Audrianna J. Gurr

August 20, 2026

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We Were Taught to Be Good Patients. Menopause Is Teaching Us to Get Loud.

At the end of June, I attended Menopunkapalooza in Portland, Oregon, not simply as a participant, but as a mental health provider offering information and resources at the Menopunks Peri/Meno Resource Fair. I arrived with two posters, years of professional experience, a book shaped by research and the voices of more than 100 women, and my own lived understanding of how disruptive perimenopause and menopause can be. I was grateful not to be doing this work alone. My friend and colleague Christina Malango, RN, MSN, joined me as my support, collaborator, and co-presenter at the resource fair. Having Christina beside me made the experience feel steadier, more joyful, and more connected. Our shared presence reflected something central to Menopunkapalooza itself: meaningful menopause care grows through collaboration, shared knowledge, and women helping one another speak more clearly and confidently about what they need.

I left feeling as though I had witnessed the beginning of something much larger.

The event brought together Gen X musicians, artists, medical and mental health providers, activists, and community members. There was live punk music, humor, honest conversation, clinical information, and the kind of collective energy that develops when people recognize that something they have been carrying privately is, in fact, shared.

It was loud. It was irreverent. It was joyful.

And it was a protest.

A New Kind of Punk Rebellion

Punk music has always had roots in resistance. It questions authority, rejects conformity, and gives a microphone to people who have been told to be quieter.

At Menopunkapalooza, that rebellious spirit was directed toward the way women and other people experiencing menopause have historically been treated by health care systems, workplaces, and society.

The message was clear:

We have a right to accurate information.

We have a right to understand our options.

We have a right to ask questions about our own bodies.

We have a right to health care that takes our symptoms and quality of life seriously.

The Guardian later featured the festival and included a photograph of my mental health poster at the resource fair. Seeing the poster in an international publication was deeply meaningful to me, not simply because my work appeared in The Guardian, although that was certainly thrilling. It mattered because mental health was visibly included in the wider conversation about menopause care.

Our emotional experiences belong in this conversation.

Menopause Is Not Only a List of Physical Symptoms When we talk about menopause, people often think first about hot flashes, night sweats, and changes in menstrual cycles. Those symptoms matter. But they are not the whole story. Hormonal shifts can coincide with disrupted sleep, increased anxiety, irritability, low mood, cognitive changes, loss of confidence, and a frightening sense of no longer feeling like oneself. When sleep deteriorates and anxiety rises, it can become harder to function in nearly every part of life. The person experiencing this may still be trying to work, parent, maintain relationships, manage a household, care for aging family members, support a community, and make hundreds of ordinary decisions every day. From the outside, she may appear to be carrying on as usual.

Inside, she may be wondering what on earth has happened to her.

At the resource fair, I was struck by the openness with which people described these experiences. There was tremendous relief in hearing the private made public and in discovering that an individual struggle might also be part of a larger, recognizable transition.

Validation does not resolve every symptom. But being believed matters.

Having language for an experience matters.

Knowing that you are not failing, weak, or “losing it” matters.

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When the Person in the White Coat Does Not Have the Answer

Many of us were raised to trust authority, follow instructions, and avoid being seen as difficult.

Women, in particular, have often been conditioned to accommodate. Be polite. Do not take up too much time. Do not be dramatic. Do not challenge the expert. Accept the answer you have been given, even when it does not explain what is happening inside your own body.

That conditioning can follow us into the examination room.

A medical degree represents important knowledge and training. Physicians, nurse practitioners, nurses, and other health professionals bring vital expertise to our care. But no individual provider can be an expert in every area of medicine, and menopause education has historically been limited in many training programs.

That does not mean we should distrust medical professionals.

It means we are allowed to ask whether the person treating us has the particular training our situation requires.

There is a difference between rejecting expertise and seeking the right expertise.

When a provider does not recognize your symptoms, cannot answer your questions, or dismisses the effect those symptoms are having on your life, you are allowed to ask:

Questions You Are Allowed to Ask Could these symptoms be connected to perimenopause or menopause? What treatment options are available for my particular symptoms? What are the potential benefits, risks, and alternatives? What additional training or experience do you have in menopause care? Could you refer me to someone who specializes in this area? What should we explore if this treatment is not appropriate for me? You are also allowed to seek a second opinion. That is not rude. It is not disloyal. It is not an accusation that your provider is incompetent. It is health care.

