The Menopause Manifesto: Own Your Health with Facts and Feminism

by Jen Gunter

Just as she did in her groundbreaking bestseller The Vagina Bible, Dr. Jen Gunter, the internet’s most fearless advocate for women’s health, brings you empowerment through knowledge by countering stubborn myths and misunderstandings about menopause with hard facts, real science, fascinating historical perspective, and expert advice.

The only thing predictable about menopause is its unpredictability. Factor in widespread misinformation, a lack of research, and the culture of shame around women's bodies, and it's no wonder women are unsure what to expect during the menopause transition and beyond.

Menopause is not a disease--it's a planned change, like puberty. And just like puberty, we should be educated on what's to come years in advance, rather than the current practice of leaving people on their own with bothersome symptoms and too much conflicting information. Knowing what is happening, why, and what to do about it is both empowering and reassuring.

Frank and funny, Dr. Jen debunks misogynistic attitudes and challenges the
over-mystification of menopause to reveal everything you really need to know about:

- Perimenopause
- Hot flashes
- Sleep disruption
- Sex and libido
- Depression and mood changes
- Skin and hair issues
- Outdated therapies
- Breast health
- Weight and muscle mass
- Health maintenance screening
- And much more!

Filled with practical, reassuring information, this essential guide will revolutionize how women experience menopause--including how their lives can be even better for it!

Genres: Nonfiction, Health, Feminism, Science, Audiobook, Self Help, Womens

385 pages, Paperback

First published May 25, 2021

Reviews

[K.J. Charles]

Disappointing. Starts off with chapters of impassioned explanation that we think of the menopause as a bad thing because of the patriarchy and we should embrace our life experience and wisdom and whatever, followed by about 2/3 of the book recommending a wide variety of drugs and medical interventions to deal with the horrors of this ghastly experience. Sure, blame the patriarchy for my elbows hurting.

It's overwhelmingly about drugs/treatments. I'm completely alongside the thesis that the medical establishment has grossly failed menopausal women, but one chapter each on diet and exercise (which the author even notes are far and away the changes that could most benefit menopausees, and ones well within our own powers to control), seems a bit lacking compared to the amount of space given up to hormone therapy etc. Granted I'm approaching this as someone who has yet to need medical intervention touch wood and never takes supplements anyway, so others may find this much more valuable, but honestly, just say it's an explanation of the medical issues around menopause up front.

I also found the avowed feminism quite grating. I blame the patriarchy for a lot of things, but when you get down to bullshit linguistics, you lose me. (Supposedly women have easier menopause experiences in countries that use different terms like 'change of life' or whatever. Please demonstrate how that one is causation not correlation. It comes in a chapter that tells us that Spanish and German people see bridges as respectively strong or beautiful because bridge is a masculine noun in one language and a feminine noun in the other. This is not how gendered languages work and AFAIK has been comprehensively shown not to be a thing.)

Furthermore, and this is where I got really fed up: The author bends over backwards to be inclusive, including a chapter about how menopause allowed human evolution via the power of turning women into grandmothers, ~but we acknowledge not everybody has a good grandmotherly relationship~. But, the book mentions trans men exactly once, in a note that women don't get pregnant from sex with trans men (thanks for that). There is no other mention of trans men in a book that is relentlessly about women's experience of menopause, women's bodies, women's difficulty accessing good treatment. I mean, even a note saying "trans men also go through menopause"? An acknowledgement that she's using 'women' in lieu of a term covering cis women's and trans men's bodies? A recommendation of queer-friendly books, overview of issues for trans men, or simply 'this is outside my expertise'? Not a word.

My search for a half way decent book on menopause continues, though to be honest: get exercise, eat vegetables, whole grains and oily fish, get some sleep, don't smoke, don't drink to excess. AKA do all the things you know perfectly well you should be doing anyway, and how very tedious that is.

[Nataliya · Rating 4 out of 5]

“Women are so much more than just their ovaries, so it’s important to sit back and look at the whole picture for perspective.”

Menopause inexplicably seems like a firmly-kept secret. It will happen to most of that half of the population who were born with functioning ovaries, provided we live long enough, yet it’s mind-boggling how unprepared people are for it, how little do they know about it, how little the society itself knows about it — and how societally it’s often framed as the expiration time for those undergoing it. The “non-hot” undesirable time defined even in its title as resulting from the loss of reproductive capacity, the function to which we - throughout history and sadly, now as well, are dismissively reduced.

“The term menopause came to be before science knew hormones existed. It was never meant to signify a pause. It was invented by a man who felt women should cover their arms and not wear blush—whose book on the subject contributed nothing valuable to the body of knowledge except it left a term that ties women forever to menstruation.”

Women can spend more than half of their lives without any potential reproductive capability, yet while puberty is celebrated (there were debutante balls but no “I can’t ever again be expected to die in childbirth” balls) menopause is viewed mostly as a disease or a transitional state to dying, a time of irrelevance.

“In medicine, men get to age with gentle euphemisms and women get exiled to Not Hotsville.”
———

“When menopause is discussed in Western society, it’s often viewed negatively, as a cruel joke or even as a disease. This stems from the harmful belief that women lose value once they are no long able to reproduce and the false hypothesis that menopause is a biological flaw as there is no equivalent for men who can make sperm into their old age. But if we looked at that argument from another angle we might as well say that men are biologically flawed because they can’t get pregnant or because they develop heart disease earlier than women.”

Jen Gunter takes her trademark strongly feminist and non-nonsense approach to this period in life in the same style as her other books - The Vagina Bible and Blood - and goes through history (no, people who parrot that menopause was unknown to the “ancients” because people didn’t live that long — Ancient Greeks knew when it starts just fine), touching on how the end of direct reproductive capabilities benefitted society survival (the grandmother hypothesis), the changing attitudes to it (usually not good, still) and the history of treatments aimed at making it less symptomatic. She goes into the wide variety of physical and physiologic changes that can happen to many women (and points out over and over again that there is no standard of what it will be like for any individual), the health effects, the recommendations for health maintenance (exercise, bone health, etc as menopause goes way beyond those funny-sounding hot flushes), as well as managing expectations, plus information about hormonal methods coming from a doctor who was trained in the time when HRT was expected and then living through a time when it was demonized and feared and now when her younger colleagues have not always received unbiased training in it.

“If menopause were on Yelp it would have one star.”

She doesn’t view menopause as a disease and she does not take the opposite view to celebrate everything about it as she knows that just because it’s expected it doesn’t mean it’s supposed to be glorious.

Gunter maintains the same narrative style as her other books, so if it worked or didn’t work for you before would be a good indicator whether this one will be enjoyable as well. I’d recommend it as one of those books people should read to have a better fact-based idea of how or bodies work and, for those who will go through these life changes, what to expect in the world of unexpected symptoms.

4 stars.

——————

Also posted on my blog.

[Claudia · Rating 5 out of 5]

"When told by a patriarchal society the story of menopause is one about deserted youth, frailty, and diminished worth. The story I want you to remember is about value, agency, and voice and the knowledge to keep yourself in the best of health while demanding an equal seat at the table.
That's my manifesto."

Another book by Dr. Jen Gunter? Sign me in! I am a huge fan of her previous book, The Vagina Bible: The Vulva and the Vagina—Separating the Myth from the Medicine, which I think should be taught in schools, so when I heard of this one, it instantly ended up on my need-to-read-asap-list.

