If you’re a woman who tuned in for the fourth season of the internationally acclaimed TV series Borgen, you undoubtedly observed the main character, Birgitte Nyborg, navigating the challenges of hot flashes, varying appetite, and disrupted sleep—a portrayal eloquently capturing the complex nuances of menopause.

Intriguingly, the decision to explore menopause in the narrative wasn’t arbitrary; screenwriter Adam Price sheds light on the thoughtful considerations that went into depicting Nyborg’s experience. The evolving age of Birgitte Nyborg, from a dynamic political leader in her 40s in the first season to a woman in her early 50s in the latest installment, provided a natural backdrop for addressing the profound changes in her life.

“For us, it was natural to talk about what’s going on in her body. It’s especially interesting because she sees herself as one hundred percent professional, with almost nothing in her life not professionally oriented,” says Price. “It’s fascinating to portray her body working against her.”

Crucially, the role of Birgitte Nyborg is portrayed by Sidse Babett Knudsen, a woman in her 50s, adding authenticity to the character’s age-related experiences.

Discussing Every Life Stage is Crucial

While delving into the specifics of menopause in Borgen, Adam Price emphasizes the broader importance of discussing every life stage. Borgen, known for its exploration of the intersection between the professional and the private, delves into the fundamental question of whether one can maintain power while preserving personal well-being.

“In the latest season, Birgitte Nyborg is a very powerful politician. She is party chairman and foreign minister in a newly appointed government, which means she works 16-17 hours a day as foreign minister,” notes Price.

Nyborg’s relentless schedule occasionally collides with the realities of menopause, offering what Price describes as an “insanely interesting” exploration. Her body sends signals, reminding her that she is in the midst of a significant life transition.

Drawing on Experiences from Home

To authentically portray menopause, Price draws from personal experiences, specifically from his mother’s candid discussions about her own menopausal journey. His mother, a highly accomplished professional in acting, directing, and theater management, exemplifies a generation that values control and resents any disruptions to functionality.

“We could see quite clearly that things were happening when she got hot flashes, how the hormonal fluctuations were reflected in mood swings. I think it’s important for the people around to know why it is happening,” Price reflects.

The Hot Flash Scene

The portrayal of menopause in Borgen is not merely a theoretical exploration but a carefully researched depiction of specific symptoms. In one poignant scene, Nyborg, amidst an important government meeting, experiences a hot flash, an entirely normal yet inconvenient occurrence.

“A hot flash is completely normal, but for Birgitte Nyborg, it’s incredibly inconvenient. She is almost angry with her body,” explains Price. “She’s angry at her menopause because it prevents her from being the person she used to be, and I think that’s interesting.”

This scene becomes pivotal, as Nyborg’s brief absence leads to a shift in the meeting’s dynamics. The realization that the meeting might have turned out differently without the hot flash adds an intriguing layer to the narrative.

Balancing Act

Price acknowledges the delicate balance required in portraying menopause in Borgen. The intent is not to overshadow Nyborg’s functionality but to intermittently highlight menopause as a supporting theme, reminding both the character and the audience of the significant life phase she is navigating.

“It’s crucial that we show the truth and tell some things that are sometimes complex. Hopefully, we can help push an agenda. We’ve certainly tried to do that in Borgen,” concludes Price.

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“Yes, I’m menopausal. Or at least in a transition in my life.”

He has noticed that age-related changes pops up as a topic of conversation amongst male and female friends.

The male friends primarily discuss that the potency is not what is used to be. The female friends on the other hand report that the man at home has become “grumpy”. More on that later.

He himself has begun to feel changes in his knees and back.

Pelvic exercises for men

He readily admits that he had no idea about what menopause was all about. Partly because it is a taboo and partly because he believes that there is a shortage of literature. In his work as a coach, he meets men who, like himself, are surprised by the changes that andropause brings along.

“We know very little about it. What does it mean that testosterone levels drop. Many men also have no idea that they can actually do something about it. No one has ever told men that doing squat or pelvic exercises are good for the potency. Try to tell a man to do squeezing exercises, then I can promise you that all traffic will stop, because that’s what women do in our universe,” says Manu Sareen, who is studying to become a sexologist.

