I remember the movie vividly. It was around 1983 and as a young student nurse in my early 20s, my friend and I went to the theatre to view it. The theatre was entirely full of women, many of them middle-aged.
Rita, (played by the fabulous Julie Walters), was a 20-something hairdresser who wanted to return to school and finish her education. Societal expectations at the time, and very limited career choices, meant that Rita grew up in a generation of women who had very little choice in their ongoing education and careers.
The film was ‘Educating Rita’. If you are post-menopausal today, you may remember it. Almost single-handedly, the theme of this movie – the basic premise that education means choice – empowered a generation of women to become better educated.
As an educator of women’s midlife health and ageing, I often think about the Rita’s of the world, because I come across them nearly every day.
Women, who, like me, grew up as the last of the Baby-boomer generation, with very little knowledge about women’s health and ageing, especially the menopause transition. It just wasn’t talked about.
Historically, there has been little to no teaching of the menopause, leaving generations of women with a detrimental knowledge gap. (Munn et al. 2022).
To me these are the Rita’s of the world, especially those who have just entered post-menopause and have had to struggle because they don’t know ‘why’ or ‘how’ to change their lifestyle to help their body accommodate their hormonal changes.
For Gen X, this is now changing thankfully. Progress has been made with the first National Institute for Health and Care Excellence (NICE) guidelines published for menopause in 2015, although lifestyle solutions are not at the heart of these guidelines.
That’s why I love the opportunity to educate women on the lifestyle science specific to menopause. Not only women on my programs, but also Practitioners.
My role is as an ‘Educator’ and this is a role that Practitioners should take seriously, because it differs from a ‘Teacher’.
The Merriam-Webster Dictionary defines a teacher as ‘one whose occupation is to instruct’, contrasting this with an Educator, which is described as ‘a student of the theory and practice of education.’
In other words, being an Educator in the menopause space, means integrating the ‘why’ (theory) and the ‘how’ (practice).
Structuring your coaching within this pedagogical framework helps to draw attention to the multi-dimensional aspects of their self-care – an approach that is often described as ‘holistic’.
Drawing on this multi-dimensional, holistic approach and positioning lifestyle solutions within women’s health and ageing science, has allowed me to structure the MyMT™ Programs in the 7 Dimensions of Women’s Healthy Ageing.
What is the holistic approach to women’s health?
A holistic approach to women’s health integrates emotional, mental, and physical well-being. These are essential components of holistic coaching, allowing our discussions to extend beyond merely avoiding illness.
It’s about fostering overall health and creating an environment where women feel empowered to make changes to help them to thrive, particularly during menopause and into their ageing years beyond.
With the dominant paradigm for menopause symptom management sitting within a biomedical framework of pharmaceuticals and supplements to replace oestrogen deficiency, many women in their 50’s today, have very little knowledge about lifestyle choices which have been evidenced to assist with their symptoms and weight gain.
This imbalance in how menopause is portrayed, was recognised by the Lancet Medical Journal only this year. As the paper stated,
‘The framing of this natural period of transition as a disease of oestrogen deficiency that can be eased only by replacing the missing hormones, fuels negative attitudes to menopause and exacerbates stigma.
Furthermore, appropriation of feminist narratives by commercial organisations, which position use of menopausal hormonal therapy (MHT) as a way to empower women to regain control of their bodies, while downplaying risks, further endorses the framing of menopause as a disease.’
As I have found myself, to elicit meaningful change in healthy lifestyle behaviours, attention should be given to other influences affecting women in their day-to-day life.
This includes, socio-economic factors, environmental factors, cultural influences, and of course, their existing knowledge about menopause.
All of these factors have an impact on menopause symptoms, simply because, they also impact a woman’s stress levels. Hence, it is these factors that provide us with a conceptual framework for educating and coaching women in menopause.
Educating and Coaching within a Framework of Women’s Health
It was back in 1998 that a conceptual framework for women’s health was proposed by women’s health researcher, May Cohen (1998).
As she suggested, ‘The health of women involves their emotional, social, cultural, spiritual and physical well-being and is influenced by social, political and economic factors, not just their biology. Such activities must focus not only on diseases that are more common, more prevalent or more serious in women, but also on priority health issues identified by women themselves.’
This conceptual framework, placing women at the forefront of their health issues, challenges the disease model of women’s health. It was the genesis for the WHO Women, Health and Ageing Conceptual Framework developed in 2007.
These frameworks have helped me to educate women and Practitioners, allowing me to contextualize menopause in ageing theories and of course, lifestyle medicine research.
Then by ‘listening’ to women we can understand their unique health concerns, that may not be being addressed by the medical and supplement industry.
As we approach another year ahead, I want you to know that the work you do as an Educator in the Menopause space matters, especially when it comes to supporting lifestyle behaviour change.
I believe that you are more than a ‘coach’ – a definition of which is supported by the process of building client-led self-determination and self-efficacy.
To me, you are an ‘Educator’ – tasked with helping your clients to understand the ‘why’ and ‘how’, nurturing them towards more hopeful and healthier future years ahead.
As an Educator, it’s wonderful to have you here with me. And in the words of Rita (Julie Walters) herself, “Education means choice – it still matters today, the world over. And not just for women, but for all of us.”
I couldn’t agree more.
References:
Cohen M. Towards a framework for women’s health. Patient Educ Couns. 1998 Mar;33(3):187-96. doi: 10.1016/s0738-3991(98)00018-4. PMID: 9731156.
Munn C, Vaughan L, Talaulikar V, Davies MC, Harper JC. Menopause knowledge and education in women under 40: Results from an online survey. Womens Health (Lond). 2022 Jan-Dec;18:17455057221139660. doi: 10.1177/17455057221139660.
The Lancet. Time for a balanced conversation about menopause. Lancet. 2024 Mar 9;403(10430):877. doi: 10.1016/S0140-6736(24)00462-8. Epub 2024 Mar 5. PMID: 38458210.
World Health Organisation (2007). Women, Ageing and Health:
A Framework for Action. Focus on Gender