As I expected, the book is a great source of information - think of anything related to menopause and you'll find it in here. Every topic is dissected and presented under her eagle's eye, from all points of view, with pluses and minuses, and observations based on available studies.

Menopause is much more than just your period stopping, and I think that's the only good thing about it, from a comfort point of view. She takes it step by step and presents all symptoms, possible treatments for its discomforts, diet, exercises, and a lot more.

I was stunned to learn that many women see it as a shame and don't talk about it, or that they feel their sex life, or life, in general, is over: why?! Or maybe there is such a cultural difference between North-American culture and our East-European one? I never heard of a woman here feeling ashamed by it, nor being belittled by men for it.

Anyway, for a medical book, it is a highly compelling read; I could not put it down, and that is also thanks to her writing skills. She explains everything as clear as possible; there is not a single topic to be poorly understood. I think it's a must read for every woman after 40 years old. Menopause is not something that may or may not occur to us, it is something we will have to deal with, and most of the times it comes with a lot of other health problems and discomfort, so it's better to know what to expect.

Dr. Gunter, Chapeau! Again.

>>> ARC received thanks to Kensington Books / Citadel via NetGalley <<<

[Krista · Rating 4 out of 5]

A manifesto is a public declaration or proclamation and we are well past due for a manifesto on menopause as 2021 is the 200th anniversary of the introduction of the word. My manifesto is for every woman to have the knowledge that I had to help them with their own menopause. I demand that the era of silence and shame about menopause yield to facts and feminism. I proclaim that we must stop viewing menopause as a disease, because that means being a woman is a disease and I reject that shoddily constructed hypothesis. I also declare that what the patriarchy thinks of menopause is irrelevant. Men do not get to define the value of women at any age.

Dr Jen Gunter (OB-GYN, women’s health advocate, and internationally renowned author of The Vagina Bible) states in her introduction to The Menopause Manifesto that most women will approach menopause woefully unprepared for the changes they will encounter; societal shame dissuading women from even talking about their experiences among themselves. And as Western medicine has traditionally put most of its focus on men’s bodies and their care, women entering the menopause transition tend to not even get good information from their primary care providers: life-disrupting symptoms are dismissed as “normal” and “inevitable”; treatments offered are one size fit all; and in the US, ongoing cost and duration of medical care can be a deterrent for access. Gunter makes it very clear throughout this book that this lack of information and adequate care can be tied to the patriarchy, and she concludes the introduction with, “It shouldn’t require an act of feminism to know how your body works, but it does. And it seems there is no greater act of feminism than speaking up about a menopausal body in a patriarchal society.” The information that follows is clear and comprehensive, Gunter’s tone is generally informal and engaging, and although I picked this up on a bit of a whim, I’m very glad that I did: all information is power and I learned quite a lot. (Note: I read an ARC through NetGalley and passages quoted may not be in their final forms.)

There’s a common fallacy that women were never “meant” to experience menopause. This assertion claims that menopause is an accidental state that resulted from longer life expectancies from modern sanitation and medicine, allowing women to live beyond their ovarian function. A benevolent patriarchal society allowed the failings of women — menopause — to be uncovered. The tenacity of this myth is testament to the impact of patriarchal dogma. Erasing menopausal women from history is literally reducing women to the functioning of their uterus and ovaries. When something feels off balance I replace the word “women” with “men” to see how it sounds. If it sounds reasonable I’m more likely to consider the hypothesis worthy of further evaluation, but if we would never speak about men that way, then there’s going to be a lot of side eye on my part. Has anyone ever in the history of medicine ever uttered these words? “Through good sanitation and health care, men are now living long enough to develop erectile dysfunction?” Doubtful.

I knew so little about menopause that I didn’t even realise that only humans and toothed whales experience it (and for killer whales, it seems to confer some kind of an advantage: female orcas usually live to be around ninety, and males just to fifty), so that does beg the question: why menopause? Dr Gunter proposes the “grandmother hypothesis” — that human women (evolutionarily speaking) stop reproducing in order to help their daughters raise their own children, sharing their hard won knowledge and wisdom (this seems to be true for the whales, too) to the benefit of the species — and I suppose this shifting role is better than being consigned outright to the rubbish heap. Whatever the reason for the menopause transition, women’s bodies will go through a range of unpleasant experiences (from hot flashes and irregular periods to insomnia and incontinence) and Gunter stresses that a doctor should describe such experiences as “typical” instead of “normal” (where “normal” implies that these are just things women need to deal with instead of addressing). In some cases, women suffering from life-altering symptoms may be prescribed MHT (menopausal hormone replacement) and Gunter goes into interesting detail about the history of hormonal treatments — including an explanation for why it’s no longer pejoratively called “HRT” (hormone replacement treatment; nothing is being replaced because nothing is failing) — and I appreciated that she explained why the small increase of risk for breast cancer can be offset by estrogen’s role in preventing the more likely onset of cardiovascular disease or osteoporosis. I also appreciated the information she shared about so-called natural alternatives (hardly natural and never effective), the uselessness of a daily multivitamin, and the danger of pharmacist-compounded, rather than pharmaceutically manufactured, hormone creams (why do these even exist? Even the so-called libido-enhancing “scream creams” sound like snake oil.)

The best way to approach menopause is to be informed so women can understand if what is happening is menopause-related; what diseases she may face due to her combination of genetics, health, and menopausal status; and what is the best way to achieve quality of life and health and how to best balance those goals against any risks. This can only happen with accurate information and without the prejudice of the patriarchy.

There is a lot of good, specific information in The Menopause Manifesto, far beyond what I took away as general interest, and I can totally see how it could be a useful resource for a woman to consult before seeking medical advice. I’m glad this exists and that I read it.

[Emmalita · Rating 2 out of 5]

I have been eagerly anticipating both menopause and The Menopause Manifesto: Own Your Health with Facts and Feminism for quite a while, and right now I’m disappointed in both. I know Dr. Jen Gunter knows that not every one with a uterus is a woman. I have seen her speak inclusively about trans men and nonbinary people. She also started the hashtag IfMenHadPeriods, which, well, some men do have periods. Unfortunately, The Menopause Manifesto seems to be only for women, and this undermines her stated desire to use facts and feminism to dismantle the patriarchy. In 2021, centering a book about menopause solely on women feels like a deliberate choice. I don’t know what her purpose is in ignoring trans men and nonbinary people, but the result is I cannot recommend or support this book.

It particularly bothers me that in the introduction she declares the irrelevance of the patriarchy’s opinion on menopause while clinging to patriarchal definitions of gender. I am a cis woman and I have always resented people telling me who I should be because my body has female reproductive organs. It would be even more frustrating to have female reproductive organs and be defined as a woman even when you know you are not. Feminism that allows people to be defined by their bodies is going to fail in it’s goal.

It’s a fact that not everyone with a uterus who will go through menopause is a woman. The feminism that insists on gender binary is not trying to dismantle the patriarchy. It’s trying to rent a room in the patriarchy while slamming the door on trans, nonbinary, and genderfluid people. It won’t work. We have over a hundred years of a feminist movement that shows dismantling the patriarchy just a little gets women nowhere. Women won’t have equality until everybody has equality.