Men must understand menopause

At the same time, he thinks it is “strange” that men also have no idea what their menopausal women are going through. He points at topics such as hormonal changes, decrease in the sex drive and vaginal dryness and everything else that some women suffer from both mentally and physically.

“It’s pretty crazy how much worry it causes for some women. And this is something you as a man should know that your woman is going through, so you can get a better understanding. Because if y stay in the belief that everything is as it usually is, and the woman feels otherwise, then it is suddenly a problem. There is an explanation for everything, and I have at least learned in my life that the more you talk about things, the easier it becomes to handle.”

Grumpy men

Manu Sareen believes that men’s menopause is more a mental thing eventhough physical changes also occur. It can be the whole idea of ​​having to get used to stepping into the last phase of life for better or worse that can be a challenge. Especially because he believes that men have a tendency to keep their problems to themselves.

“Men struggle with potency problems and physical stuff without doing anything about it. We have more knowledge on what is under the bonnet of our car than when it comes to our own body. A man can tell you exactly how many cylinders his car has. But he can not tell you about what is happening in his own body. That’s for sure. And then I think it’s a mental challenge to constantly stay up to date on what’s going on in one’s body. We avoid the subject because it is not so psychologically nice to deal with, ”he reflects.

He says that hormonal imbalance can affect the brain. And that men may not even notice that they hav become grumpy. But there is no doubt that women are noticing it. Manu Sareen reveals that several women report that the man at home gets in a significantly worse mood when he is around 50 years old.

“I think it may be because men are becoming aware of their own death. They may feel that theu haven’t realized themselves. Andropause is being re-framed to something negative, to a panic age, and I know that annoys many men. They feel the need for a life change. They have reached a point in their lives where they have an opportunity or desire to do something else,” he explains.

Manu Sareen hopes that more men and women will talk openly about the changes that are happening during menopause, andropause and just about the fact of getting older. He believes that the change is around the corner:

“There was not much focus on postpartum depression and men 10-15 years ago either. If you said you had a postpartum depression as a man, then people would make fun of you because that’s what women had. But there is a change happening.”

Mens version of menopause is andropause

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Menopause is a taboo in the states as it is in many other countries. Basic information and knowledge on menopause are limited so when Teresa Watkins searched for “hot flashes” as her symptoms increased intensively, she could not relate to what was written on the topic.

“My symptoms were not as typically reported. A lot of literature in the U.S. focuses on hot flashes, but really describes it as a face and neck sweating and flushing. I did not have any of those symptoms and still have not had them. But I have other symptoms and when I started using the Femilog app and read that hot flashes can just be periods of increased sweating or increased heat anywhere in the body it was a huge relief. It was so nice to have another source of information and to hear from women who aren’t having the typically described hot flashes”.

Changing clothes three times a day

The hot flashes were a real struggle for Teresa Watkins. She would feel extremely warm and on top of that her hands, feet, groin, and armpits would all get very sweaty. When the hot flashes would pass after around five to ten minutes her body parts would be extra sweaty leaving her no other option to change her t-shirts and underpants since they would be damp with sweat. This would happen three to five times during the day.

Apart from that she also started noticing changes in her mood. She would not experience mood swings like often reported by women. Instead, her moods would be very intense. She would get bothered or irritated by small things that usually would not bother her such as getting irritated on her spouse when a household chore had not been done.

“Normally I would barely notice it and then I would be unreasonably angry and so upset. I would not say anything but having that strong feeling of negativity over many little things with family members and friends felt like a real struggle to manage all the time. I would have a couple of days a month where I was so depressed and felt worthless and not very deserving of love and friendship. And then in one or two days I would be fine and back to my normal self. My anxiety in addition to waking up with my mind racing would increase. I felt like everything was a little more sensitive or a little more reactive”.

Hormones changes everything

Teresa Watkins got prescribed hormone supplements – estrogen and progesterone – to soothe her symptoms back in December, but it took her two months to finally take them. She describes how hard it was for her to decide taking hormones since she is not the type who takes medication even when sick.

