Who is Mad Alice and why is she so... mad?
A forged-by-fire millennial menopause manifesto in the making
If you’re thinking “What is up with the horse?” Let me explain.
Mad Alice is a persona that represents many of us right now. This is what I imagine a young Alice might look like if she were alive today (thanks Midjourney). She is strong, skilled, determined, and has a whole lot of grit.
She’s also pissed — and for good reason.
The name was inspired by two things. The current state of midlife healthcare for women — and a woman (who loved horses) that I never met.
1. “Mad” - the most prominent emotion felt by women in all stages of the menopause transition today.
I have read thousands of comments online from people who have been neglected, misled or mistreated by care providers when trying to find solutions for debilitating symptoms.
The term ‘hysterical’ was coined in medical Latin as an abstract noun from Greek hystera "womb". Back in the day, women were put in asylums and subjected to all sorts of experimental mutilation to ‘cure’ the mysterious midlife condition.
Well, it turns out she’s not crazy.
All people who menstruate go through the menopause transition. It’s half the population (technically 50.4%). And 85% of women report experiencing adverse symptoms.
Our bodies essentially go through reverse puberty. Hormone levels are decreasing. And unlike male hormones, female hormones are doing so erratically — affecting every system in our bodies. Symptoms range from annoying to debilitating and can persist for a decade. This should be a goldmine chronic care management opportunity for clinicians, right? Well… turns out not so much.
There is no medical residency or recognized fellowship for menopause today.
80% of OB/GYNs are untrained in menopause.
75% of women who seek care don’t receive any treatment.
We get ping-pong’d around a siloed system that wastes our time and money.
The very things we have to work SO HARD to get.
1 in 4 women consider leaving their job due to the impact of the menopause transition.
And this makes a lot of sense to me. Especially for working moms. Because after fighting the uphill battle of advancing your career while being pregnant — and coming back to prove yourself after your leave(s) of absence — getting hit with perimenopause is the third treacherous mountain nobody ever prepared us to climb.
The Torres del Paine of being a woman in America.
I wanted to see what it could look like to take back this word.
We aren’t crazy, but we are angry. And we have a ‘forged by fire’ resolve to do something about it. We are taking back control over our health and working to change the system as we do it.
2. Alice - my grandmother-in-law. A woman who took life by the reins.
I never met her, just listened to the stories. She wasn’t perfect by any means, but she was bold. And she loved riding a horse named Mouse. Story has it she rode it into a friend’s house one day. And on a split saddle, wearing pants. An act of rebellion against societal norms of the time. Very bold.
I like to imagine that if she were alive today, she would have been one to tell me about her experience navigating the menopause transition. Unlike my mom — who is one of the lucky 15% who didn’t notice their symptoms.
But — it’s frankly negligent to ask women to rely on generational word of mouth or ask their friends for help with our unaddressed midlife healthcare needs. Imagine if we did this to men for sexual dysfunction.
“Having a little trouble down there, eh? Well, have you asked your dad? How about your grandpa? Have you tried asking what your friends do for that? While you’re at it, might as well ask them about what they are doing for hair loss prevention. More efficient yah?”
If that seems ridiculous, that’s because IT IS.
The reality is that it is going to take a while for our healthcare system to evolve. Even though there is so much active discussion around menopause right now — and great experts on the subject. As both a numbers problem and an incentives problem, it’s going to take some time.
Until then, Mad Alice is here to help.
More Madness
Sources
https://newsroom.simplyhealth.co.uk/35-million-women-have-considered-quitting-job-due-to-menopause-and-menstrual-health-symptoms/
https://www.amjmed.com/article/S0002-9343(05)00885-5/pdf
Yessss!