The Change We Forgot to Finish Talking About

We used to call it "the change."

Then we decided that sounded ominous, medicalised it, and moved on.

I think we lost something in that translation.

I see it every week: a woman comes in for her HRT review. Dose is right, bloods are fine, and yet she's still not herself. The fatigue hasn't lifted. The fog hasn't cleared. There's a rage in her she doesn't recognise, and she's half-embarrassed to name it. We tweak the prescription and send her on her way, assuming the rest isn't ours to touch.

But what if the rest is exactly the point?

In traditional Chinese medicine, which I also practise, this stage of life is called the "second spring." Not decline but renewal. In many non-patriarchal and traditional societies, the woman who is no longer defined by reproduction becomes something else entirely: the elder. The one whose voice carries.

Here's the catch: a second spring doesn't arrive on its own. It has to be cleared for, like a garden. And most of my patients haven't had a minute to do that clearing. They're still running the household; chief executive of home, unpaid, unrelieved, even with a helpful partner, while holding down a job outside it too. Many had children later, so instead of the freedom their grandmothers found at this age, they're doing the school run. No wonder the voice they're meant to be growing into keeps getting drowned out.

So yes. Prescribe the HRT. I take it myself, and it works.

But don't let it be the whole consultation.

It takes less than sixty seconds to ask one more question: what's one thing in your life you could change that would also help?

I ask my patients to keep a private journal of their resentments and fears; not to hand in, not to discuss, just to notice. What gets written down starts to lose its grip.

Because menopause, looked at properly, isn't just the end of something. It's a rare, sanctioned chance to return to yourself - to find out who you are once you stop performing who you were.

It's not just the change. It's the chance to get your mojo back.