I am crying out for more conversation and science based knowledge about menopause. I would like to know what the hell is going on with my body as I transition into menopause. But, I can’t trust a woman physician who directs her information only at women any more than I can trust a man telling me about my body. I can’t trust that she’s seeing facts and not building a reality that suits her vision.

I really want to like this book. I want to be able to recommend it to my friends, but I can’t.

I received this as an advance reader copy from NetGalley in exchange for an honest review.

[Donna Craig · Rating 1 out of 5]

Another menopause book DNF’d. I guess it is the thing now—to be angry about menopause and blame the patriarchy. I’m just not buying it. No one I know is angry about menopause. Who wants their fertility to continue into their fifties? Why aren’t women writing about how exciting it is to step into the next phase of life? I won’t be reading books about menopause that label themselves as feminist. It seems to be code for angry and resentful.

[Hannah Greendale (Hello, Bookworm) · Rating 3 out of 5]

Women need 25 g of fiber a day and men 38 g—I'm sure there is a great joke in here about men being more full of shit. A snarky and informative book, but Dr. Jen Gunter is so busy being (understandably) angry at the patriarchy, that she forgets to celebrate women's bodies.

Another amusingly absurd quote: I could write a ten-thousand-word essay on how wipes are a combination of infantilizing women (they're meant to remove stool from a baby's bottom; women are not babies and are capable of wiping with toilet paper or using a bidet), a remnant of purity culture (the cleanliness, or faux cleanliness of wipes means a woman is "good"), and the obsession of a patriarchal society with degrading women based on their normal bodies (if women need their skin prepped for men and the reverse isn't true, then the conclusion is women are inherently dirty). If wipes were about genital hygiene and not oppressing women, then there would be shelves of these products for men with scents such as Dick's Delight, Sunset Escape, and Puppy Paws.

[Kaethe · Rating 5 out of 5]

Jen Gunter on Twitter is my hero!

Her books are excellent and I agree with what Ayelet Waldman said of The Vagina Bible: The Vulva and the Vagina—Separating the Myth from the Medicine: you need to read this book "if you have a vagina or spend any time at all in reasonably close proximity to one."

I wish I had this book in my early 40s so I could be forwarned about what to expect, know how to discuss symptoms with my doctor, and know how to deal with the transitional chaos and the flooding. I really wish I had known about the flooding ahead of time. Warning: surfing the crimson tide is one thing, but after years of the same waves there will come random flood tides. Be prepared: these will be super plus AND extra heavy overnight situations.

Also it's good to know someone who isn't afraid to call out bullshit on medical advice from celebrities or misogyny on the internet. Gwyneth knows what she did. Also Oprah, and Suzanne Somers. Dr. Jen has zero toleration for doctors who are ill-informed, fat-blaming, or otherwise unacceptable.

Since it wasn't written yet, I've been reading this after the fact, and it is still helpful in practical advice for dealing with my much-interrupted sleep at night, which of course I thought was just me.

And the science geek in me really loves that, when applicable, she includes racial and ethnic breakdowns of the studies, as well as including disparities in outcomes by demographics.

Read this and be well.

Somers spelling corrected 30Apr2922

***

1 January 2024

Why, yes, I did reread it to go back over some material and take notes, because library copy.

Library copy

[Tanya · Rating 3 out of 5]

I really enjoyed Gunter's The Vagina Bible , so I jumped at the opportunity to read this follow-up, even though I'm still a good twenty years away from having to deal with these issues.

The word "menopause" first appears in an 1812 paper by French Dr. De Gardanne, but how or why it became widespread is not exactly known (and Gunter makes a great case for why it is less than ideal). Before "menopause" a variety of other terms were in use, from the good "change of life", to the not-so-great "middle-age decline", to the positively awful "women's inferno", "women's winter", and "death of sex".

Much like her "vagenda" in The Vagina Bible, her menopause manifesto aims to dispel myths rooted in misogyny and empower women through knowledge and facts with a readable blend of expert advice, humor, personal anecdotes, and historic perspective. As expected, this proves harder in this volume: The only predictable thing about menopause is that it's unpredictable, and there is an even greater amount of taboo and misinformation circulating about this topic than any other phase of women's health, all compounded by often inconclusive scientific data due to a lack of research.

With engaging, accessible writing, Gunter goes into the biology of menopause, as well as the pros and cons of available (somewhat US-centric, because of the brand names given) treatments and therapies. Some chapters were denser with information than others, but there is, again, a concise "bottom line" section at the end of each chapter, summarizing the most important take-away points. A lot of the contents were complete news to me, and I think that even just the explanations of symptoms would be reassuring to many who are going through it and feeling alone. There are practical tips and strategies for lifestyle changes that have scientifically proven, positive effects, and don't require a medical professional, such as dietary changes and physical exercise. Because of this, and the sensible way it is structured, it would be a good reference book to have on hand, and I'd recommend it to anyone who is approaching the menopausal transition, is currently going through it, or is living with someone who is, and wants to understand this change of life, and be supportive.

Menopause is a planned change in a woman's life, just like puberty, not a disease, and if it was openly discussed and demystified, many women wouldn't suffer bothersome symptoms in silence, either assuming it was something they had to accept as normal, or worse, being dismissed by medical professionals for the same reason after trying to get treatment.

—————

Note: I received an ARC of this book in exchange for an honest review.

My Dr. Jen Gunter reviews:
The Vagina Bible · ★★★★
The Menopause Manifesto · ★★★
Blood · ★★★★

[Louise H's Book Thoughts · Rating 5 out of 5]

I found The Menopause Manifesto to be an informative and entertaining read. It is clear that Dr Jen Gunter feels passionately about the topic, along with the importance of the medical profession understanding how the menopause affects countless women.

As a woman of a certain age myself it can be difficult to find reliable information that is useful, non judgemental and is offered by someone who clearly knows what they are talking about. Whilst the internet is a mine of useful information, it is also a font of misinformation, old information and quackery. Medical sites, such as the NHS website in the UK, tend to be quite dry, overly factual and don't always offer more than the bland, generic advice that you will hear from most male doctors. Reading this felt like being amongst friends, ones who are willing to share the good, the bad and the ugly of menopause along with their own personal insight and advice of what they have found helpful.

Every woman will experience menopause differently, yet treatment is often very generic. This book made me feel more confident in understanding what I am going through, how I can deal with it. This was all achieved with a writing style that is warm, friendly and humorous, whilst also being educational and packed full of useful information.

[Shelleyrae at Book'd Out · Rating 4 out of 5]

“I demand that the era of silence and shame about menopause yield to facts and feminism. I proclaim that we must stop viewing menopause as a disease, because that means being a woman is a disease and I reject that shoddily constructed hypothesis. I also declare that what the patriarchy thinks of menopause is irrelevant. Men do not get to define the value of women at any age.”

After 38 years of regular but long, heavy and painful periods (minus 4 successful pregnancies and three miscarriages), I’ve actually been looking forward to menopause in some ways. At 48, I have now been experiencing the symptoms of peri menopause for about 18 months, and while I expected some of the more well known effects such as hot flushes, insomnia and irregular bleeding, I now realise, thanks to Jen Gunter and The Menopause Manifesto, that the inexplicable joint pain I have been suffering may also be related.

