63 pages • 2 hours read
Dare I Say It: Everything I Wish I'd Known About Menopause
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Chapters 3-5Chapter Summaries & Analyses
Chapter 3 Summary: “Vag of Honor”
Watts, like many others, experienced sexual issues in middle age. She began dating a fellow actor, Billy, whom she met while filming Gypsy, and when they first slept together, Watts was insecure about her hormone patch. However, when Watts told Billy that she was menopausal, he was empathetic, sharing his own experience with aging—“I’ve got gray hairs on my balls” (31)—and helping Watts feel better. She reflects on her internalized conditioning to idolize youth, remarking that life is hard enough without “inventing” new stressors, like fighting aging.
According to Watts, although women tend to experience a decreased libido during menopause, many women also “embrace a new form of sexuality that feels good for them, because they know themselves, and they lose the awkwardness of youth” (32). Watts discusses multiple ways menopause can impact a woman’s sex life and her relationships, sharing anecdotes from a variety of women with unique experiences. She cites Dr. Somi Javaid, who specializes in hypoactive sexual desire disorder (HSDD). Dr. Javaid argues that biosocial factors impact a woman’s libido more than a man’s, and the menopausal transition can cause numerous biosocial changes, like incontinence.
Watts offers advice for incontinence, mentioning Kegel exercises and methods for managing issues with the bulbocavernosus muscle and vaginal prolapse. She advocates for tools like pornography and vibrators, which can enhance libido, and criticizes the traditional advice to women with sexual dysfunction to force themselves to have sex. Watts also draws attention to bias in the language differences between men’s and women’s sexual health issues, contrasting the terms “erectile dysfunction,” which she refers to as “palatable,” and “vaginal atrophy,” which, she argues, “sounds like doom” (37). She then goes on to discuss more tools and treatment methods—like medications, questionnaires, and testosterone—for menopausal women facing sexual dysfunction. While testosterone is typically associated with men, Watts notes that it plays an important function in women’s sexual health, sharing a testosterone therapy “horror story” about a woman who accidentally overused her medication and developed intense side effects. Watts describes her own experience of testosterone therapy, in which she first struggled with it but then tried it again and saw benefits.
Quoting Dr. Javaid, Watts emphasizes the complexity of sexuality, regardless of age or menopausal state. She advocates for open honesty as a form of foreplay and argues that people should not be comparing themselves to others, especially performers. Turning to Dr. Casperson, Watts notes that middle-aged men also often experience changes in sexual function. Before Dr. Casperson prescribes Viagra to her patients, she asks them about their partners; she has found that many married men will request Viagra without talking to their spouses. Watts reiterates that there are several options for treating sexual dysfunction, arguing that women should not have to suffer through treatable symptoms, and closing the chapter with a bulleted list of key takeaways from the chapter.
Chapter 4 Summary: “Shame”
Watts remembers beginning to compare herself with others when she hit puberty, which resulted in feelings of inadequacy and shame, as she felt her development was delayed in comparison to her peers. She argues that women and girls face immense shame due to societal expectations, and she criticizes the secrecy and silence surrounding that shame. She also acknowledges the irony that young girls are pressured to look more mature, while adult women are pressured to look younger—pressure she noted herself in the Hollywood industry, where she never felt she was the “right” age. When she first started subtly mentioning her menopause symptoms, she was met with disbelief, deepening her shame and reinforcing her silence for a time. Dr. Jen Gunter spoke with Watts about the high levels of shame she sees in her treatment of menopausal women, arguing that society is the cause of it and identifying the media’s portrayal of women and medical inadequacies and biases as major culprits. She shares her experience with “frozen shoulder”—a common ailment among menopausal women—which doctors originally dismissed as a forgotten injury.
Women, Watts asserts, are also judged for enjoying sex and for seeking treatments to make sex more pleasurable. She identifies a double standard in medicine, where men’s sexual issues are considered worthy of notice while women’s are often not: “Imagine that we treated men in midlife with a medicine that was going to cause their penis to shrink up or be unrecognizable. Doctors would mention this, and by the way, men would never take this drug” (54). Women who are treated for breast cancer often experience medically-induced menopause but are told to be grateful they are alive, rather than having their symptoms treated.
Watts writes that she has stopped caring about others’ judgments of her, allowing her to open up—both privately and publicly—about menopause. She shares an anecdote in which she was purchasing vaginal medication, and the pharmacy announced the product over the intercom during a price check. Instead of being mortified as she passed an acquaintance waiting in line, Watts confidently spoke to him.
Chapter 5 Summary: “Anxiety, Rage, Panic, Depression, Grief”
Watts likens menopause to puberty, sharing stories of women who experienced intense emotions, like panic and rage, during menopause. Citing Dr. Ellen Vora, Watts discusses the mental health conditions—including anxiety and depression—that women in menopause face. A primary barrier to getting appropriate healthcare is the time constraints faced by doctors, who have around 15 minutes or less to examine, diagnose, and treat patients, often resulting in ineffective or unnecessary medication. Dr. Vora also criticizes the narrow Western perspective on mental health, advocating for a more thorough approach that considers lifestyle factors instead of just prescribing medication. She distinguishes “true anxiety,” or anxiety that helps humans avoid dangers, and “false anxiety,” caused by bodily conditions such as missing a meal or having a hangover. To effectively address true anxiety, individuals must first eliminate false anxiety, including processing built-up “unmetabolized grief.”
