"Doctors warn against over-medicalising menopause"

[flashbac]

"Writing in the British Medical Journal they said there was an urgent need for a more realistic and balanced narrative which actively challenges the idea that menopause is synonymous with an inevitable decline in women’s health and wellbeing..."

www.theguardian.com/society/2022/jun/15/doctors-warn-against-over-medicalising-menopause-after-uk-criticism

I must admit, the raising awareness of how shit the menopause can be has created some worry about my impending menopause, so much so that I've decided against a career change in my 40s.

Are we making too much of a big deal and being overly negative? Or are these doctors just being patronising? Anyone had an easy menopause?

I don't know what to make of this tbh. I'm 48, and experiencing some symptoms which could be attributed to menopause. However, so far I'm managing without any medical input. However, I'm still having periods, so I'm aware that I may have worse to come. I'm finding the worry, the anxiety, the fluctuations in libido and the feeling that I'm "past it" in lots of ways to be the most difficult parts.

Ah is this the same narrative that says having a baby is completely natural so women don’t need the medical care they think they need or want? Basically another moment for the medical profession to tell women to shut up and stop costing money

When they stop the little blue pulls for erections, we can talk about women's aging being 'natural'.

I am guessing that wasn’t written by female doctors.

there is never going to be a one size fits all approach that works. But it’s right the conversations are now happening around menopause, and the fact some women need medical intervention to help which is fine. It has been taboo for to long meaning to many women have suffered when they didn’t need to.

Babies come out of women, so why would they want pain relief if we put things in to their uteruses to take biopsies?

That sort of thing. Same energy. They can fuck off. The menopause is and has been crippling for women in my family.

Absolutely agree with this. 👍🏻

These are the same Dr's who on average send women suffering with endometriosis home with a flee in the ear for wasting their time for ruffly 8 YEARS before sending them to gynaecology for further investigation. Nah they can shove their opinion somewhere painful (to them) and I'll stick with my lovely female Dr who has been marvellous with me and my hellish peremenopause thanks

Well it would make a change from under medicalisation!!! Basically if I go to my gp the symptoms are causing an issue that will need help with. So bloody help!!! If that’s drugs/talking therapy/exercise whatever. Personally …. male gp citriloplan (no help) female gp hrt (bloody amazing)

I as very very lucky and feel like I sailed through the menopause but the few years before were pretty horrific with fibroids and flooding and severe migraines every month. I never felt like I needed HRT so I think the article has a point. But I have friends who have suffered terribly with severe symptoms and have really needed HRT. It's right that the subject is being discussed and promoted.

What utter bullshit. No one is 'over-medicalising' the menopause. Quite the opposite, in fact - women still have to battle for HRT in many cases. I had to go private to get the HRT I needed for painful, debilitating and emotionally devastating peri-meno symptoms as my GP simply failed to take me seriously.

Interesting that this is in the same newspaper today... Letters page

"An Australian cross sectional survey of midlife women (n=776) in 2001 found that 90% were not troubled by the physical or psychological changes of the menopause transition.9"

Actual article in the BMJ is quite interesting. Suggests we should "normalise" the menopause and educate, so the fear factor is removed and thus doesn't cause even more distress.

www.bmj.com/content/377/bmj-2021-069369

Appears to be written by women, if we judge by names...

Also interesting:

"Social influences on the experience of menopause are further illustrated by the effects of migration. Women who migrated from India to the UK (n=52) reported similar vasomotor and psychological symptoms to white British women (n=51), while those who remained in India (n=50) reported few or no vasomotor symptoms."

There is a 2 year shortage of HRT. I think the timing of this is just too conicindental.

Interesting rapid response comment from Dr Louise Newsom et al

Sorry, Newson

What about over-medicalising erectile dysfunction - any BMA articles on that? No? Thought not 🙄

I am guessing that wasn’t written by female doctors.

According to the link, it was written by 4 female doctors
Martha Hickey, obstetrician-gynaecologist
Myra S Hunter, clinical health psychologist
Nanette Santoro, obstetrician-gynaecologist
Jane Ussher, critical health psychologist

I just linked it to the shortages. Make is shut up and go away so it doesn't show them up type of thing.

