The news that a sequel to last year's Sex and the City movie is being planned should be of interest to more than shoe fetishists. By the time the film is released, most of the lead actors will be aged 45 or over and - potentially - menopausal. While I doubt that any serious academic research has been undertaken into the ovarian function of Hollywood stars, I'd hazard a wild guess that this is not standard blockbuster territory. Whether Samantha, the character of 52-year-old Kim Cattrall, will be having hot flushes alongside hot sex remains to be seen.

Depending on which report you've been reading, this month middle-aged women have either never had it so good, or never so bad. In a survey published last week and examined in this paper's women's pages, 77% of respondents said that they were having the best sex of their lives in their 40s. It was suggested that hormonal changes brought on by the approaching menopause - when testosterone becomes ascendant - might be responsible for this later-in-life epiphany.

Elsewhere, according to a new study by the NHS Information Centre, middle-aged women suffer more anxiety and depression than any other group in the country, with nearly a quarter of those aged 45 to 64 exhibiting symptoms, an increase of 20% in the last 15 years. Responding to the figures, 53-year-old Sally Brampton, former Elle editor and current agony aunt, who has herself had clinical depression, wrote how her generation felt overworked, overlooked and biologically redundant. The menopause was a particular shock, she said, for women who came of age in the 60s, with all the exciting new possibilities that era afforded them, and swore to themselves that they would never turn into their mothers.

While the travails of thirtysomething women - in their relationships, fertility choices and career ambitions - are relentlessly picked over, those of their older sisters receive markedly less attention. Yet they are often dealing with the heaviest stress of their lives, still raising children while managing the care needs of elderly parents, as well as coping with fundamental changes to their own body and self-image. And those changes are not made any easier to accept when the menopause remains the subject of casual misogyny, euphemism and taboo.

A plethora of self-help books offering advice on "managing", "surviving" or "outsmarting" this transition does little to dispel the notion that it is something only to be dreaded. And, while the menopause can of course be accompanied by unpleasant symptoms such as hot flushes, sleeplessness and depression, these are neither universal nor, in most cases, debilitating. Although loss of libido is most often ascribed as a side-effect, recent research has found that many women's capacity for arousal and orgasm actually increases.

But these leavening facts have no place in the current discourse, which characterises this age as a time of loss, pathologising what really ought to sit as naturally on the timeline of a woman's development as puberty or pregnancy.

In Hot Flushes and Cold Science, her fascinating history of the modern menopause, published next month, Dr Louise Foxcroft charts the way that it has been historically medicalised in western culture, to the extent that it is now viewed by women as well as the medical establishment as a disease requiring urgent intervention. She also examines the dearth of evidence connecting the menopause to mental health, despite their often lazy linkage, and argues that lows which occur around that time might equally be ascribed to other life events involving partners, work, children, elderly parents, quality of sleep or health.

What is not in dispute is that the menopause is a phenomenon with a cultural context. Our society continues to equate female sexuality and attractiveness with youth. And it still measures a significant proportion of a woman's worth according to her ability to reproduce.

Regardless, I suspect that many older women have indeed reached that state of grace where they are confident enough to judge themselves - and demand to be judged by others - not only according to what they look like in the mirror. And, as Foxcroft concludes, when it comes to being done with the palaver of contraception and pregnancy, freedom is a powerful aphrodisiac.

Diana Athill aside - winner of last year's Costa biography prize and heroic chronicler of desire beyond 50 - very few cheerful narratives exist for those women who may well be more sexually confident than ever before, but are only encouraged to feel obsolete.

As our population continues to age, an increasing number of women will be spending a sizable chunk of their lives post-menopause, and could perhaps do with better public mirrors than Twiggy or Marie Helvin in an M&S campaign can provide. And more realistic ones. I doubt there are many 60-year-olds who still want to be supermodels, but they might not balk at the idea of being appointed US secretary of state.

l.brooks@theguardian.com