal pressure you’ve been subjected to about looking young” (108).

Watts developed itchy skin in her forties and found that gentle products with natural ingredients worked better for managing her symptoms, which inspired her to research cosmetics and eventually found Stripes Beauty. As she began working with menopausal women, she was struck by the “loneliness” they expressed and their “need to feel seen” (110). She reflects on her initial hesitancy to speak up about menopause and aging, and she describes how important it was for her to find support and guidance. She came across a TED Talk presented by Derek Sivers, in which he argues that leaders must be willing to look “foolish” in front of others because that feeling of foolishness fades as more people join. His concept helped boost Watts’s confidence, encouraging her to forge ahead with her business plans. While Stripes Beauty offers several products tailored to menopausal women, Watts reminds readers that the products should not be “substituted” for expert medical advice.

Common skin afflictions associated with menopause include hormonal acne, simultaneously dry and oily skin, eczema, dermatitis, and rosacea. Watts notes that not all treatments or methods for managing symptoms are effective, describing her own bad experience with a chemical peel and warning individuals against dangerous cosmetic practices, such as trimming cuticles that protect the nail bed.

Hair loss—considered a dermatological condition—is also common in menopausal women. Citing expert Dr. Wechsler, Watts suggests women can eat more iron, whether dietary or supplemental, to help with hair loss. Watts and other women in her family have thin hair, and she has found success in adding protein and iron-rich foods to her diet and in treating her hair gently. Other potential remedies include supplements, biotin gummies, and powder to fill in sparse areas of hair.

Noting the sheer number of cosmetic products available, Watts suggests people keep four main cosmetic products—a cleanser, a toner, a serum, and a moisturizer. Other products include creams, masks, exfoliants, and injectables, and dermatologists tend to recommend three products: zinc sunscreen, tretinoin, and Botox. Watts discusses how many women opt for bold eyeglass frames, and she advocates for progressive lenses to eliminate the need for multiple pairs of glasses. She identifies the social double standard where women are encouraged to appear younger while men’s aging is celebrated, although she tries not to let the social pressure get to her.

Watts criticizes the vague and widespread advice to “sleep more,” describing the insomnia she developed in middle age. She refers to sleep loss as an “insidious” effect of menopause, sharing anecdotes from several women who struggled with insomnia and accompanying issues like mood swings and rage. Watts has found some relief from her insomnia through HRT and by tracking her sleep. Tracking her sleep, especially, has been helpful, despite her understanding that sleep trackers may not be very accurate.

Referring to Dr. Suzie Bertisch, the text discusses the frequent dismissal of menopausal women’s sleep issues—“[T]hey were told by their doctors that this was just the natural phase of life, and there’s nothing more you can do about it. Shrug your shoulders, grin and bear it” (128). Treating menopause-related sleep issues can be complex because it may be difficult to identify and address underlying causes. Dr. Bertisch recommends a full workup and behavioral changes to address sleep issues; beyond that, she recommends an insomnia-specific branch of cognitive behavioral therapy (CBT-I). Watts also discusses medical sleep aids as an option, noting her own unfortunate experience taking Ambien and discussing potential side effects like chemical dependence or cognitive issues. She synthesizes universal sleep advice, encouraging readers to establish a routine, calm themselves before bed, get plenty of exercise, and avoid alcohol.

Dr. Gilberg-Lenz described her patients’ uncomfortable reactions when she stopped dyeing her hair, suggesting that she made them “feel old.” Watts dyes her hair two times a year, noting that many women stopped coloring their hair during the COVID-19 lockdown. Citing stylist Stacy London, Watts stresses the importance of accepting and adapting to the aging process, including changing one’s appearance as one’s body and preferences change.

Watts suggests people can accentuate the things they like about themselves, wear breathable fabrics and layers, tailor clothing, and wear eye-catching accessories. According to Watts, many menopausal women feel liberated by their changing styles as they age. Watts shares that her “great liberation […] has been realizing that when it comes to how we look, as the saying goes, the people ‘who mind don’t matter, and those who matter don’t mind’” (139).