For the uninformed, menopause occurs when there are no more follicles in the ovaries capable of ovulating, meaning there are no more eggs, and menstruation ceases. The average age when this happens is 50-52 years. However the transition to menopause (often referred to as peri menopause) can start several years earlier, and the length, and the severity of symptoms, may vary significantly from woman to woman. There are dozens of common symptoms and conditions associated with menopause from an increased risk of heart disease to a decrease in libido, but they don’t just occur in a vacuum - they may be influenced by general health, age and lifestyle factors. Gunter provides detailed but mostly accessible medical facts about the biological process of menopause, its medical ramifications, and a comprehensive guide to treatment options. Useful chapter summaries in point form are provided if you are inclined to skim the denser scientific material. Personal anecdotes and blunt observations from the author ensures the material is rarely dry.

The Menopause Manifesto not only delivers the science but also explores how menopause is perceived (primarily in America and similar cultures). Gunter includes discussion about patriarchal medicine’s tendency to dismiss or minimise the experience of menopause, the culture of shame attached to the transition, and the lack of education surrounding the process. The feminist slant of the book is unapologetic as Gunter encourages women to empower themselves with knowledge so as to better advocate for their own health.

The Menopause Manifesto is a comprehensive, practical resource for all in possession of female reproductive organs. I wish I had read something like this five years ago and strongly recommend that women aged from in their early forties consider educating themselves about menopause well in advance.

[Bookworm · Rating 3 out of 5]

I was expecting something different. I think this book is fantastic if you are a medical professional wanting to learn more about how to treat patients during the menopause years. It includes many different ailments that women experience and how to treat them. Lots of information about medications and when to prescribe what. I found it too technical though. And to be honest, it left me feeling depressed because there are so many health problems women can experience during and after menopause that I didn’t even know existed! I started worrying that I might one day suffer from some or many of these. Yikes!

[Marci carol · Rating 4 out of 5]

Ugh it didn’t save my review! The first half was a little dry but relevant info for some. I really enjoyed the second half. I wish I had read this earlier. Thank you for validating womens menopause needs and answers to age old questions. Thank you for recommending when to look for another provider and what resources to find credible. I wish I’d read this sooner. Thank you for not dismissing women’s health and saying ,” just deal with it! You should be grateful!” Thank you for your research and being a voice for those who need one. I feel much better either way my new choices after reading this book and understand risk vs benefits.

[Sally Kilpatrick · Rating 5 out of 5]

Lots of great information here. I would say too much information, but I'm not sure I believe in such a thing. That said, those who are suffering and looking for specific solutions might be frustrated with discussions of history. I, on the other hand, found the book to be empowering through knowing the history of how menopause has been perceived and treated.

Gunter is mad, and I don't blame her. Throughout the book she calls out both society and the medical profession for how they've treated--or not treated, in some cases--the very natural menopause transition.

At the end of the book she talks about her rage and says "The source of my rage was this reproductive reckoning. The realization that menopause was just one more way that the burden of perpetuating the species is unequally borne by women and one more way that our biology is weaponized against us. It is the ultimate gaslighting because it's this biology--from puberty to grave--that literally birthed humanity as we know it."

Honestly, I'm pretty salty, too. The fact that medical research is so damned skewed toward men means that Gunter only has so many suggestions to give because she wants to give good information with scientific backing. Again and again, she points to "cures" for menopause that haven't been properly studied. Again and again, she declares that women deserve better.

Come for the history of menopause and for what facts she can give us on how to ease symptoms and generally make our way through a fraught reverse puberty that not a one of us asked for. Stay for her reminder that menopause has actually contributed to the longevity of the species, most specifically through how grandmothers have helped mothers keep the family hearty and hale. As she further says in the conclusion, "Many women have been conditioned to fear menopause as an expiration date for relevance and as a sign of weakness only because that is what men thought. In fact, we have this amazing data that tells us that menopause is the opposite--a time when historically women contributed great things to society because of their knowledge and their age....When told by a patriarchal society the story of menopause is one about deserted youth, frail, and diminished worth. The story I want you to remember is about value, agency, and voice and knowledge to keep yourself in the best of health while demanding an equal seat at the table."

Side note: Before reading, I heard complaints that this book did not address the trans community. Early on in the book, Gunter noted that all of the studies she could find to cite involved women who have or had ovaries. She also noted that "More research is desperately needed." She does give what information she can in that early chapter.

[Camelia Rose · Rating 5 out of 5]

When I was a fresh faced college graduate, I had a particularly nasty colleague who happened to be a middle-aged woman. I didn't hesitate to hull "menopause"--the most powerful verbal insult I could think of--at her. It didn't take long for me to feel ashamed. While I still think she was cruel, attributing cruelty to female hormones or the lack of is a harmful way of thinking.

Dr. Jen Gunter has everything you need to know about menopause. Hot flushes? Bone health? Sleep disturbance? Her view on MHT (Menopause Hormone Therapy) is insightful and nuanced. Yes, this book is infused with feminism, and no, it doesn't make it less scientific.

"Apparently there is nothing of lower value than an aging woman’s body, and many in our society treat menopause not as a phase of life, but rather as a phase of death. Sort of a predeath."

"When menopause is discussed in Western society, it’s often viewed negatively, as a cruel joke or even as a disease."

"Interestingly, in some ancient Greek societies postmenopausal women were appointed as priestesses (menopause was viewed as a renewed virginity affording the level of purity a woman needed for priesthood)"

"So the question should not be why does ovarian function and consequently fertility have a hard stop around fifty? Instead the question we should consider is how did women become so physically successful that they began to live beyond their reproductive capacity?"


The language is clear, friendly and funny at times. Highly recommended for every woman of 40+ or women of all ages, really.

Another cool quote:

"A very cool and sort of mind-blowing fact is when your grandmother was pregnant with your mother she also contained the primordial follicle inside one of your mother’s ovaries that was destined to become you."

[Alexis · Rating 2 out of 5]

The Menopause Manifesto isn’t a manifesto. It would perhaps have been better for Dr. Jen Gunter, author of The Vagina Bible, to follow her previous branding and call this second book something like The Menopause Bible – which invokes a lot of information and story about which there is the need for interpretation, debate, and critique as a key part of faith.

I am really excited by the increasing number of books and blogs talking openly about hormone transitions of all sorts, and how they can be made less bad. I’m a feminist who studies transformations in medical practice, and I came into this book ready to cheer for anyone attacking medical sexism, especially the specific form that sexism takes in how it talks about menopause. I’m a nerd and I love there being uncountably many books about stuff I’m interested in. I’m an easy sell!

So, I’m disappointed in how strongly I cannot recommend this book to you. I was about to write, “to you feminist readers of this blog who think critically about fitness, many of whom are nonbinary, or trans women, or fat, or disabled, or asexual, or cancer survivors, or not parents, or all those things at once.” But really, having to put all those caveats in means that pretty much wherever you land on these matrices of experience the book will stab you on one of your other vectors of awesomeness.

My impulse to say: “If you’re thin, cis, straight, monogamously coupled, have had no problems having and bearing children, never had chemo related early menopause, and if you’re otherwise are this book’s normal, you can read this book” is actually really awful. I know that the particular brand of liberal feminism that means you can write a whole book, with the best will in the world, as though all the rest of us are sidenotes, actually doesn’t help even people in the supposed centre of the frame.