“By February I realized I was so uncomfortable and struggling with so many symptoms that I didn’t think I wanted to do that for a full year. My symptoms made me feel miserable. I also had some forgetfulness which affected my work. That foggy memory. I would have very tender breasts and diarrhea. Luckily, we work from home right now because of the pandemic, but having to run to the toilet five times in the middle of a workday and being physically uncomfortable all the time and then the emotional symptoms on top of it made me decide to take hormones for a short period of time,” she reveals.

And the results were almost immediate.

Her symptoms have been more manageable ever since she started taking hormones. Teresa Watkins still has the emotions, but the intensity of being so angry have decreases and she does not wake up five to six times as she used to during the night anymore.

“Thankfully, I have had no side effects other than positive ones such as fewer headaches. My hot flashes are less frequent and less intense. I still have them occasionally in the daytime. Prior to my menopause symptoms I was always coldblooded and wearing a sweatshirt to stay warm. After a week of starting on hormones I noticed I am now occasionally again wearing a sweater in the house. I think my temperature has normalized. I know menopause is a natural process and I don’t mind the changes, but it is nice to have something that helps me maintain my work and my relationships.”

Involve your partner

Teresa Watkins has been taking extra care of herself and advice other women to do the same during menopause. She knows that one size does not fit all when it comes to menopause symptoms.

“We each have to find our own answers. But I think it is important to let your partner know that you are going through menopause. I said to my partner that he must be extra nice to me for the next two years. Letting him know that I might be extra grumpy and that it really does not have anything to do with him was important to me. We also talked about lower libido and he was very accepting and saying my body is aging too, so we are going to age together and figuring out how to successfully navigate ageing.”

Teresa Watkins has planned to taking hormone supplements for two years and will use her logged data on Femilog to see how the changes has affected her to decide whether to continue hormones on not.

Why Teresa Watkins uses Femilog – Menopause Health Tracker

“I would absolutely recommend Femilog to women. It was so comforting to understand that what was happening to me was also a part of menopause. When I enter my symptoms each day there is always that list below in the app that has little tit bits about mood and libido. It is so helpful to read those. By paying attention on what is going on in my body it makes menopause less scary.

I like getting the little responses from the app when I wake up five times a night and the app says that sounds terrible. It is nice getting that feedback and realizing that this is normal. It helps me putting it into perspective. For instance, when I am having a whole week of anxiety and just acknowledging that through the app that it has been a tough week, but that is okay.

The data that I have logged on Femilog will be helpful when I go in for my annual health woman examination this year. To be able to have some data I can share, and show is important.

And it will be especially helpful for me when I see the results of the hormone supplements that I a taking and notice when I have fewer symptoms and know that it might be a good time to try ending the hormones. Femilog is a wonderful app and a wonderful resource.”

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”There is a hunger for knowledge about menopause. The information that many women have is that life will probably come to a standstill when you reach menopause. One is frightened by it, and thinks that something terrible awaits me. And that’s a shame, ”she says.

Women misinterpret the situation

Menopause begins when the ovaries stop maturing eggs and the amount of the sex hormones estrogen and progesterone decreases. The decreased amounts of hormones can to a greater or lesser extent cause nuisances such as hot flashes, & nbsp; bleeding disorders and delicate mucous membranes in the vagina and urinary tract.

Lotte Hvas says that hot flashes are probably one of the most well-known genes that women associate with menopause. If, on the other hand, the talk falls on what happens to the mucous membranes during menopause, then the women lack useful knowledge and are not aware that the problem can be remedied. & nbsp;

”I have often come across women who mistakenly believe that they lose their sex drive during menopause because the mucous membranes become more fragile and dry. Many people experience changes in sex drive and automatically link dry mucous membranes with lack of sex drive. But it does not necessarily fit. It is more about a biological change ”.

According to Lotte Hvas, a large part of the information work consists of telling the women that they can actually do something about dry mucous membranes, so that it does not have to be a problem and hurt during intercourse. She mentions that there are, among other things, preparations with and without hormones, water-based or silicone-based lubricants that can alleviate the genes.

Listen to your body

Menopause is a time of change, which is experienced differently from woman to woman depending on the specific symptoms and the woman’s life in general. About a third of women feel almost nothing, a third have some symptoms that are to live with, while about a third have so many symptoms that it can affect the quality of life. When menopause is experienced so differently, it can be difficult to advise. Lotte Hvas therefore believes that it is important for women to listen to their body and trust their body.

