A year or two ago, The Vagina Bible was recommended to me and I immediately downloaded it. I will admit I hadn't read very far into it yet but I liked what I saw. When this book was offered on Netgalley, I immediately requested and hoped very much to be accepted. Fortunately, I did get the okay and I've been reading it over the past few weeks.
Growing up, I used to hear about menopause and my impression was it encompassed not just the final menstrual period but the time leading up to it. Many years later, I discovered the more correct term for the years leading up to menopause is perimenopause, which kind of changed the way I looked at it. Dr. Gunter refers to this period as menopause transition, a term that I haven't seen before but reflects it far better. The book starts out by presenting menopause as a part of normal life instead of as a disease that renders women incomplete. This leads to a history lesson in the understanding of menopause and how it has led to poor treatment of women in the past and even in modern times. Although it seems to be a harsh view, the reality is probably better reflected here than in most resources on women's health. The first two chapters certainly opened my eyes to how badly this normal phase of a woman's life has been addressed through the ages.
The rest of part one covers biological aspects of menopause, along with views of the evolutionary advantages of menopause, and information on its timing. Part two addresses the symptoms and goes into considerable detail on cardiovascular, bone, and bladder health. It also addresses brain fog, abnormal bleeding, sex, and sleep issues occurring during menopause. Part three addresses treatment, with most attention on MHT (menopausal hormone therapy) but also information on "alternative" treatments that are available. At the end, there are several tables included, most of which look at treatments available.. The information presented is comprehensive and doesn't gloss over much. I will point out that the book is written with a US-centric view and so information is based on the standards and terminology there. I don't say this so much as criticism as something it's important to know if you live elsewhere.
One of the major takeaways of this book for me is that women should never allow health care providers to brush off symptoms because they are typical for women in menopause. Just because a symptom is common in menopause doesn't mean it's not important now. And some of these issues may be just the beginning of long-term problems that need to be addressed earlier to be most effective.
Another big takeaway for me is that an entire industry has been made to make profits off women looking for treatment. And most of them are not proven effective. This one isn't a surprise for me but it did show me how pervasive it is in modern society. Also, I really liked the way Dr. Gunter points out that any treatment, conventional or not, needs testing to prove effectiveness. After all, if it proves effective, it would be considered medical treatment.
The last takeaway that I'd like to mention is the focus on cardiovascular and bone health. Women are at much higher risk of both once they reach menopause and it's heavily promoted that a benefit/risk analysis should be done for each woman to determine if MHT or other treatment is needed in menopause. It doesn't try to say that any choice is the correct one but that it should be determined case by case.
I found this an incredibly useful book and think it should be essential reading for women approaching menopause transition or even already there. As a woman who reached menopause in recent years, there was still information that was quite useful and it has prompted a couple future discussions with my doctor. I highly recommend it and give this a solid four stars.
Thank you to Netgalley and Kensington Books for sharing an advanced reader copy in exchange for a fair review.
