Menopause: Pathology or Passage?
As I move closer to my late forties, I find myself drawn into conversations around perimenopause and menopause. What’s interesting is that, so far, I haven’t really noticed any “symptoms.” Part of me wonders if that’s because of the personal work I’ve devoted myself to over the last five years particularly my journey with microdosing and somatic healing.
But whenever I engage with mainstream conversations on menopause, even the more progressive ones that mention microdosing, I notice the same pattern: menopause is almost always pathologised. Reduced to a set of symptoms to be managed, treated, or medicated. The underlying message is that, at this stage of life, something is breaking down, something is failing.
And honestly, that really baffles me.
Beyond Hormones and Neurochemistry
Of course, hormones shift. Of course, our bodies change. And yes, women do suffer — anxiety, depression, insomnia, hot flushes, the list goes on. But I can’t help wondering if we’re completely missing the point when we view menopause only through a biomedical lens. When we speak about women’s bodies as a collection of hormones and neurochemicals, we reduce something vast and sacred into a problem to be solved.
Menopause is not simply a medical event. It is a rite of passage.
What Birth Has Taught Me
As a birth doula, I’ve witnessed first hand what happens when we pathologise a natural threshold. Inside the medical system, where birth is often treated as an emergency waiting to happen, trauma skyrockets. Women leave with wounds that are not only physical, but emotional and spiritual. Rates of anxiety and depression rise.
But I’ve also seen the opposite. I’ve seen women who were able to birth outside of those systems — and occasionally within them, if they were fortunate enough to fall into the ever-narrowing category of “low risk,” with a supportive midwife, and a labour that unfolded quickly and “on time.”
Those women, even when their births were incredibly challenging, came through with a sense of power and transformation. Because they were supported emotionally, physically, and spiritually. Because they were surrounded by people who believed in them, and who believe that birth is a natural event, a rite of passage, not a medical problem. They weren’t seen as merely a set of symptoms to manage
And the ripple effects were profound not only in their own lives, but in their families and communities.
Menopause as Initiation
I believe the same is true for menopause.
When we approach it as pathology, as breakdown, we set women up to suffer. But when we honour it as an initiation — a threshold into elderhood, the experience can be life-altering.
It is the stage of life where, freed from the biological pull to nurture children, we are invited to step into the role of elder, teacher, mentor, and wisdom keeper. A place where our authority and presence become medicine for the community.
Symptoms, in this view, are not just signs of dysfunction. They are messages. Invitations to tend to unfinished business, to finally face the unprocessed grief, trauma, and silenced parts of ourselves. Menopause, then, becomes the body’s way of saying: it’s time.
Why So Many Women Struggle
I don’t believe women suffer in menopause only because of biology. I believe much of the struggle comes from living in a culture that:
Devalues ageing, especially in women.
Offers no rites of passage to help us transition through life stages.
Silences us, leaving trauma and pain unprocessed until it erupts in midlife.
Demands constant productivity, when this stage is asking us to slow down and turn inward.
Without the cultural scaffolding to hold us, menopause can feel like a collapse. But what if, instead, it is the last great initiation of our lives?
The Privilege of Elderhood
For me, menopause is not about loss. It’s about the privilege of time and experience.
To reach this stage means we have lived. We have endured. We have gathered wisdom that cannot be found in books. And we now have the opportunity to share that with others — with our families, our communities, and the world.
Elderhood is not a diminishment. It is an expansion into sovereignty. It is creative authority. It is the moment where we stop being pulled outward by everyone else’s needs and begin to embody our deepest calling.
A Different Narrative
Yes, women suffer. Yes, we deserve support — somatic, spiritual, nutritional, medical if needed. But let’s not lose sight of the bigger story here.
Menopause is not the end.
It is not failure.
It is not decline.
It is an initiation into power, presence, and wisdom.
And maybe the reason our culture clings so hard to the medical model is because it is terrified of what a generation of women stepping into their elderhood could mean.