October is Menopause Awareness Month, which also has International Menopause Society’s World Menopause Day (October 18th). The origins of the actual declaration of October becoming Menopause Awareness Month are a little muddy but suffice to say it shares the month with many other health awareness days and months. These include Breast Cancer Awareness Month, Health Literacy Month, National ADHD Awareness Month, National Physical Therapy Month.
It’s easy to see why menopause can get lost in the mix.
My question is, do awareness days and months actually raise awareness?
Declaring October Menopause Awareness month or even October 18th as World Menopause Day is not the hard part. The hard part is finding if it makes a difference to the women it is supposed to reach.
Does Awareness Lead to Change?
A 2021 systematic review examined 73 quantitative studies evaluating health awareness days, weeks and months. The review found that there was an increase in online activity during those awareness periods, searches etc but evidence of changes in knowledge, behaviour and health outcomes was much less clear.
Let’s think of this as a continuum:
Attention → information seeking → knowledge → behaviour → outcomes
Awareness campaigns seem to be good at grabbing attention and creating information seeking but the impact appears less clear beyond that.
Rhode 2023 says “there is not sufficient evidence to show that they [awareness campaigns] change health behavior by leading to individuals seeking out screenings, diagnosis, or treatment.”
Menopause is much more visible than it was even a few years ago. October produces more articles, podcasts, events, workplace events, and social media. World Menopause Day on October 18th is likely to produce a boost to all of that.
I believe strongly in raising awareness - I wouldn’t write this newsletter, appear on panels or present at conferences if I didn’t. All this increased attention is a good thing. I would argue that we have a long way to go from Attention, and even information seeking to seeing outcomes change.
Information Is Arriving Too Late?
Harper et al 2022 stated that 60.8% of women surveyed reported being not informed at all about perimenopause/menopause before 40. Only 12.3% sought information before symptoms. 68.2% began looking as symptoms started. In a 2018 US study of 1,611 perimenopausal and postmenopausal women aged 40 and older, 65% of those who answered a question about preparedness said they had not felt prepared for menopause.
Women are seeking the information they need but it appears they are doing so after something has changed for them. That’s reactive information seeking not preparedness.
Someone can be aware of the menopause transition. They can know symptoms like hot flashes or brain fog are associated with it. They can even know that October is Menopause Awareness Month but none of that means they understand the menopause transition well enough to recognize what is happening to themselves, a partner, a co-worker or a patient.
What Would Success Look Like?
This creates a question. Who is Menopause Awareness aimed at? Is it women who are premenopausal (those who haven’t reached perimenopause but are approaching it), perimenopausal women, post menopausal women, workplaces, partners, families, healthcare professionals? Because all of these categories have different needs for different information. That information exists, but the evidence shows it isn’t always reaching women before they need it. Whether it is reaching others in their lives is another question.
A male partner might see something mentioned online about Menopause Awareness and not see the connection between that and his changing relationship. A manager might see mention of hot flashes and not connect it to the environment his employees operate in.
Coming back to the question at the beginning - do awareness months actually raise awareness? I think that depends very greatly on how you measure that. Does the volume of content produced during October equal awareness raising? Perhaps better measures would be whether more women recognise possible symptoms before experiencing them, know where to find reliable information, feel prepared for the transition, understand when medical advice may be appropriate, and whether partners, families and workplaces better understand how this transition affects them too.
Ultimately the question is, if Menopause Awareness Month is successful, what should be different on November 1?
As part of my own awareness raising in October I’m presenting at the Global Meno Educa-THON event online on October 16th (10am Central US) - you can attend for free via zoom.
Want to add to the conversation. Leave a comment. I reply to them all.
This substack runs on copious amounts of tea. If you’d like to support it, you could always buy me a cuppa.
I think you pose a really interesting question worth discussing. Menopause awareness is unfortunately not the same thing as solving for menopause symptoms. It's great that many more women (and men) are getting clued into the hormonal upheaval associated with peri/menopause, and the ensuing chaos of disruptive symptoms that may follow, but does normalizing that conversation actually help women feel better during the menopausal transition? I'm going to argue, perhaps not. Women deserve evidenced-based solutions, not paid influencer-hype or questionable suggestions. Unfortunately, I'm not sure the research needed to help women will ever happen because menopause is not a disease to be cured (and therefore drug companies are less incentivized to create and test drugs). It's important to remember that what works for one woman will not work for every woman; there is no one-size-fits-all protocol here. I suspect my opinion will be unpopular, but for the average woman just trying to get through the day (with lack of sleep, brain fog, and increased anxiety and lowered energy), menopause awareness might not actually help much. I would love to be wrong on this one, and I look forward to hearing everyone else's thoughts.