And I believe that Gunter really, really means well! She has taken on Goop around its antiscience grifting, the Toronto Star about bad medical reporting, and regularly engages various randos on the internet about health generally. The Menopause Manifesto has some great parts. Gunter is very sympathetic to taking hormones, especially in the perimenopausal years when they can actually help with vasomotor symptoms (hot flashes and night sweats, for example), and so she has detailed accounts of various hormone options and what they do. So those chapters will be helpful if you’re in perimenopause, having those symptoms, and interested in hormone therapy to help with them – it explains a lot.

The other very great part of the book is a list of signals for when to walk out of a doctor’s office around menopause stuff, because these things indicate that they are either quacks or so behind the science as to be potentially harmful to you. That list includes:

salivary hormone level tests
hormone level testing to guide therapy
recommending only hormone therapy and not the other things that can help menopause symptoms
prescribing topical progesterone cream to offset the dangers of transdermal or oral estrogen
selling supplements or products.

(Re this last one, here is your reminder that it’s always a good time to read or reread Middlemarch and to reflect on the long history of people trying to practice integrity and care, including in and around medicine.)

But one of *my* signals for when to walk out of a doctor’s office, unless there are really really specific conditions that actually involve weight, is when they say:

To solve these [waves hand] health problems, you should lose weight!

Gunter does this All. The. Time in this book. It’s SUPER WEIRD! Even when she’s talking critically about how sexist weight loss advice is, she reproduces it.

Doctors in general have a tragic axiom lock around weight – they struggle so much to look at fat people and treat our actual health, even when they know that fat isn’t the reason we’re in their office. They can say in one breath that standard measures, like BMI, are unscientific and useless and in the next breath reiterate just slightly updated versions of dodgy, unscientific pap about fat. Gunter goes for “visceral fat” and waist circumference.

Many doctors, Gunter included, go on from using bogus measures of fatness-as-illness to suggest weight loss as a good remedy for what ails us (in this case, menopause). In a book so critical of pseudoscience and from someone aware of the problems with generalizing health advice from a single person’s experience (Gweneth Paltrow might have good personal results from jade vaginal eggs, but she oughtn’t market them), it’s so odd to see Gunter recommend that her readers do what she does as though it will work for us.

She says, “Admittedly it’s a work in progress and I’m not recommending this approach for anyone. But experts say that journaling is a low-risk intervention that can help with weight loss and weight maintenance” (83). Which experts? Where are the studies? And it’s jarring to have her acknowledge that weight loss advice is sexist, and political, that weight interventions overwhelmingly fail, and proceed to give the usual pablum weight loss advice in the chapter “Metamorphoses of Menopause” (Watch what you eat! Cook at home! Don’t eat ultra-processed food!). I’m here to say, I’ve done or do all of these things and I’m still fat! And I’m good with that!

The standard move here is to follow “I’m fat” with “and I’m really healthy!” But appealing to health as a foil for the “it’s bad to be fat” line is just another trick. Many of us are never going to be not sick, and all of us deserve solid help for problems with menopause, fat or thin, sick or not.

Gunter writes:

“Obesity is a medical condition, but it’s one of the few in which we assign or imply blame to the patient. It’s also one of the conditions where medicine generally provides the least amount of guidance and support. What if we treated people with cancer or high blood pressure the same way? Can you imagine a world where a provider would give the diagnosis of breast cancer, imply it was the person’s fault, and then send her out into the ether to find help?” (85)

So, you can see that Gunter thinks that people should have more and better support around fat. But, as readers of this blog know well, obesity is not a medical condition – fat is not a disease. Even if it were, the precise approach to fat that Gunter here excoriates is pervasive in the book, not just in that chapter. Weight loss is suggested as a remedy for almost every problem perimenopause and menopause might throw at you, and it is named as a potential beneficial side-effect for almost every medical intervention Gunter recommends. I was going to try to give you pages to avoid if you want to get some of the helpful stuff from this book but not be sent down a fat-hating, body-surveilling wormhole and I’m afraid I got overwhelmed. So, general content warning, I guess.

But then content warning for so much more. I know I’m harping on this, but it really is shocking how Gunter is able to identify sexist medical inaccuracies and perpetuate them in the same breath and in the name of feminism.

Aside from leaving when medical professionals talk go first to fat, I have a couple of other signals to walk out of offices – when people go to evolution to explain health advice they’re giving me, when all their heroes are straight and cis, and when they have no disability analysis.

These are more signals that make me wish I’d walked out of this book, but, well, I guess I can offer you my experience. It is just hopelessly, deeply, pervasively committed to a particular understanding of evolution that grounds the worth of menopause in a narrative of “the grandmother effect” (a real and good thing, just not something that we should limit our explanatory scope to). This narrative pervades the text in a way that brings along with it a whole cluster of things around reproduction as the point of human existence, bundled with a whole bunch of stuff around evolutionary fitness. Making menopause a good thing because evolution just tangles us back up in eugenic narratives of personal fitness as a subset of the health of the population. This sucks.

The Menopause Manifesto is deeply straight. Its normative subject is someone who is going through menopause in her forties to fifties, with a uterus and overies, who is having sex with cis men. I feel it really minimizes cancer and decisions people might make around cancer risk that do not ignore other problems postmenopausal people face, such as heart disease and osteoporosis.

All of these grate the more because Gunter references misogyny over and over, and she is able to identify the sexism in her archive even as she reproduces it. It is actually very possible to write a book about menopause that does not do these things – Heather Corinna has done so just this year!

I think that all of us should be demanding books that apply to and help women think about their experiences but that at the same time resist gender oppression generally. Acknowledging that non-binary people exist and go through menopause, acknowledging that trans men exist and go through menopause, that some people have had early menopause because of cancer or other medical treatment, acknowledging that not everyone wants to have vaginal sex, that not everyone needs to have a pregnancy test, and so on – these things actually help us fight sexism and oppressive gender norms. (Sophie Lewis’s book Full Surrogacy Now! offers a parallel example to Corrinna’s What Fresh Hell is This?, giving a political analysis of pregnancy without restricting it to women. It’s possible, and great!)

So, closing sidebar, not the point of the book but a plea for more science. Anyone who menstruates and weight lifts who I know probably has been interested in studies about lifting and menstrual cycles. There is data that training hard during your follicular cycle, the bit between when you start bleeding and when you ovulate, has strength benefits. I remember my aunt Karen Moe Humphreys, a two-time Olympic swimmer, gold-medalist in the butterfly, who has been a fierce and impressive athlete her whole life and continues to get stronger in her sixties, reflecting on her strength gains post-menopause and saying that she wished people would research this more.

Gunter, and everyone else writing about menopause, talk often about how perimenopause can involve higher levels of follicule stimulating hormone circulating in our bodies – but they do not make the connection to work on weight training during our follicular cycles as helpful. Rather they take it as given that menopause will make us weaker, less muscly, more fragile, no matter how much we exercise. So, I’m interested in someone doing more science on this, but in the absence of good studies, I’m personally going to decide that perimenopause is a good time to get incredibly strong.

