Menopause Cafés Serve Up What Women Need

Edna Astbury-Ward

Disclosures

September 10, 2019

Susan (not her real name) was tired of the constant heavy bleeding, like the period that never ends. She didn't see how it could be normal, but her doctor assured her that it was common during menopause, and that it would eventually subside. In the meantime, she should take iron tablets, although Susan didn't think they were doing any good.

"I'm still fatigued and fed up," she said. "And sad, because it's starting to affect the intimate side of my relationship. Even if I was keen on the idea and had the energy or inclination, it's just all so messy and off-putting. I don't feel sexy at all." Other women sitting at her table murmured their understanding, one commiserating that she "can't even go away for a weekend without a whole suitcase full of pads and tampons."

Susan didn't feel that she could talk to her husband about this, nor to her usual friends. Instead, the best place for her to share how "the change" was affecting her life was among the empathetic women gathered at a Menopause Café.

The mere thought of having a hot cup of tea or coffee is enough to scare off many menopausal women, but this is a café with a difference—a place where strangers gather to eat, drink, and discuss the challenges of menopause.

The aim of a Menopause Café is simple: to increase awareness of the impact of menopause on those experiencing it, their friends, colleagues, and families. It's an open, respectful, and confidential space where people can express their views safely, without experts or expectations. It's not a menopause class or information session, regardless of how useful or important that may be. Nor is it a support group or counseling session. There is no preset agenda; the topics are chosen by those who attend.

Is There a Downside?

Some menopause experts say these gatherings offer benefits that aren't provided through traditional healthcare settings. But some also worry that they could become echo chambers for bad advice.

The fact that Menopause Cafés are growing in number suggests that women are seeking engagement on a different level. But do Menopause Cafés run the risk of becoming a substitute for, rather than a complement to, conventional routes of gaining health information and support?

"My concern is that if women talk only to other women in groups such as these, then myths and legends about menopause can be perpetuated and even create fear," said Jane Wilkinson, a general practitioner at Menopause Wellbeing, in Chester, United Kingdom, and member of the Medical Advisory Council of the British Menopause Society.

"For example, if someone relates a bad experience with hormone therapy, that could prevent other women from asking their doctors about it," Wilkinson continued. "Some women may come away a bit disappointed that they don't know any more than when they went in. Although I do welcome any opportunity to raise the issue of menopause and bring it out of the shadows, if you are going to create this forum, then with that comes the responsibility to dispel the myths surrounding menopause and to provide accurate and impartial information."

Louise Newsome, a GP who specializes in perimenopause through a private menopause clinic in Stratford-upon-Avon, agrees that the exclusion of experts could prevent women from receiving evidence-based, nonbiased information during Menopause Cafés. She believes that Menopause Cafés would benefit from being led by a GP or nurse with a special interest in menopause. "Women should be signposted to healthcare professionals who are able to help them with their menopause-related concerns."

The exclusion of menopause experts may be a missed opportunity for women to engage with a health professional who could answer their questions, adds Wilkinson. But she also understands why women might be drawn to Menopause Cafés and why they may not be satisfied with the menopause-related care they receive from clinicians.

"I've held question-and-answer sessions about menopause," Wilkinson said. "Women want answers, but much of the feedback has been about how much they also valued talking to other women and the benefit they received from peer support. Some women don't have anyone to talk to about what they’re going through. It could also be useful to hold such events in the workplace, where women in numbers may have a greater voice about workplace conditions (such as uncomfortable apparel requirements) during menopause."

A Safe Place to Share

The first Menopause Café took place in June 2017 in Perth, Scotland. Founded by mental health counselor Rachel Weiss, Menopause Cafés are pop-up events, held wherever someone volunteers to organize one, from the smallest village to the largest metropolitan area. The gatherings are modeled after the popular Death Cafés that have already sprung up in 65 countries, including the United States.

