"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?

More women than men get dementia. Fact. That is at all age stages not just because women live longer.

Brain fog and memory loss in your 40s and 50s. The brain is affected by oestrogen loss. Fact.

Neuroscientists around the world recognise this. Brain scanning is relatively new tech for mass studies due to its cost so research is only just happening on a large scale. So we need more research and data. So yes of course even more evidence is needed but we only just have the tech to do that.

this is cutting edge stuff. If you have women in your family with dementia you need to be aware of this stuff. It’s easy to say ‘no evidence’ ‘it’s big pharma’ etc but I’m 5-10 years time there will be women saying ‘why didn’t you tell us’

OOPs vaginal atrophy and the associated urinary conditions. Perhaps they have been partially affected by the increasing media coverage as opposed to the old hushed terms used.

Sorry my message got chopped in half.

All I can say is, all this 'awareness' raising has made me shit scared of the menopause, but I can see its also beneficial for those really suffering from the effects of menopause. I think the pendulum has swung too far the other way now.

Dementia and osteo kill more women than even cancer does. They also lead to very difficult final years. It’s depressing stuff but people need to know for the future especially if family history of this.

bone health - yes calcium and load bearing exercise is vital. Do that. Get scans. But also be aware of the bone protecting benefits of hrt.

It's certainly not faith based - researchers and doctors are not faith healers.

Hopefully when GPs get the training so badly needed and women have greater access to health knowledge we can all move on to jollier topics!

Try to embrace the positive knowledge that you have now - pity our poor Grandmothers who had to suffer all of this before any of this became available and lived on Librium and our Great Grandmothers who had nothing to turn to. There is no need to be scared.Knowledge is your armour.

Yet there is no actual evidence that hrt helps with things like dementia

And all the research on osteoporosis with hrt has been done in women with symptoms who are also more likely to have poor diet and low levels of exercise which are both also strong factors in osteoporosis

Ie osteoporosis studies have not been normalised against other factors

But yeah tell everyone it's essential , make women paranoid about it

Why on earth would it?

In the same way, when I heard about other women's birth experiences, I didn't get 'shit scared' about having children.

I appreciate some women might, but in both cases - just inform yourself about what you would like to do in the event of adverse incidents.

What does being scared achieve?

I wonder if people are told to stop over-medicalising erectile dysfunction.

Why on earth would you get paranoid about what strangers post on a forum? I don't read posts about the Russians invading the UK and get paranoid about that.

My grandmother was sectioned and given ECT back in the 1950s for what was clearly menopause issues
my mother terrified me as a ten year old screaming and throwing things and had the most awful time
i went to my gp and was prescribed HRT immediately and checked for a whole load of other health conditions and treated with compassion and care
I am so glad the menopause is being medicalised

@becausetrampslikeus that was for

The menopause is a subjective subject. I do agree that it is far too medicalised as are so many other conditions that are part of the aging process.
Many of my friends are patients at the Stratford clinic ( live fairly locally and friends can afford private medical care) but they pay astronomical price to obtain “state of the art” menopause treatment which suggests to me that there is an underlying economic gain for specialists in this area. £400 for a 10min review to obtain your bespoke prescription is not medicalisation.
It also has the knock on effect of alarming women who have been happy to go through a natural menopause. HRT is good to alleviate the symptoms but ultimately it will not stop the aging process. Many of the symptoms are due to wildly fluctuating levels of hormones and not the lack of hormones. Once through menopause your hormone level out albeit at a lower level.
Like many preventative treatments we need to identify the women who will most benefit from HRT re osteoporosis but b sting in mind that they may still need other adjuvant treatments.
I started HRT 5 years ago to try and alleviate muscle and joint pain. However it didn’t really have a massive effect. I had to stop after diagnosis for breast cancer. The joint pain returned but has settled now.
I have regular bone scans to check for osteoporosis but take Vit D and magnesium to help. Vaginal dryness and atrophy is not really a problem and I use hyaluronic acid gel to help. My libido dropped initially but is back now ( probably more likely due to stress of breast cancer treatment than lack of hormones).
To be quite honest I feel so much better now I am properly post menopausal than I did when I was taking/using hormones to delay the inevitable. Maybe I was lucky that I didn’t really start menopause until my early fifties.
I was a staunch supporter of HRT but after my experience with hormone sensitive breast cancer I’m now on the fence.

