The reader's edition
The Menopause Manifesto: Own Your Health with Facts and Feminism: the summary
Jen Gunter is a Canadian-American obstetrician and gynaecologist and the author of The Vagina Bible. In The Menopause Manifesto she explains the biology of the menopause transition, from perimenopause through the final period to the years after it, and argues that women have been badly served by both medicine and the wellness industry. She walks through what changing oestrogen levels do to the body: hot flushes, sleep, mood, the genitourinary syndrome of menopause, bones and the heart. She reviews the evidence on menopausal hormone therapy, including how the Women's Health Initiative results were reported, and on non-hormonal treatments, diet and supplements. She writes as a doctor and a feminist, frankly and with humour, and treats myths and marketing as things to be checked against the evidence. Read a chapter at a time, with a printable action book at the end.
- Jen Gunter
- 2021
- 4 chapters
- 5 min read
- 9 takeaways
This is HourLife's reading of The Menopause Manifesto: Own Your Health with Facts and Feminism, in our own words. It is not a substitute for the book.
Chapter 01
Before you start
The book in a minute
Tap a paragraph to highlight it. Turn pages with the arrows, the arrow keys, or a swipe.
Jen Gunter is a Canadian-American obstetrician and gynaecologist and the author of The Vagina Bible. In The Menopause Manifesto she explains the biology of the menopause transition, from perimenopause through the final period to the years after it, and argues that women have been badly served by both medicine and the wellness industry. She walks through what changing oestrogen levels do to the body: hot flushes, sleep, mood, the genitourinary syndrome of menopause, bones and the heart. She reviews the evidence on menopausal hormone therapy, including how the Women's Health Initiative results were reported, and on non-hormonal treatments, diet and supplements. She writes as a doctor and a feminist, frankly and with humour, and treats myths and marketing as things to be checked against the evidence.
Below are the 9 ideas HourLife readers vote up most, each in our words with a note on what it asks of you, and then the steps that put them to work.
Chapter 02
What readers keep
The takeaways
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1
HourLife takeaway
Menopause is one day: the point twelve months after your final period.
Gunter is precise about the words. The years of change before it are perimenopause, and everything after that one day is postmenopause. Getting the terms right makes it easier to describe what is happening to you and to be taken seriously when you do.
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2
HourLife takeaway
Perimenopause is less a slow fade than a few years of hormonal turbulence.
Oestrogen does not simply drift down. It can swing high and low from cycle to cycle while ovulation becomes irregular. That is why symptoms can come and go, and why periods can get heavier or closer together before they stop.
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3
HourLife takeaway
A hot flush is a thermostat problem in the brain, not a weakness of character.
Gunter explains hot flushes and night sweats as a change in how the brain regulates body temperature as oestrogen falls. Seeing them as physiology rather than nerves takes away some of the shame, and points toward treatments that are actually tested.
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4
HourLife takeaway
The way the Women's Health Initiative was reported scared a generation away from hormone therapy.
Gunter argues that the 2002 headlines lumped every woman together, when age and time since menopause change the balance of benefit and risk. In her view, many healthy women with troublesome symptoms near menopause have been denied a reasonable option. Guidance has kept changing since the book came out, so the right choice for you is one to make with a clinician.
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5
HourLife takeaway
Dryness, pain with sex and bladder trouble have a name, and they are treatable.
The genitourinary syndrome of menopause is common and tends to get worse without treatment, yet many women are never asked about it. Gunter covers moisturisers, lubricants and low-dose vaginal oestrogen, which acts locally. Naming the condition is often the first step to getting it looked at.
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6
HourLife takeaway
The neglect of menopause in medicine is a feminist issue, not an accident.
Gunter points to how little many doctors are taught about menopause and how often women's symptoms are brushed off. She connects that to a long history of treating women's bodies as less worth studying. Her answer is information: a patient who knows the facts can push for better care.
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7
HourLife takeaway
The supplement aisle sells reassurance, and the evidence rarely follows.
Gunter is sceptical of herbal remedies, wellness products and compounded so-called bioidentical hormones that are sold with big promises and little testing. Her test is simple: what does good research show, and who profits from the claim? Natural does not automatically mean safe or effective.
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8
HourLife takeaway
Bones and the heart are the long game after menopause.
Lower oestrogen speeds up bone loss and is linked with changes in cardiovascular risk. Gunter treats the menopause years as a good time to look at blood pressure, cholesterol, bone health, strength training and smoking. These are the quiet parts of the transition that matter for decades.
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9
HourLife takeaway
A blood test usually cannot tell you that you are in perimenopause.
Because hormone levels swing so much, a single result can look normal one week and not the next. Gunter explains that for most people over their mid-forties, age and the pattern of periods and symptoms say more than a lab value. Tests still have a place when something else needs ruling out.
Chapter 03
Put it to work
Your action book
Do the setup steps once, then keep the habits going. The setup changes your week; the habits keep it changed after the first good one.
The download puts this whole reading and a printable action book in one PDF: the setup checklist, then a page of real calendar days for each habit, starting on the day you choose.
Set up once
Start a symptom log
Use the tracker on this page or a notebook. Once a week, rate hot flushes, sleep, mood, bleeding and the rest from none to severe, and keep it going for at least four weeks.
Write down your period history
Note the date of your last period and how your cycles have changed over the past year: length, flow, spotting. If you have gone twelve months without a period and then bleed, book a doctor's appointment.
Book an appointment just for this
Ask for an appointment about menopause alone, and a longer slot if your practice offers one. Bring your log and three questions, written down.
Know your heart and bone numbers
Find out your latest blood pressure and cholesterol. Ask your clinician when a bone density scan makes sense for you.
Audit your supplement shelf
List every supplement and remedy you take, with doses. Take the list to your clinician or pharmacist and ask what the evidence is for each, and whether any interact with your medicines.
Keep it up
Lift something heavy twice a week
Put two short strength sessions in your calendar: weights, bands or bodyweight. Muscle and bone both respond to load at any age.
Log on the same day each week
Pick one evening and spend two minutes rating the week. A steady record is more useful in an appointment than a memory of your worst night.
Keep the bedroom cool
Turn the heating down at night, use layers you can throw off, and keep water by the bed. Note in your log whether night sweats are what wakes you.
Chapter 04
The last word
Before you go
Pick one step from the action book and do it today. An idea from a book starts to count once it changes what one ordinary day looks like.
Menopause is not a failure or a disease to be ashamed of. It is biology, and you are owed the facts about it.
That is the end of our reading. Where to go from here, or go back to the full The Menopause Manifesto: Own Your Health with Facts and Feminism page.
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