How to Menopause

Fadal structures How to Menopause into two-to-four-page essays, making each topic easy to absorb, as well as organizing various points, perspectives, and lists. She defines perimenopause, menopause, and postmenopause from both a scientific and personal perspective. She then adds the severity and cruciality of addressing menopause, noting, “the symptoms of perimenopause send almost 90 percent of women to their doctor for advice on how to cope” (22). With subtle additions like exclamation marks, Fadal makes the topic approachable and denotes her own surprise upon learning these things: “Menopause is technically only one day long!” (23). Her tone is casual, honest, and conversational: “OMG! What’s happening? I wish I could tell you” (54), reinforcing her relatability and making this topic easier to navigate. This stylistic choice helps dismantle the authoritative distance often found in medical literature, inviting readers into an accessible, peer-to-peer conversation about their bodies.

Fadal’s book explores a gradual but powerful paradigm shift. October has been Menopause Awareness Month since 2009, and conversations around menopause are becoming more mainstream. Influential women such as Oprah Winfrey, Michelle Obama, Naomi Watts, and Katie Couric have voiced their experiences and concerns. Fadal points out the historical neglect of women’s health, noting that it wasn’t until 1986 that women were even required to be included in pharmaceutical trials. Although improvements have been made, Fadal stresses that menopause-specific research is still neglected in funding and attention, creating gaps in understanding and care for women in this vital stage of life. This section positions menopause not just as a health event but as a feminist issue shaped by decades of systemic bias, research exclusion, and dismissive care. By framing this life transition in historical and political terms, Fadal highlights how personal experiences are inseparable from public structures.

Fadal strongly emphasizes inclusivity across ethnicities, backgrounds, and gender identities regarding menopause and women’s health in general. She uses testimonials to show that women are not alone, all with the goal of Removing the Mystery and Stigma Surrounding Menopause. She quotes Laura Okafor Crain: “Many women […] describe perimenopause as a room that was once familiar but now they cannot find the light switch anymore. We can’t prevent the layout of the room from change, but we can prevent the abrupt darkness by preparing ourselves […] and learning how we can navigate it” (27). This metaphor speaks to how lost and confused women feel during menopause and how unnecessary this reality is. All that is required is effort and education. Fadal’s invocation of Crain’s metaphor adds emotional depth to the clinical and structural critiques she offers, reminding readers that menopause, at its core, is about orientation and reorientation to one’s body, identity, and community. Her inclusion of racial and gender disparities acknowledges that while menopause is universal among women, its experience is shaped by intersecting systems of inequality.

Fadal hopes that through her optimistic advice, women in menopause can begin Embracing Midlife As a Period of Empowerment and Growth. Fadal’s optimism and inspiring words are needed during this stressful and isolating time, and she wants no woman to feel alone, noting that over one billion people on Earth are currently menopausal. She notes that humans are among the rare species in which females live long beyond reproduction, suggesting that this phase of life has its own unique purpose and is a privilege of the species. She urges women to view menopause as a time where they can focus on themselves, adding that postmenopausal women are often happier than they were before menopause, provided they find ways to flourish rather than stagnate. This reframing transforms menopause from a perceived decline into a gateway—what Fadal calls a “second adulthood,” rich with self-actualization and potential. She presents postmenopause as a dynamic beginning that allows for reprioritizing joy, health, and identity on one’s own terms.

Fadal makes clear that menopause symptoms are frequently misdiagnosed or dismissed. She warns, “These symptoms are not just annoying. They have serious health implications” (19). Fadal’s inclusion of a nurse’s admission that she can no longer experience sexual pleasure through her clitoris is included to inspire awareness and highlight a need for better care. Additionally, hot flashes can signal future cardiovascular risk. Fadal argues for hormone therapy, citing groups like the Menopause Society and Endocrine Society to make her claims more credible. “Menopause is… a matter of life and death” (71). She exposes the myth that estrogen is only about sex, explaining that every organ is affected when it starts to drop. Social consequences occur alongside physical symptoms: Fadal’s own divorce and financial stress reflect the life changes many women face during midlife. Hormone blood tests, she says, are unreliable due to daily fluctuations. Fadal had to see six doctors before finding one with menopause expertise—an experience that reveals how unprepared many providers still are to treat it. This section builds a strong case for systemic reform in medical education and practice, urging both individual advocacy and collective pressure on institutions to catch up with the needs of aging women. By layering personal testimony with scientific data, Fadal bridges the emotional and intellectual, making her case not just persuasive, but urgent.