Finding the Care That Fits You

Hormone therapy was an important part of the conversation at Menopunkapalooza. For some people, it can bring profound relief and may feel like a lifeline. It is also not the only possible form of support, nor is it appropriate for every person or every medical history.

Empowerment is not about insisting on one specific treatment.

It is about having access to accurate, current information and being included in decisions about your own care.

One person may need a conversation about hormone therapy. Another may need targeted support for sleep, anxiety, depression, sexual health, pelvic health, UTIs, migraines, or cognitive concerns. Someone else may benefit from changes in medication, psychotherapy, nutrition, movement, stress reduction, social support, or a combination of approaches.

The goal is not to locate the universal menopause solution.

There is not one.

The goal is to understand your own pattern of symptoms, identify how those symptoms affect your functioning, and find providers who will work collaboratively with you.

I often think of this as creating a symptom-to-impact map:

What am I experiencing?

When did it begin?

How often does it happen?

What makes it better or worse?

How is it affecting my work, sleep, relationships, confidence, or ability to function?

What have I already tried?

What kind of support do I need next?

You do not have to arrive at an appointment with a diagnosis or a perfectly organized case. But tracking your experience can help make something vague and overwhelming more visible.

It can also help you say, with greater clarity: This is affecting my life, and I would like help.

We Are Not Being Put Out to Pasture When I was younger, I heard a woman in my life say that after menopause, women were essentially “put out to pasture.” Even then, the phrase felt cruel. Now it feels absurd. The average person reaching menopause may have decades of life ahead of her. These are not empty, leftover years. They may represent an enormous portion of her adult life.

Midlife women are leading organizations, building businesses, creating art, treating patients, teaching students, raising and launching children, caring for communities, deepening friendships, beginning relationships, leaving relationships, making discoveries, and reconsidering what they want the rest of their lives to contain.

Many have spent years nurturing other people, pleasing others, conforming to expectations, and waiting for permission.

Menopause can bring losses and genuine difficulty. It may also bring a shedding.

A woman may discover that she is less willing to abandon herself to keep everyone else comfortable. She may feel more certain about what she knows, what she values, and where she intends to place her energy.

She may recognize herself not as someone fading from relevance, but as an elder, a mentor, a leader, or, if she enjoys the word, a crone.

Not a discarded woman.

A woman with knowledge and power to share.

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From a Whisper Network to a Louder Voice

The original riot grrrl movement encouraged young women to speak openly about experiences that had been hidden, minimized, or dismissed.

Decades later, many members of that same generation are confronting a different silence.

We are asking why so many people enter perimenopause without basic information. Why mental health changes are not always recognized as part of the picture. Why finding trained care can require persistence, money, luck, or all three. Why women are still told that distressing symptoms are simply something they must endure.

Menopunkapalooza transformed those questions into music, conversation, community, and action.

The people gathered there were not asking permission to matter.

They were not quietly accepting that suffering was simply the price of growing older.

They were saying:

There must be a better way.

That may be the most powerful lesson I carried home.

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We Don't Have to Disappear Quietly

You do not need to become an expert in menopause medicine.

You do not need to know the correct treatment before you ask for help.

You do not need to prove that your suffering is severe enough to deserve attention.

You can begin with what you know:

Something has changed.

This is affecting me.

I want to understand my options.

I need more support.

Please help me find it.

And when an answer does not fit, you are allowed to keep asking.

Perhaps this is our generation’s newest form of protest: refusing to disappear quietly, refusing to mistake endurance for wellness, and refusing to believe that the largest part of our lives is already behind us.

We are still here.

We are still growing.

We are still creating.

And, when necessary, we can be very loud.

Questions to Consider Take a moment with these, not as a test, but as an invitation to notice what your experience is telling you. Which physical, cognitive, or emotional changes have I noticed recently? How are those changes affecting my everyday life? Do I feel heard and respected by my current health care providers? What questions have I been hesitant to ask? Is there another opinion, specialist, or resource that could help me? Where have I mistaken being “easy” or agreeable for receiving adequate care? What might it look like to become a more active partner in my own health? What knowledge, freedom, or strength is emerging for me in this stage of life? In Community Power. All the best, Audrianna Joy Gurr.

This article is intended for educational and reflective purposes and is not a substitute for individualized medical or mental health care. Treatment decisions, including decisions about hormone therapy, should be made with a qualified provider who understands your symptoms, health history, preferences, and individual risks.

Suggested Related Reading

​The Guardian, “It affected my confidence in my pussy: Gen X punk legends rage at menopause festival,” July 7, 2026.​

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