Monday Reviews: The Pause

Every Monday, The CSPH takes a look at a book or film focusing on an aspect of sexuality. This week we are featuring the book The Pause by Lonnie Barbach.

Menopause catches a pretty bad rap in our culture; if we listen to mainstream pop culture, menopause is a thing to be feared, and avoided at all costs. In reality, menopause is one more thing that some bodies just naturally do. It is a natural process, like digestion, urination, or giving birth. While in all of those processes, most people do just fine, but the few who don’t tend to dominate the stereotypes that fuel our cultural anxiety. In 1993, Lonnie Barbach published one of the first mainstream pop-psychology books about this largely hidden process in an attempt to expose the truths and normalize the experiences of those who find themselves mid-transition. The Pause fully explores the experiences surrounding menopause, including the hormonally tumultuous two to ten years before the actual cessation of menstruation. Lonnie Barbach brings her personal experience as a post-menopausal woman and clinical psychologist to her depictions of the wide range of menopausal experiences while offering a balanced look at the tools available to help individuals navigate the transition.

The book is divided into several sections, with the first two chapters exploring Barbach’s definition and perception of “The Pause” as a natural transitory process. In an attempt to normalize the process, Barbach defines “The Pause” as the entire period of transition rather than a single defining event.  Walking the reader through the various experiences an individual might experience during the transition emotionally, physically, and sexually, the second section also provides an overview of hormone replacement therapy as well as other treatments for managing these experiences, such as homeopathy, acupuncture, and herbs. The final section discusses the health risks and preventative measures for osteoporosis and heart disease that face post-menopausal women while also highlighting the benefits of post-menopausal life, such as increased personal awareness and confidence. Finally, the book’s epilogue speaks to men about how to best support the women in their lives who are in the midst of “The Pause.” Despite the gendered language, the epilogue would be useful for any partner of an ovary-owner experiencing menopause who wishes to better understand and support their partner’s transition.

Barbach’s down to earth writing style coupled with personal testimonies of those who have begun or completed the menopausal process makes for an easily relatable read. The use of the “popcorn” analogy to explain the hormonal process that accompanies diminished egg release and the onset of “The Pause” allows for an easy understanding of the physiology behind the menopausal process. She explains that we can imagine eggs as popcorn kernels and hormones as heat. When the heat—or hormones—start intensifying during puberty, kernels—or eggs—start releasing, erratically at first then becoming more consistent as the heat or hormones level out. As fewer kernels or eggs remain, the release starts becoming erratic again, and the heat or hormones intensify to try the remaining eggs to release, resulting in menopause. While the age of the book leaves some of the science outdated, the book nevertheless provides a great resource for women and their partners to better navigate the complexities that can come with menopause.

The Pause would be a good starting place for young ovary-owners who wish to educate themselves about the menopausal experience in order to understand and prepare for this life change.  Additionally, The Pause would be a helpful resource for those individuals who have begun to experience peri-menopausal symptoms and seek to understand what is happening with their bodies, or for people who have progressed through menopause and wish to normalize their experience by reading the experiences of others. Unfortunately, this book throughout assumes cis-gendered bodies, correlating ovary ownership to being a woman, and does not consider the menopausal experience for transgendered or intersexed individuals. For those seeking a current review of the science surrounding hormone replacement therapy and other treatment modalities, a more current book might be appropriate. Ultimately, this book would be a great resource for any individual who is looking to better understand the experience of approaching and moving through menopause.

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