Is There Life After Menopause? And What Does Culture Have to Do With It?

Petra was in her late forties when she came to see me.

Her GP had referred her because, although her perimenopausal symptoms were relatively mild, she was experiencing considerable distress.

“I don't recognise myself anymore,” she told me.

She described looking at photographs taken only a few years earlier and feeling a strange sense of loss.

She missed the woman in those photographs.

The woman who walked into a room feeling attractive. Who enjoyed being noticed. Who knew how to dress, how to carry herself, how to feel confident in her own skin.

Now she found herself scrutinising photographs, noticing changes in her face, wondering whether other people noticed them too.

She was frightened of becoming invisible.

And beneath that fear was an even more unsettling question:

Who am I if I'm no longer young and desirable?

Petra's distress wasn't simply about the changes she was seeing in her body. It was also about the meaning she'd learned to attach to those changes.

And much of that meaning came from culture.

Let's talk about culture.

When we think about cultural differences in menopause, we often imagine women from different ethnic or religious backgrounds.

But Petra was Australian, born and raised in mainstream Australian society. So where was culture in her story?

Everywhere.

Culture isn't limited to ethnicity or geography. It exists wherever people share values, beliefs and expectations about how life should be lived.

And most of us belong to several cultures at once.

Think about the culture of beauty, wellness, productivity and self-optimisation that surrounds us.

We're encouraged to look younger, feel younger, perform better, optimise our hormones, maintain our bodies and resist the visible signs of ageing.

Even the phrase anti-ageing is interesting.

What exactly are we against?

There's nothing wrong with wanting to look attractive, feel healthy or access treatments that improve our quality of life.

But what happens when youth becomes a form of social currency?

When being young gives women access to attention, visibility, desirability and even a sense of worth?

What happens when that currency begins to lose its value?

For Petra, ageing wasn't simply a biological transition.

It threatened the way she'd learned to exist in the world.

But ageing hasn't always carried the same meaning.

In some societies, growing older brings greater authority, respect or a recognised place within the community.

Life transitions may be acknowledged through rituals, changing roles and collective recognition.

Of course, no culture is without its limitations.

Some cultures that honour older women may also restrict their sexual autonomy.

Contemporary Western cultures may offer greater freedom for women to define their own lives, while simultaneously placing enormous pressure on them to remain youthful and desirable.

The question isn't which culture is better.

It's what each culture rewards, what it discourages, and what it teaches us to value.

And what about sexuality?

I find this particularly fascinating.

Think about the images and messages we've absorbed about what a sexual woman looks like.

How old is she?

What does her body look like?

How does she dress, move or express desire?

Now imagine a woman in her sixties.

Can you easily picture her as sensual, playful, sexually confident and enjoying a deeply fulfilling erotic life?

Or does something about that image feel unfamiliar?

If it does, I wonder why.

Perhaps we've had far more exposure to images of youthful sexuality than to the erotic lives of older women.

And when we rarely see something represented, it can become difficult to imagine it for ourselves.

A woman might begin to believe that declining desirability is an inevitable part of ageing.

That sexual pleasure belongs to younger bodies.

That menopause marks the beginning of the end of her erotic life.

But these aren't simply biological realities.

They're cultural narratives.

Coming back to Petra.

Our work wasn't about convincing her that ageing was wonderful or that appearance shouldn't matter.

It was about understanding what youth had represented in her life, and whether those experiences of confidence, pleasure, desirability and worth could exist beyond it.

Because ageing involves change. Sometimes loss. Sometimes grief.

But it can also bring something unexpected.

I've worked with women who, in midlife and beyond, begin to discover aspects of their sexuality they'd never felt free to explore.

Women who become less concerned with performing desirability and more interested in experiencing pleasure.

Who begin to understand their bodies, communicate their needs and develop an erotic identity that belongs to them, rather than one shaped primarily by other people's expectations.

Of course, menopausal symptoms can be profoundly disruptive, and medical treatment can make a difference.

But women don't arrive at menopause as a collection of hormones.

They arrive carrying decades of experiences, relationships and cultural messages about what it means to be a sexual woman.

And perhaps one of the most liberating things we can do is become curious about the stories we've inherited.

Because there is no expiry date on female sexuality.

And for some women, this stage of life isn't the end of their erotic journey.

It's where a more fulfilling one begins.