Every October, Menopause Awareness Month arrives and we talk about hot flushes, brain fog, sleep, hormones and all the other things many of us now know rather more about than we ever expected to.

So this year I thought we might start somewhere different: with some of the truly spectacular things women have been told about menopause over the years.

Because, frankly, we’ve come a long way.

In the 19th century, doctors used diagnoses including “climacteric insanity” to describe mental illness around menopause. One British doctor warned that women who had sailed happily through puberty and childbirth could still “break down at the menopause.” Middle-aged women were variously described as irritable, melancholic, hysterical and mentally unstable.

And lest we get too nostalgic about Victorian medicine, some doctors of the era removed healthy ovaries to treat conditions including “menstrual madness”, nymphomania and masturbation. Clitoridectomy was also advocated by some physicians for supposed female nervous disorders. This was controversial even at the time, but still: perhaps keep that in mind next time someone complains about the Medicare waitlist.

By the 1930s, menopause was increasingly being framed as a “deficiency disease”, with proposed remedies including preparations made from animal ovaries.

So yes, medical thinking has improved considerably.

But I think some of those old ideas have left a surprisingly long shadow. We’ve gone from barely talking about menopause to talking about it everywhere, which is enormously important. Yet sometimes the story can make it sound as though every woman approaching 45 is about to become sleepless, furious, forgetful and generally unfit for public life.

That isn't the whole picture either.

Here are a few facts worth knowing.

In Australia, natural menopause typically occurs between 45 and 55, with the average around 51. Perimenopause commonly starts around 47 and lasts four to six years, although there’s enormous individual variation. And while around one in four women experience severe symptoms, another one in four experience no menopausal symptoms at all. The remaining half sit somewhere in between.

There are also things we can do. Regular exercise, a balanced diet and good sleep habits can support symptoms and longer-term health, while physical activity becomes particularly important for protecting muscle, bones and cardiovascular health as we age. For women who need treatment, MHT is the most effective medicine for menopausal symptoms, although it isn't appropriate for everyone.

I find that part of the conversation much more interesting.

Menopause deserves proper medical care and far better literacy than generations of women received before us. Difficult symptoms shouldn't be dismissed, minimised or endured in silence.

But neither should we arrive at midlife expecting disaster.

At Eir, we talk a lot about investing in the body you want to live in for the next 30, 40 or 50 years. Eat well. Build muscle. Protect your sleep. Manage your stress. Know what’s happening hormonally and get good medical advice when you need it.

And perhaps, this Menopause Awareness Month, we can retire one final myth: that menopause marks the beginning of some inevitable decline.

We’ve already survived “climacteric insanity” and crushed animal ovaries.

I think we’ll be fine.

Lisa x