Weiss "wants the whole world talking about menopause." Recognizing that concerns related to menopause aren't limited to a specific age or gender, Menopause Cafés are open to anyone—men as well as women. No one is required to speak; participants are welcome to just listen, although it is hoped that everyone will join in. To enliven the 2-hour sessions, a bell is rung every 20 minutes or so to encourage attendees to change seats to meet and converse with new people.

Menopause Cafés are not designed to lead people to any conclusion, product, or course of action. Indeed, having speakers or informational materials is actively discouraged to prevent the sale of menopause-related treatments or services. It is also made clear on the organization's website that should any of the hosts or facilitators work in the field of menopause, they should "be willing to leave their professional identity at the door" and avoid giving medical advice to participants.

Finding What Works and What Doesn't

Interest in Menopause Cafés has been growing, so I attended one to find out what the buzz was about. This pop-up event was being held at the Good Hope Café in Lewisham, a cosmopolitan area of southeast London. (Note that Menopause Cafés don't have to be held in traditional cafés; they can be hosted almost anywhere, including a private dwelling. Space at the Good Hope Café was donated by a local community time bank.)

The Good Hope Café in Lewisham, United Kingdom.

Freshly made cakes and tea greeted me on arrival and, being a hot day in July, well-placed fans delivered a cooling breeze. The space had a vibrant and energetic feel, with attendees who represented the diverse population of Lewisham. I was welcomed by one of the organizers and shown to a table where other women were already engaged in lively conversation and laughter. I immediately felt at ease among this band of women. (There were no men at this event.)

Organizer Fay explained what prompted her to set up this Menopause Café. "I realized that all I talk about now is menopause, so I thought, why not? I just couldn't find support anywhere and nobody seemed to have any time to listen." This was a common theme among the group. Martha said that when it came to menopause, she observed "a lack of urgency from physicians."

Many women came to the event out of curiosity, after seeing it advertised on Facebook. "What have I got to lose?" asked attendee Nia.

In spite of the air of lightheartedness and camaraderie, there was an underlying sense of needing to talk—to share tips, hints, and tricks related to all things menopause with other women. Some said they were there to "find out what works and what doesn't." Others thought it was a good way to get "free advice." Some women attended with a friend, and indeed, one woman said she "may have been a bit scared to come on my own."

Despite the overall feel-good factor of the event, there was an unmistakable deeper and more meaningful element when women shared stories about their own experiences with menopause. Lethargy and a "lack of oomph" was a common complaint. One woman said that she had stopped doing so much that she "left bum prints on the sofa." Others described their menopausal symptoms, such as weight gain, night sweats, and hot flushes, and were relieved to hear that they weren't the only ones tormenting their families and coworkers with grumpiness and mood swings.

Women at the Lewisham Menopause Café.

Women with complex or unusual menopausal symptoms seemed to gain the most from the event. When one woman described her dismay at losing her hair, others listened with kindness and understanding. Women talked about the distressing and debilitating effects that prolonged and irregular heavy periods had on their bodies and their relationships. Many women just wanted to see how other women coped with menopause, and others seemed to be seeking confirmation that the symptoms they were experiencing were indeed caused by menopause, and that they were not in fact "going mad." Quite a few women lamented the lack of a test to diagnose menopause, and one woman wished for "a crystal ball that would tell me how long it was going to last, so that I could get my life back in order." Many women admitted to spending a lot of money on ineffective remedies, especially herbal and over-the-counter products.

Overwhelmingly, the women at the Lewisham Menopause Café said that they got something positive from the event, that it was much needed, and that they found it very helpful. On the basis of this feedback, it appears that the essential concept of a Menopause Café is a good one. These gatherings allow women to be themselves, to express concerns about menopause and be listened to with respect and compassion. At a Menopause Café, women can raise menopause-related issues that they might have hesitated to talk about before, with anyone.

The organizers hope to inspire Menopause Cafés worldwide. As a social franchise, anyone can host a Menopause Café as long as they adhere to the group's principles. A future events map displays the date, time, and location of upcoming Menopause Cafés. Of interest, the first Menopause Festival, #FlushFest2019, was held in Scotland in April 2019, where the theme was "Break the taboo, have some fun."

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