”It’s a period where it can all rock a little. You lose some control over your body. And it can all feel very insecure in a world where we need to be in control and have a check on everything. But we must remember that menopause is a transition, not a downfall. And if the quality of life is severely affected, you must seek help. One should not make menopause sick, but also not downplay it ”.

Lotte Hvas has written the book “Menopause – better than her reputation”. Femilog draws lots for the book among the group’s followers.

Af redaktion. Foto: Sussie Jensen

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Hormones or not hormones? That question has probably crossed the minds of women who have had problems caused by menopause.

If you seek advice and guidance on the subject, you will soon realise that the answer can often depend on who you ask. Because there are different medical attitudes to hormone supplementation during menopause.

Looking 20-25 years back in time, about 50-60 percent of menopausal women in Denmark  would have tried hormone therapy. By 2020, that number has dropped to about 20 percent. That is a decrease of about 67 percent.

Interprets results differently

The reason for the declining number is, according to Professor Ellen Christine Leth Løkkegaard, Department of Gynecology and Obstetrics, Nordsjællands Hospital, lies back in the 1990s, where the total advantages and disadvantages of hormonal treatment was conducted in a large study. 

However, the clinical trials were discontinued twenty years ago because it was found that women became more ill from hormonal therapy, which primarily resulted in blood clots in the brain.

Ellen Christine Leth Løkkegaard explains that the experts interpret the results differently, with some experts advocating hormoneal treatment, while others hold back. This is not least because there are both advantages and disadvantages to the treatment.

Pros and Cons

Looking at the benefits of taking hormones, the professor believes that the supplement is a “really good treatment” for hot flashes and sweating. Some women experience that the mood gets better, while others will feel a beneficial effect against vaginal dryness that women experience when estrogen levels fall.

If, on the other hand, you look at the disadvantages of hormone therapy, it is important to keep in mind that there are receptors for hormones in all cells of the body. In some organs hormones have a beneficial effect and in other organs it has a harmful effect. Therefore, there is a bill to pay in the long run when a woman opts for hormone therapy.

”We discuss how big that bill is, and how much one should look at it in relation to making the decision to take hormones, and there we do not completely agree. This is similar to the discussion about whether the glass is half full or half empty. Some experts choose to look at the consequences in the short term – because there are also – and then some look at the long-term complications of hormone treatment, “she explains.

A matter of 

According to Ellen Christine Leth Løkkegaard, a woman must therefore look at how bad her conditions is before making the decision on hormone supplementation.

”If you have a really bad toothache, you may need to take a pill that may give you stomach ulcers. But you take the pill because you have so much pain in the tooth that the crucial thing for you in that situation is that the toothache disappears. In the same way, it is with menopausal symptoms,” she points out.

Hormones for a maximum of five years

Women who have breast cancer, are at high risk for breast cancer or have had a blood clot in the brain should completely refrain from hormone therapy. If you are looking for alternatives to hormones, you can look at your diet and exercise habits and lifestyle. Ellen Christine Leth Løkkegaard says that there is also evidence that red clover tea to a certain extent has a beneficial effect on heath and sweating.

Danish Society for Obstetrics and Gynecology, recommends that you take hormones for a maximum of five years and gradually reduce them. It has not been proven that you can avoid the symptoms coming back. But by stepping down slowly, one can trick the body into making sure the symptoms do not come back. Therefore, one should not interrupt a course abruptly as the symptoms recur.

Why women lose hormones

In childbearing age, a woman “lays” an egg every month, which in theory can be fertilized so that the woman can become pregnant. In connection with the production of eggs, some hormones are produced. The hormones help to effect the entire maturation of the egg.

In the first half of the cycle, the process is dominated by estrogen. For the second part of the cycle, it is a combination of estrogen and progesterone. As the woman loses her fertility when she reaches menopause because the ovaries run out of eggs, there is in the production of estrogen and progesterone further from the ovaries. The woman experiences a drastic drop in estrogen and progesterone she has no more of.

Women take hormones as a supplement to the lack of production from the ovaries. She can either take hormones as tablets, gel or in other forms.

Derfor er eksperterne uenige om hormonbehandling i overgangsalderen

By editorial staff

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