Because poor diet and low levels of exercise isn't the issue.

I was a head gardener in an organic veg garden when I got osteoporosis, ate all home grown organic food for years prior to that. Making out that people with osteoporisis are all lazy junk food eaters is quite frankly a fucking kick in the face to be honest.

And yes if you want to live happily past the menopause, if you need it you need it. Forcing women to keep calm and carry on and make you it's their fault is cruel and so you can fuck off with that.

This seems a good study which breaks down an increase in some cases and no extra risk, or decrease depending on type of HRT

www.bmj.com/content/374/bmj.n2182

Although I still think Really made good points re pitfalls of Google as the solution rather than discussion and hearing views, especially if they are linked to information found

It is part of the problem

Yes, I agree that anyone who thinks physical ailments are “in your head” is badly misinformed and being sexist. Of course CBT can also help women cope with any physical ailments that are not helped by HRT/medication as we do know it doesn’t always work on all women.

When folk say bossily 'Google it' we have info like this from the government website which says "all forms of systemic HRT are associated with a significant excess incidence of breast cancer, irrespective of the type of estrogen or progestogen or route of delivery (oral or transdermal)" Should we ignore scientific facts because someone on mumsnet thinks it protects against dementia?

www.gov.uk/drug-safety-update/hormone-replacement-therapy-hrt-further-information-on-the-known-increased-risk-of-breast-cancer-with-hrt-and-its-persistence-after-stopping

As I've said I am very much pro choice and if the issues associated with depleted oestrogen are having a massive impact of course hrt should be considered but there is a lot of minimising of the actual risks that goes on on threads like this and some uniformed posters who keep saying it is risk free, it protects against dementia and you can take it forever. We had one poster on another thread proudly announce she looked ten years younger than her poor crumbly hrt free pals and was mistaken for their daughter. Just bizarre and probably down to genes rather than hrt.

I want facts not opinions and the facts are all over the place regarding studies and evidence.

There's inconclusive evidence about dementia and falling hormone levels. That's not the same as no links. It hasn't been studied much yet - yes because the research techniques are new but also because of misogyny. Up until recently it was perfectly acceptable for every town and village to have the 'batty old ladies'. Older couple where the man does everything because the woman can no longer drive/manage finance/make booking etc - despite bringing up children decades before almost single handedly. As far back as the witch trials.

And the thing is, there is truth in it. I look at both my mother and MIL who both had large families. Both turned into, frankly, nightmares in their fifties which I now realise coincided with their menopause. People have walked on eggshells around them ever since. Neither took HRT as in those days it was seen as dangerous (and probably was in the older forms). Now in their early seventies, these women are barely functional.

Do you want to be that kind of older woman? I don't.

People who think ailments that are "all in your head" aren't real ailments are also unreasonable. All symptoms need to be treated and people who are unwell need support whether it is for physical or psychological problems.

I hate it when people are dismissed because it doesn't show up on an xray or a scan.

I sat with a menopause specialist and she explained in detail what all those risks are and what they actually mean per numbers when broken down. It's not as obvious as it looks to a lay person. If you want the facts then see a doctor experienced in this.

I listed that one first because it is something that is bothering me. I have trouble holding back the tears when I see babies and toddlers. I look at photos of my DC and long to turn back time and be a mum to babies again. I’m in the middle of menopause (got the symptoms), and my emotions are all over the place about it. I know I’m not alone in feeling this way as I have met women who feel similarly to me. I agree not all women will feel this way, it’s great that you have sailed through the emotional aspect of losing your fertility.

In regards to brain fog that would be strategies to cope if HRT doesn’t work (and we know it’s not a cure all for all menopause symptoms and doesn’t work on all women). It would probably be similar to the CBT done for people with cognitive difficulties. First off, making sure you don’t feel stupid or useless so addressing the emotional impact of it. Secondly, finding the aids and tools that can keep you organised and focussed. Thirdly, teaching fatigue management. This type of CBT is usually tailored to the individual. It’s not the mass group therapy type of CBT you may be familiar with.