The hidden struggle

Visualise yourself lying awake until 3:00 a.m. day after day and then waking up feeling like a train wreck. Imagine the embarrassment of forgotten appointments. Consider experiencing hot flushes (flashes) 10, 20, or 30 times a day—especially in Japan’s hot summers. Imagine feeling joint pain when exercising or riding your bicycle. How would you cope with a low mood, irritability, or the reality that you won’t have more—or any—children? Welcome to many women’s experience of menopause.

Menopause is the stage when a woman has had no period for 12 months. But we need to start further back with perimenopause, or the transition to menopause. This often begins when a woman is in her forties but can be as early as her thirties or later in her fifties. Menopause can include the symptoms mentioned above, along with the following: night sweats, headaches, weight gain, heart palpitations, dry eye, panic attacks, anxiety, intimacy difficulties, and more. These health issues can affect women physically, emotionally, relationally, and in their ministry. Fortunately, not every woman has every symptom (some have none), but most experience some.

But why write about this here? Consider that menopause affects half the world’s population directly and the other half indirectly! It will shape the experience of more than half of missionary personnel. (Missionary women outnumber men 2:1 in some areas.¹) Therefore, this topic is important not just for women but also for husbands and families, teammates, and mission organizations.

Thankfully, menopause is more talked about than it used to be. For example, the UK government published a paper called “Menopause and the Workplace” in 2022.² In 2021, the Gospel Coalition (Australia) posted an article entitled, “What does menopause tell us about God and ourselves?”³ There’s even a World Menopause Day (18th October). But how much consideration has this issue received in the mission community at a personal or organisational level? What are some ways we can address the issue?

By God’s grace, I suggest we meet this transition in a similar way to other life transitions.

Truths to remember:

• Change is normal. Seasons change; human beings change. God designed it that way.
• Change brings uncertainty. Human beings often find comfort in what they know.
• Jesus never changes. “Jesus Christ is the same yesterday and today and for ever.” (Heb. 13:8 NIV)
• Jesus is ever-present. “Surely I am with you always, to the very end of the age.” (Matt. 28:20)
• God’s in charge. “In all things God works for the good of those who love him.” (Rom. 8:28)

Tips for women:

• Take responsibility. Be proactive; educate yourself about menopause and speak with a medical professional about any symptoms. Share your struggles, as appropriate, with your husband, colleague(s), or team.
• Practice self-care and self-compassion. You may not be able to do as much as you used to; you might feel overwhelmed. Allow time and space to care for yourself through exercise, diet, a healthy sleep routine, time to relax, time to be with others, and a vibrant devotional life.
• Practice spiritual reflection. Reflect on this transition through prayer and/or journaling. Ask God to help you, to make you a blessing, and to receive his gifts to you. Confess your sin as you need to.
• Leave space to be sad. Change and transition involve grief. Acknowledge your sadness and allow yourself to grieve.
• Practice gratitude. What treasure can you find in this transition? You could keep a thankfulness journal and share it with those around you.
• Connect with people. Don’t go it alone! Make time with those who love you, talk with older women, and if you need more help, ask!

Tips for colleagues/organisations:

• Educate yourself about menopause and how it affects women.
• Listen and show empathy/understanding towards your wife, colleague(s), or team member(s).
• Encourage your wife or colleague(s) in their care for themselves. For example, you might want to join them in an exercise routine or diet (but don’t force them into it!).
• Pray for your wife or colleague(s) in this challenging and long-lasting transition.
• Be flexible about time off, starting late, finishing early, workload, etc.
• Be patient and forgiving as needed.
• May God give each of us grace to age gracefully and to help our colleagues do the same.

1. Marti Wade, “More Women in Missions: Four Reasons Why,” Pioneers, https://pioneers.org/article/more-women-in-missions-four-reasons-why (March 19, 2021).
2. “Menopause and the Workplace: How to enable fulfilling working lives: government response,” Department for Work and Pensions, policy paper, https://www.gov.uk/government/publications/menopause-and-the-workplace-how-to-enable-fulfilling-working-lives-government-response/menopause-and-the-workplace-how-to-enable-fulfilling-working-lives-government-response (July 18, 2022).
3. Ruth Baker, “What Does Menopause Tell Us about God and about Ourselves?” The Gospel Coalition, https://au.thegospelcoalition.org/article/what-does-menopause-tell-us-about-god-and-about-ourselves (August 6, 2021).