And whatever you’re deciding to do with your perimenopause and menopause, I just want to say that you can do it just as you are, and you deserve help and care that doesn’t hate on any part of you.

[Emily M · Rating 4 out of 5]

I was really liking the level of scientific detail when I remembered the rather mixed reviews that initially caused me to pick up a different book when I started seeking info about menopause. I went back to those reviews and…yeah, there are for sure some valid criticisms (including leaving out queer people to a weird degree). However, I still appreciate what Dr. Gunter has produced here. So, I’m going to try and address both the good and the bad and how I came to my overall rating of 3.75/5.

First off, someone suggested this should have been called “The menopause bible” (to match her other book, “the vagina bible”), because this thing is DENSE with information, whereas “manifesto” suggests more personal story and/or political statement. And, as I say, I love me some scientific detail. I saw some reviews complaining how long this is on audiobook…DO NOT do that to yourself! This is not a “read cover to cover” book, and definitely not a “listen in the background while cooking or driving” book; this is a reference book with occasional witty asides, and it should be treated as such.

For instance, I learned that periods can get much, MUCH heavier as well as more irregular as one goes into menopause, and found myself asking: “But what if you are already taking hormonal birth control to reduce period heaviness and pain?” I jumped to the section on contraception and found out that, supposing you tolerate the pills well and don’t have certain risk factors, there is no reason not to keep taking them into your mid-50s because they can help avoid heavy and irregular bleeding, as well as potentially having benefits for bone health and hot flashes. Sweet! Likewise, you don’t really have to sit there and read a list of treatments for a particular condition if it doesn’t pertain to you – you can skip it for now and move on!

Thus, the “facts” side of the promise on the cover is well delivered (with some important exceptions I’ll discuss next), covering most of the current state-of-the-science. I would actually have appreciated going all-in with numbered end-notes, instead of just “selected references”…because it is good to be able to check the study associated with a particular statement, even if most users probably won’t! Dr. Gunter frequently reminds the reader how one size doesn’t fit all, and that it is wise to look into the details of what kind of testing has been done on particular interventions. She also does a good job of putting risks in perspective. For instance: “The lifetime risk of breast cancer is 15 percent. The lifetime risk of a hip fracture is 17 percent” A lot of people are MUCH vigilant about the former…but this reminded me I know more people who have died or been incapacitated by a hip fracture than by breast cancer! Likewise the always useful comparison of increased risk of blood clots from using birth control (minor) vs the risk from giving birth (HUGE)…and of course the risks and benefits of different hormone treatments for those of different ages or pre-existing risk factors.

The “feminism” part of the book comes mostly in the form of discussion of how patriarchal attitudes have shaped research, practice, and language when it comes to menopause. And Dr. Gunter is absolutely right that this needs to change faster than it has been. However, the most glaring flaw of this book is its lack of intersectionality in the facts and feminism.

How does this manifest? Often in opportunities that were right there but just not taken. For instance, it is mentioned that there can be disparities in timing of menopause or incidence of certain conditions between racial/ethnic groups. It is also mentioned that stressors such as childhood or sexual trauma can affect certain health outcomes. I know that some studies have shown that racism is a stressor that can affect health outcomes…but this is not mentioned as a potential cause for those differences. Likewise, while readers are briefly reminded that P in V sex is not necessary for satisfaction – and that in fact lesbians have more orgasms on average! – not only is there no direct discussion of issues that may arise for Sapphic couples in menopause, but the FIRST suggestion of what to do if V pain makes sex difficult is to try the back door. Which…OK, you could, but maybe ask some of those satisfied Sapphic folks, because that wouldn’t be OUR first suggestion! In fact, because the benefits for the woman’s pleasure aren’t described, it feels like more of a concession to her presumed-cis-man partner. Not that that’s an entirely bad thing (people should want their partner to be happy), but if I’d been writing this book I’d have pointed out how often women’s bedroom difficulties at any age (including pain) come from men being too damn impatient!

Most glaringly, given that this was published in 2021, is that there is ZERO mention of trans men or nonbinary people who also experience menopause – except as an aside that if your partner is a woman or a trans man they can’t get you pregnant (duh). They aren’t mentioned negatively, mind you, but the exclusion is weird given that Dr. Gunter’s prior book, ‘The Vagina Bible’, reportedly mentioned issues specifically affecting trans men or trans women who’ve had a vaginoplasty. Granted, there has been limited research on menopause in trans men specifically, as well as in many other small minority populations (eg how do hot flashes affect autistic people with sensory sensitivities?). However, this book could have at least mentioned that people who aren’t women can experience menopause and may experience different issues…including dysphoria triggered by how menopause is considered only a “women’s issue”. Even as someone who bounces between “she” and “they” (and who thus usually doesn’t mind being read as a woman), I would have enjoyed the reading experience more if every third or fourth sentence, even, had been “People going through menopause may find” instead of only “women” as a descriptor - so I can only imagine how grating/invalidating a trans-masc person would find it!

The concluding section also seems to lose the plot a bit when it comes to the argument of what is social and what is biological. We get lines like “The price of evolution and all that we have achieved due to brains and mobility literally depend on women bearing an unequal physical burden. That women have more challenging biology than men isn’t exactly a secret; after all before the Affordable Care act was passed…being a woman was essentially a pre-existing condition.” And, like…what happened to all the talk about how menopause ISN’T a disease, and reminding readers that men have higher risks of certain conditions? Sure, periods and dangerous childbirth and hot flashes are not great – but women still outlive men on average! And how insurance companies categorize things is for sure a social construct! In fact it says two paragraphs later that “Women are gaslit into believing that their bodies…are problematic”. IS THAT NOT WHAT YOU WERE JUST DOING?!? Then there’s a bit about how women do more housework etc and, yeah, sure – patriarchy. But then it says “Taxing our bodies to fix the gaps seems to be encoded in our DNA” and NO! We’ve been socialized to fill in the gaps for men who haven’t been socialized to do the same! The ending paragraph about remembering your worth is good, but the rest is all over the place. Perhaps this disjointedness was a consequence of that conclusion starting as a “primal scream”!

At least one reviewer suggested reading What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You instead on those grounds (the lack of trans rep in particular). But I find the two books are not substitutable. I love the dark humor of WFHIT, and its inclusiveness, but it does not have the same level of useful “what exactly to ask your doctor” detail as this book has. While both have personal experience with menopause to draw on, Heather Corinna is a queer disabled person who is an activist and writer, Jen Gunter is a cis-het doctor (with some of the biases that come with that), and that difference comes across very obviously in how the books are written. And, whether Gunter points it out or not, a lot of the rich information contained here will apply to anyone with the relevant anatomy. Hopefully, someone soon will write a book that includes both things! In the meantime, if you are on the fence about how this book might make you feel, you might try what I did: Starting with WFHIT as an easier-to-read, more inclusive introduction, and then picking up this one from the library to test out without commitment.

[Isil Arican · Rating 5 out of 5]

Vagina Bible was one of the best books I read, so I was looking forward to publication of The Menopause Manifesto by Dr. Jen Gunter again and it did not disappoint! Not to mention how timely it was for me to read it as a woman who started her ups & downs journey into the realm of peri-menopause.

I love Jen Gunter's style: She is factual, informative, fun and can explain complex medical concepts with a plain language and able to fill the gaps between clinical data & social implications, so we can question not only the biological/physiological facts but also the preconceived ideas the society imposes on us regarding women's health.