Watts turns the discussion to grief, noting how many menopausal women face major sources of grief, like retirement, the death of one’s parents, or children leaving the home. Citing Sigrid Nunez, author of The Friend, she explores how life is filled with different sources of grief, like the loss of a potential future or the lifelong grief of major losses. She also shares Dr. Vora’s advice to process grief by crying, admitting her past own struggle to let herself cry or seek therapy. Over time, Watts has “changed,” prioritizing her mental health. She uses a combination of lifestyle choices, such as meditation and taking needed breaks, and medical interventions like hormone replacement therapy (HRT).
Chapters 3-5 Analysis
In Chapters 3 through 5, Watts continues to challenge the cultural silence around menopause, exposing how sexuality, shame, and mental health intersect with aging. She weaves together personal anecdotes, expert insights, and social critique to deconstruct long-standing biases that have left menopausal women underserved and unseen. By blending humor, honesty, and advocacy, Watts not only normalizes conversations around these issues but also empowers readers with the knowledge and tools to navigate them, continuing to highlight the theme of Taking Control of Menopause Through Information.
One of Watts’s assertions is that menopause does not signal the end of a woman’s sexuality but rather a shift in how women experience intimacy and desire. She challenges the entrenched idea that youth is a prerequisite for desirability, recounting her vulnerability in revealing her menopause status to her partner and his unexpectedly reassuring response. She describes this moment as more romantic than any scripted Hollywood line, highlighting how intimacy in midlife is about connection rather than unattainable physical perfection. This sentiment encapsulates one of the book’s central messages: aging does not equate to loss but rather to redefinition. With anecdotes like these, Watts continues to address the theme of Redefining Aging for Women, highlighting the unexpected benefits of vulnerability and authenticity.
Watts further critiques the way society frames aging through her reference to The Graduate, where Anne Bancroft’s Mrs. Robinson was portrayed as an aged seductress even though at the time of filming, Bancroft was only six years older than Dustin Hoffman. This example exposes Hollywood’s role in perpetuating the idea that women “expire” far earlier than men, reinforcing anxieties about menopause and aging. By addressing these myths head-on, Watts encourages readers to challenge the biases that shape their self-perception.
A crucial component of her discussion is the way that medical discourse reinforces this devaluation of women’s sexual health. She points out the stark contrast in terminology: men experience “erectile dysfunction”—a neutral, clinical phrase—while women endure “vaginal atrophy,” a term that evokes deterioration and decay. This linguistic bias reflects the broader medical tendency to view female sexuality as secondary to male function. Watts refuses to accept this framing, instead emphasizing that women deserve both treatment and pleasure. She highlights the range of available options—from hormone therapy to vibrators—asserting that sexual dissatisfaction should not be an inevitable part of aging. In doing so, she reinforces the idea that menopausal women deserve the same level of sexual agency and medical support as men.
A recurring argument throughout Watt’s discussion is that society not only ignores but actively normalizes women’s suffering. She expands on this critique, pointing out how often menopausal symptoms—whether physical, emotional, or sexual—are dismissed or misdiagnosed by medical professionals, exacerbating The Physical and Emotional Impact of Menopause. She shares her experience with “frozen shoulder,” a common menopausal ailment that doctors patronizingly dismissed as a forgotten injury, illustrating the broader issue of how medical practitioners often overlook symptoms that predominantly affect women. This pattern extends into sexual health, as Watts highlights through Dr. Casperson’s critique of male patients seeking Viagra without consulting their partners. When asked if they had discussed their sexual difficulties with their wives, these men often admitted they hadn’t considered it. Casperson’s response—“So you’re in my office, wanting Viagra to put your penis in another person and you didn’t talk to the person about that?” (42)—is both humorous and cutting, exposing the disconnect between medical priorities and relational realities. While men’s sexual struggles are readily addressed, women’s concerns are often met with apathy or reduced to psychological issues rather than physiological conditions worthy of treatment.
Watts also critiques the common advice given to women with low libido—essentially, to force themselves into sexual activity. She flatly rejects this notion, arguing that “if you’re sexually unhappy, it’s not true that there’s nothing you can do about it except make yourself try to have intercourse more” (36). This ties back to the overarching idea that women should not have to passively accept discomfort, whether in their physical health, sexual relationships, or interactions with medical professionals.
Watts identifies shame as one of the most pervasive barriers preventing women from seeking help, sharing their experiences, or acknowledging their struggles with menopause. She traces this conditioning back to adolescence, where young girls are encouraged to mature quickly while simultaneously internalizing a fear of growing old. This contradiction creates an impossible standard where women are either too old or too young, never existing at the “right” age. Hollywood reinforces this shame by portraying aging women as either invisible or undesirable, while the medical field compounds it by failing to address the realities of menopause. Dr. Gunter, one of Watts’s featured experts, argues that much of the shame surrounding menopause is socially constructed rather than a natural response to aging. This is evident in the way menopausal women’s experiences are often met with disbelief, including Watts’s own early attempts to discuss her symptoms. This shame is also predicated by silence, and Watts continues to highlight The Importance of Community and Expert Guidance, advocating for speaking openly about menopause in order to erase that shame and acknowledge women’s shared experience.
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