03 Jun Rewriting The Rules on How To Menopause with Tamsen Fadal
Have you ever wondered why something that affects literally HALF of the population remains shrouded in whispers and shame? With over 1 billion women expected to be in menopause by 2025, you’d think we’d have this conversation figured out by now. Yet here we are, with 80% of women experiencing symptoms like hot flashes, brain fog, and anxiety, while fewer than 20% feel comfortable discussing it with their doctors.
I’ve walked this path myself, and I know how isolating it can feel when your body seems to betray you at every turn. That’s why today’s conversation with Tamsen Fadal, bestselling author of “How to Menopause,” feels so crucial. Her story isn’t just inspiring—it’s a roadmap for any woman who refuses to accept that midlife means decline.
When Your Career Becomes Your Wake-Up Call
Tamsen’s journey began like so many of ours do—with confusion, dismissal, and the constant refrain of “it’s just stress.” As a news anchor for 30 years, she was used to being sharp, focused, and in control. But perimenopause had other plans.
The symptoms crept in gradually: irregular bleeding, weight gain, sleepless nights, and that terrifying brain fog that made reading a teleprompter feel impossible. Every doctor visit ended the same way—stress was the culprit, stress was the explanation, stress was apparently the answer to everything.
Then came the night that changed everything. During a live broadcast, Tamsen experienced what she now knows was an intense hot flash. Heart racing, sweating profusely, feeling like she might pass out, she was escorted off the anchor desk and found herself on the bathroom floor. The medical response? A note in her patient portal stating simply: “In menopause….any questions?”
That’s it. No explanation, no support, no guidance for what would become the next chapter of her life.
The Menopause Identity Crisis
What struck me most about Tamsen’s story is how it mirrors so many women’s experiences with midlife transitions. We’re not just dealing with physical symptoms—we’re grappling with a complete identity shift. Who are you when the body you’ve known for decades starts operating by different rules? Who are you when your appearance changes, your energy shifts, and society seems to view you as past your prime?
Tamsen described the confidence crisis that comes with brain fog, the anxiety of not being able to perform at your usual level, the shame of feeling like you’re failing when you’re actually doing everything “right.” This isn’t just about hot flashes—it’s about feeling like you’re losing yourself.
The pressure she felt in her twenties and thirties was all external: how long to stay at the gym, when to get Botox, how to balance a hundred competing priorities while maintaining a perfect facade. But now? Her pressure is purposeful: How can I help more women? What do we need to do to change the conversation? How do we ensure all women have access to the information and support they need?
Breaking Through the Shame Barrier
One of the most powerful moments in our conversation was when Tamsen talked about the question she received during a book event: “How bad should my symptoms be before I get help?” Her response was immediate and profound: “If you’re asking that question, they’re already bad enough because you shouldn’t be suffering.”
This hits at the heart of so much menopause shame. We’ve been conditioned to believe that suffering is normal, that we should just “tough it out,” that seeking help is somehow weak or unnecessary. Meanwhile, we’re missing work, avoiding social situations, and withdrawing from the activities and relationships that bring us joy.
The shame works both ways, too. While some women beat themselves up for struggling, others become righteously judgmental about those who choose different paths. Whether someone decides on hormone replacement therapy, natural approaches, or a combination of both isn’t a moral judgment—it’s a personal health decision that should be made with proper information and support.
The HRT Conversation We Need to Have
Let’s address the elephant in the room: hormone replacement therapy. The fear surrounding HRT stems largely from a 2002 study that created widespread panic about breast cancer risks. But as Tamsen explains, the headlines that emerged didn’t accurately represent the study’s findings, and the population studied was very different from women who would typically start HRT today.
The tragedy is that this fear prevented an entire generation of women from accessing effective treatment. Most experts in the field now agree that hormone therapy does not cause breast cancer, and for many women, it’s the most effective treatment for menopause symptoms.
But here’s what’s crucial: this isn’t about convincing anyone to take HRT. It’s about ensuring women have accurate information to make informed decisions. Whether someone chooses hormones, lifestyle modifications, non-hormonal treatments, or a combination approach, the goal is the same—feeling better and maintaining long-term health.
Beyond Symptom Management: The Detective Approach
What I love about Tamsen’s approach is that it goes beyond just managing hot flashes. She emphasizes becoming your own health detective, understanding that menopause affects multiple body systems. It’s not just about estrogen and progesterone—your thyroid changes, your digestion changes, your stress response changes, everything changes.
This detective mindset means looking at the whole picture: nutrition that supports hormonal health, movement that maintains bone density and muscle mass, stress management that supports sleep and emotional well-being, and yes, medical interventions when appropriate.
The key is understanding that there’s no one-size-fits-all solution. What works for your best friend might not work for you, and that’s okay. The goal is to become educated enough to advocate for yourself and knowledgeable enough to make decisions that align with your values and health goals.
Redefining What’s Possible in Menopause
Perhaps the most inspiring part of Tamsen’s story is how she transformed her setback into her life’s work. She didn’t just navigate menopause—she used her experience to become a leading voice in changing the conversation for all women.
This speaks to something I believe deeply: midlife isn’t about decline, it’s about optimization. It’s about stepping into a version of yourself that’s more confident, more purposeful, and more authentic than ever before. Yes, the journey can be challenging, but the destination can be extraordinary.
Tamsen went from dreading going on set and struggling to complete sentences to becoming a bestselling author and documentary filmmaker. She found her purpose in helping other women, and that sense of mission energizes her in ways her previous career never did.
The Menopause Mindset That Changes Everything
One thing that sets thriving women apart during this transition is their decision-making mindset. Instead of accepting that decline is inevitable, they make a conscious choice that their experience will be different. They refuse to commiserate in defeat and instead commit to finding solutions.
This doesn’t mean denying the challenges or pretending everything is easy. It means approaching the transition with curiosity rather than resignation, with hope rather than fear, with determination rather than defeat.
Moving Forward Through Menopause
If you’re reading this and recognizing yourself in these struggles, here’s what I want you to know: you don’t have to suffer in silence. You don’t have to accept that feeling terrible is just part of getting older. You have options, you have support, and you have the power to change your experience.
Start by educating yourself. Read books like “How to Menopause,” watch documentaries like “The M Factor,” and listen to conversations that validate your experience while offering practical solutions.
Find healthcare providers who specialize in menopause and women’s health. If you can’t find local specialists, consider telehealth options that can provide immediate support.
Connect with other women who are on this journey. The isolation makes everything harder, while community makes everything more manageable.
Most importantly, make the decision that your experience will be different. That this transition, while challenging, can also be the beginning of the most empowered, purposeful, and authentic chapter of your life.
The fact that you’re here, reading this, tells me you’re ready for something different. You’re ready to stop whispering about menopause and start talking about it boldly. You’re ready to move from suffering to thriving, from shame to empowerment, from resignation to possibility.
This conversation doesn’t end when you finish reading this post. It continues every time you share your experience with another woman, every time you advocate for yourself with a healthcare provider, every time you choose hope over fear. We’re rewriting the menopause story, one woman at a time. And that story isn’t about decline—it’s about transformation, empowerment, and stepping into the fullest version of ourselves.
The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.