Menopause Manifesto should be a handbook for every women going through a major stage in their lives (and their partners). It explains the changes in the body, the reasons behind it as well as how to approach various solutions & treatments available. While doing so, it provides science based explanations along with lots of food for thought on how menopausal women are treated in our patriarchal cultures. She provides comparative examples to show the absurdity of some claims & suggestions. For example many women will develop fibroids by the time they reach to menopausal age, and in some cases they are suggested to get a hysterectomy (removal of uterus)- which is fine and potentially a good approach for some. However they are also mostly advised to get oophorectomy along, for the sake of 'preventing future ovarian cancers'. She points out the absurdity of this, by comparing a similar situation in men. No men has been ever offered to get their testicles removed while -say during inguinal hernia operation as a preventative measure for testicular cancer. She gives a great tip related to this biased approach in society: If you are in doubt replace women w/ men in these advices and see how that sounds. If it sounds ridiculous, re-evaluate the advice given to women. Most likely the advice is due to the fact women are seen as 'incubators' in a patriarchal society and the advice revolves around their usefulness.

Dr. Gunter explains the changes happening in the body through menopause journey, goes into the details of preventative strategies for muscle loss, bone loss or other symptoms, details potential interventions from surgical options to hormonal ones with their pros and cons, and explains how 'one size does not fit all' because it is such a personal decision for each woman. She also dissects some claimed 'remedies' that are not supported by science and data in detail, and cautions the reader against them.

As a person who is trained to be a medical doctor, many of the physiological/clinical aspects of this book was known to me to an extent. But I still learned so many new things and found this book extremely useful and fun to read. It even helped me to answer some questions I had on my own health and well being, the questions I was unable to find a solid answers from other resources, including my own doctor. As a result, I am much more informed and feel empowered to make certain decision on how to approach some health issues I am having, or what kinds of support I would need as I step deeper into the realm of menopause.

Vagina Bible was a major gift list item for many of my female friends, and now Menopause Manifesto is also added to the list of amazing gifts I will consider giving to my close age friends.

The last paragraph tells it all:
"When told by a patriarchal society the story of menopause is one about deserted youth, frailty, and diminished worth. The story I want you to remember is about value, agency, and voice and the knowledge to keep yourself in the best of health while demanding an equal seat at the table. That’s my manifesto."

A solid five star book.

[Angela · Rating 2 out of 5]

I listened to this on audio because I wanted to add it to my list of recommendations for yoga students entering menopause.

It is so long - 13 hours.

A large portion of that duration is precise, easy-to-understand descriptions of physiological processes. I learned so much, about cardiovascular health, hormonal changes, thermoregulation, and so on. Complex topics are explained in ways that are not overly simplistic, and truly are fascinating. Clearly the author is fascinated by the material, in a way that makes her a great teacher of it.

So I'm really glad this book exists, for this reason. It's a direct, easily readable way to brush up on a lot of health topics that otherwise you'd rely on the internet and your doctor to understand. Most people will want to have this level of understanding of their own systems before interacting with any medical bureaucracy around menopause time. For a long time, it wasn't so easy to just know what to expect and how to interpret doctors' advice. I'm grateful that access to information like this is getting easier all the time now.

However, I'm concerned this book would severely annoy many readers. At least if you went in expecting the author to be a certain kind of ally. So I'm hesitant to recommend it. Especially since - given the highly marketable nature of this topic (on which more below) - there are likely to be other entries in the market soon.

There are three big things going on in the book that I would expect to distract most people from the science education.

1. It has a lot of words about how patriarchy is bad, but most of the book is about strengthening whatever it is the patriarchy might be. The first place this is apparent is in the foreword, which says some words about being trans-inclusionary.

But the entire book is a very hard core trans-exclusionary project. Paragraph by paragraph, it transmits a kind of feminism that is not only a handmaiden to capitalism and specifically the pharmaceutical industry, but also a kind of feminism that reifies the gender binary.

Whatever patriarchy might be, it's definitely fortified by ideological projects such as this.

2. It's an advertisement for the pharmaceutical industry.

The author drops the idea of "lifestyle factors" for justifying HRT early in the text, and spends many chapters subtly justifying this before getting into the big sell. We're also carefully urged not to judge anyone in any way. This is a "safe space" free of shame (not really, but this is how the text pre-insulates itself from critique).

"Lifestyle factors" is code for the consumer mindset. Capitalism offers us a certain lifestyle, and sometimes we need to add new forms of consumption to keep that lifestyle intact - to go on being good consumers. Lifestyle is the language of big pharma reps. Watch for it.

But before we even get to the sell on HRT, we get the pharma perspective on everything else. Drugs and surgery are even offered as co-equal options for weight loss, as compared to addressing the diet.

Feminism sells now. Sells extremely well. So it's the central brand strategy of the book. But in this case the feminism is inextricably intertwined with big pharma. The industry isn't subjected to ANY sort of questioning about its oppressive, unequal or oppressive nature. It's marketed as the SOLUTION to the problem of misogyny. And, in some ways, big Pharma can also bu the solution to the problem of menopause.

There's a lot of different ways to do feminism. Neoliberal Pharma-feminism is definitely one of them. I suspect this book and all the add-ons around it will sell extremely well, and that it'll be the beginning of a genre of Big Pheminism. But the internal contradictions of such a project are already emerging....

3. It teaches a very limited version of feminism, one which is already giving rise to internal contradictions.

The rants are long. The rants are not substantive. And the rants 100% distract the reader from real critical thinking about the intersection of the medical system and gender. I imagine the rants are there because they are meant to appeal to a certain sort of reader. But it's pretty hard to BE that reader. The worldview just doesn't hold water.

Many of the rants are expressions of righteous anger here about the connotations of words in the medical system. Like the word "exhausted" for certain reproductive material. Or "flash" instead of "flush." Ok.

And yet the author uses a whole other set of words to subtly encourage us to see the change as a problem. A problem Big Pharma can fix. Negative words are ok if it's part of the marketing project whereby we name a problem and offer a solution.

Another rant that shows up in the book is not focused on words, but rather on women not having enough access to prescription drugs. For example, "medical misogyny" is defined as women having fewer prescriptions for statins than men. So the solution to misogyny? More prescriptions.

Back to negative connotations of certain words around menopause - for example "hot flashes." A lot of medical language portrayed as deeply offensive, maybe because it's not the language you, yourself chose. So, the feminist thing to do in this case is use any words you want for the hot times: hot flushes, hot blooms, "or even power surges." This is liberation. Ok.

Meantime, more and more as the book progresses, the author uses negatively connoting words for menopause symtoms - the thermoregulation system and other biological processes "suddenly" become "wonky," for example. The side effects of hot flushes are "gross." Following directly on passages decrying the male establishment for insensitive language, this terminology is part of book length advertisement for pharmaceuticals. The essence of the marketing is that you have to think menopause is unnatural and a problem - for drugs to be the "empowering" solution.

The misogyny the text describes is never located in the pharmaceutical industry or in capitalism itself.