I wonder if those 4 female doctors have hit menopause yet.

Makes me feel weary that when I actually get through the fort knox that is my GP, I'll have to go in, in combative mode.

This part was interesting
“Negative views about reproductive ageing in women have pervaded the medical literature for centuries. In the 19th century menopause was thought to cause a nervous disorder with multiple physical and psychological manifestations. The ovaries regulated women’s identity (femininity) and their physical and mental health were contingent on the balance between ovarian excess or deficiency. This model was clearly articulated in Feminine Forever by the gynaecologist Robert Wilson, who recommended oestrogen for all menopausal women to treat their “serious, painful and often crippling disease” and avoid the “untold misery of alcoholism, drug addiction, divorce and broken homes caused by these unstable, oestrogen-starved women.”

I sailed through menopause. I totally know that for some HRT is massively life changing (in a good way) but I do feel that “sometimes the menopause is completely fine” is lost in the narrative. I had mild hot flushes and night sweats when I was peri, some flooding; but it wasn’t debilitating and has passed. I feel epic now and am fitter and healthier and stronger than ever. I can’t drink alcohol any more (immediate bad reaction including night sweats) and yes my body feels older in lots of ways but my quality of life is v good. I love not having periods and hormone swings and all the crap that went with periods: this is much better. I don’t hear that narrative often and think we are being taught to expect that it is going to be awful. For some, yes, and it is right they get treatment to alleviate symptoms where they can; but it is also possible to “sail through.”

Oh they can fuck right off.
im just starting my peri menopause and they can fuck off.
may mum was vile during hers and I can see mine heading the same way.

if you need it, you need it.

if you can get by with little to no support brilliant.
they can fuck off with that attitude.

the minute women start talking and asking. They don’t like it do they

Surgical menopause when I was 42. I am 57 now. It was hell for a year or so but I got through it, no HRT. My skin is balanced now not oily,no acne, no mood swings. Yes I have grey hair and wrinkles and a bit of stress incontinence. But this is so much better than before.

I wonder if those 4 female doctors have hit menopause yet.

Good question. Dr Martha Hickey graduated with her BS in 1981, so must be in her 60s at least. Dr Myra Hunter received her PhD in 1988…so again must be in her 60s at least too. Dr Nanette Santoro got her MD in 1979…so perhaps even almost 70? Dr Jane Ussher “started her PhD in 1983”…so also in her 60s at least.

So all women, all doctors and all post menopause.

Very much this.

the minute women start talking and asking. They don’t like it do they

Exactly.

I think it's great that some women 'sail through' the menopause. All power to them! But it seems to me that, now that it is finally becoming mainstream to talk about the peri- and menopause, women are suddenly being told to pipe down and not scare the horses? And yes, what a coincidence that this article appears during a time of HRT shortage...

'Over-medicalising' would mean that HRT and other pharmacological solutions are being handed out to women who do not require them. Since this is very clearly not the case, i cannot for the life of me understand the point of this article. As Newson says, this feels more like gaslighting.

Then again, it would hardly be the first time that the BMJ has printed clickbait bollocks. Standards have been dropping in that publication for a lonnnnnng time.

I must admit, the raising awareness of how shit the menopause can be has created some worry about my impending menopause, so much so that I've decided against a career change in my 40s.

Please tell me you are not serious?

The idea of being aware of potential challenges around peri menopause and menopause is not to mean you decide to limit your life and potential opportunities.

I am 46 and taking HRT for about 9 months now. It's been transformational. I had a number of awful years where my normally great GP was blithely dismissive of the symptoms. Finally there was an explosion of awareness here (Ireland) which changed the approach & I was prescribed HRT.

So yes, those symptoms really affected my emotional & physical well-being including affecting me in work - but I never considered limiting career choices as a solution. And you're only doing it with a view to possible symptoms.

If & when you face that, there are options to resolve it.