In one case, the problem is the idea of physical fitness. Having to sit through an awards ceremony where other children received a fitness award is described as a "trauma" whose effects lasted decades - it is this trauma that is blamed for the author not going to a gym and being out of shape during that time. Sterotypified men at gyms are also a problem. And hiring a personal trainer is the feminist thing done to redress the trauma of everyone not getting the same medal. I got a bit lost here and elsewhere. I think whatever feminism is for this world view, it is where you buy goods and services to redress inequalities. It does not have to do with systematic critiques of legal and medical structures that lock gender domination in place.

So the mood of the book is characterized by consumer empowerment, in a way that insulates the profit-driven medical system itself from any sort of scrutiny.

It's still such a great resource for talking to your doctor. There is just lot of bathwater that comes along with this baby.

Again, the author is so good on medical topics, but if you're reading this review I am guessing the author's compromising of her own credibility could make this a tough read.

Yet I don't think it's possible to just ignore the hard sell here. The book is being marketed to us with feminism. Feminism is branding here. And it's a specific, well, bio-powered feminism. In this world there is a problem (YOUR problem), and there is a solution: drugs prescribed by your doctor, and paid for by your health insurance.

The critique - EMPOWER YOURSELF WITH FACTS AND FEMINISM- is real. It's true in some ways. And it is also a mask. (It's what keeps you from looking at the system.) And it's a brand. This kind of feminism is quite literally being sold and bought here in a transactional way.

There are lots of feminisms out there in the world now. Let a thousand flowers bloom. This one - Big Pheminism - is suspiciously large, suspiciously bright, and it's right in the center of the field.

[Dawn · Rating 5 out of 5]

I received an ARC of this title from NetGalley. I found Gunter's The Vagina Bible: The Vulva and the Vagina—Separating the Myth from the Medicine extremely helpful even at my relatively advanced age. Needless to say, I was thrilled to find this latest title all about one of my favorite topics, menopause. (Yes, I lead a fairly sad life.). Gunter presents the information in a way that feels like one your best girlfriends is talking with you and sharing super valuable tips. Add this to her experience as an OB/GYN and you have a great combo. If a book on menopause can be "fun" to read, then this is that book. My only slight criticism is that at times the author takes the feminist slant a bit far in her rebuke of the "patriarchy". I would take that aspect of the book with a grain of salt and just focus on the information she is sharing. As a woman who is deep in menopause (sorry, TMI), I learned a lot about my body and found the book to be reassuring as well as informative about other strategies I might explore with diet, MHT, etc. I think this book would be helpful for women approaching perimenopause, those like myself who are in the thick of it, and even for their partners/loved ones to better understand what the woman-of-a-certain age in their life is going through.

[JP · Rating 5 out of 5]

This book is very straight forward and told in a relaxing text which put me at ease. I’ve been looking for ANYTHING that would be helpful to help me understand what was happening and how to try to manage my symptoms.
The author says, this book was created so that we (as women) can better advocate for ourselves and become more educated about our medical needs and choices. I can not express enough how much, if you’re a women that you need to read this! I’ve ordered two copies myself because I’m giving one as a gift! This is a life changer.
Ive been menopausal for three years and nothings been as helpful or as informative as this book.
I also want to say that this isn’t just about menopause but a lot of other women’s issues.
Dr Gunter carefully examines and explains the issue. Then she shares ALL of my available options.
Hot flashes, memory, depression and osteoporosis were my favorite topics. I could go on forever so I’m just going to list some things about the book. I highly recommend this. You won’t be sorry.

The book discussed symptoms such as:
• Abnormal bleeding
• Hot flashes
• Night flashes
• Sleep disturbance
• Brain Fog (cognitive changes)
• Joint pain
Along with medical conditions such as:
• Heart disease
• Osteoporosis
• Dementia
• Alzheimer’s
• Depression
• Metabolic syndrome
• Diabetes
• UTI
Thanks Citadel Press, HighBridge Audio via Netgalley.

Quotes from the book:

“If menopause were on Yelp it would have one star.”

“Menopause is puberty in reverse.”

[Trisha]

Is it ever wrong to find out more about female health? No, I don't think it is! I'm in!

[Sonja · Rating 1 out of 5]

Dry as dust. (no pun intended)

[Coffee&Books · Rating 4 out of 5]

I'm increasingly interested in the enigma that is the human body, specifically this point in life when things that have been working as designed (or not) for so long chug to a stop and we enter another stage in life. This book is conversational, bringing bodily functions and explanations down to a layperson's level, which I appreciated. There's a lot of history, a lot of biology, much of which, as the author stated, could be found in the vagina bible, so I felt it could be left out, but for the sake of a complete guide, I understand why it was included.

There was no ground breaking or lightbulb revelations- if you've searched symptoms of menopause and 'what does this mean?' you know all of this info, anyway. The benefit is having all of those internet searches in one book. This would be a great book to have in print so the reader could highlight, tab and reference, especially part 3 which can be read in full or in parts.

I had a hysterectomy and kept my ovaries, so I don't have clues like menses grinding to a halt to clue me into menopause. This book is a useful guide to the process, and all involved.

[Jenna Freedman · Rating 2 out of 5]

Good writing, like the Yelp! review at the beginning, which ends. "And the sex was dry" lolsob, but I couldn't, in good conscience, finish or recommend at book that felt trans exclusionary. Men experience perimenopause, too; womanhood isn't exclusive to producing estrogen, etc.

She also has that arrogant doctor thing going, being sure to point out that she started medical school at 20, and how perimenopause was easier for her because she understood what was going on with her body, and she's kind of being a missionary to us ignorant savages explaining our bodies to us. Even if it's true I don't understand what's going on with my body, I don't need to be patronized.

[Lisa Berkovits · Rating 3 out of 5]

I wanted to love this one! It had some useful facts but was bogged down by too much filler. It felt dull and failed to engage—definitely not a favorite.

[britt_brooke · Rating 4 out of 5]

It’s absurd that no one really wants to talk about menopause, healthcare providers included. Medical misogyny is real. If this was regarding men, they wouldn’t be merely placated nor simply ignored. This is a fact of life for women, and is comparable to puberty, but in reverse. As I age, I realize I don’t know enough about my own body. This is an excellent resource. Dr. Gunter has a knack for explaining, and keeps a keen sense of humor.

[Rain · Rating 4 out of 5]

*3.5* I’m not there yet, but I can see the proverbial menopausal storm off on the horizon. Hence feeling it was a good time to read this one.

This book contains hard facts. Lots and lots of history, too much imo, the history bogs down the pertinent information. I was really interested in her thoughts on what is offered to pre and post menopausal bodies. Having watched my own mother suffer through the ‘cold turkey’ withdrawals from HRT back when everyone was terrified of it.

Since we all have very different bodies and backgrounds, we need to do the hard research ourselves, and this book is one tool of many for that information.

[Valerie Bowman · Rating 5 out of 5]

so thankful for this book

Thank goddess for this book. Perimenopause hit me like a car wreck and I had no clue about any of it until I read this. So helpful and validating as it was written with the exact same rage so many of us are feeling.

A bit long (went into too much detail at times) but overall a treasure trove of helpful information.

[Chris · Rating 5 out of 5]

Well researched and well written. I would highly recommend to any woman long before even peri-menopause. It’s never to early to know what’s coming. Dr. Gunter makes a complex topic approachable for the rest of us with clear and often funny explanations.