"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 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'd rather the Government website contained the same info your meno specialist has tbh. Why doesnt it? We are lay people obviously why put the info out there if it is misleading.

HRT is good to alleviate the symptoms but ultimately it will not stop the aging process.

🤦🏻‍♀️
You think people believe it will? I mean ...

I think that has been done to death but just to clarify I don't know anyone who is doing TV programmes saying all men of a certain age need the little blue pills. Some men do, some women need HRT.

The study doesn’t even imply that women shouldn’t get HRT or any medical interventions. It’s really about balancing out the narrative surrounding menopause to be less negative and also to ensure that more unbiased information is given to women to that they can be less anxious about and better manage menopause.

when I was taking/using hormones to delay the inevitable

That's not what HRT / HT does tho?

You are not understanding what I said. The bare facts/stats ARE there as with any medication you take printed on the instructions BUT as a lay person I certainly did not understand how to interpret these correctly. She sat with a pen and paper and discussed this in detail. I'm just saying that the one to one really helped me to understand the risk factor and particularly as it applied to me.

It's not misleading - it is a bare statement of statistics but there is further detail in the interpretation and how it applies to you.

It does however help to alleviate some of the ageing processes eg vaginal atrophy and the weakness of the surrounding muscles. Without oestrogen the vagina starts to dry up

I don't know why this keeps happening to my posts... Genitourinary syndrome of menopause (GSM) signs and symptoms may include:

Vaginal dryness
Vaginal burning
Vaginal discharge
Genital itching
Burning with urination
Urgency with urination
Frequent urination
Recurrent urinary tract infections
Urinary incontinence
Light bleeding after intercourse
Discomfort with intercourse
Decreased vaginal lubrication during sexual activity
Shortening and tightening of the vaginal canal

HRT can help this ageing.

I look 10 yrs younger than I should. Nothing to do with HRT. I have always had a fat round face despite whatever weight I am. Most of the women in my family age slowly. It’s all about the genes and nothing to do with hormones. None of the women in my family suffered with dementia despite averaging 85+ for generations. None of them took HRT. My aunt ( in-law) lost her mum and all her mums sisters to dementia. So far she has not shown signs of dementia but lives in constant fear of it after her family experience.
In my line of business I get to see generations of families. The diseases that seem to run in families seem to be diabetes, heart disease, dentists and cancer.
I very much doubt HRT will prevent dementia however it may delay it.
Dentist is increasing because people are living longer.
When I was diagnosed with breast cancer I researched the hell out of it. HRT didn’t cause it but as my cancer was very hormone sensitive it probably massively accelerated the growth of the tumour, maybe not giving my immune system to deal with it.
Since 1 in 7 women will develop breast cancer, many hormone sensitive are we really comfortable encouraging every woman to demand early treatment of HRT.
The other side effect of HRT was that I developed large uterine fibroids.
Many side effects are not really discussed. I think GPs are right to question this move towards HRT for every woman.

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.

^This has me concerned. The Stratford Newson menopause clinic generates around £5m per year. Their website is full of patient information leaflets that state all kinds of things about HRT safety and effectiveness but never cite any scientific references. The list of “symptoms” attributed solely to menopause and also supposedly cured by HRT is as long as my arm. These same people often speak out saying NHS GPS are untrained and ill-informed regarding menopause. All this makes me wary tbh. They have a vested interest in encouraging women to not use free NHS GPS for menopause care and come spend £400 for 10min consults with their doctors (most of who are also GPs in terms of medical qualifications). There’s a lot of money to be made out of preying on womens insecurities and anxieties surrounding menopause and having a negative unbalanced narrative generates more patients and more profit for them.

dentist- should read dementia

Hyalofemme twice a week has prevented all these symptoms for me. I have zero hormones due to taking anastrozole. It can be prescribed and is a lot cheaper. My bag is in perfect condition ( gyni commented on it during recent exam) and far better than when I was on HRT.

My bloody autocorrect is on fire this morning vag not bag. Slightly ironic🤣

This doesn’t attract me, and makes me wary, it also reminds me of pain management market o/s to a certain extent

Not saying it’s the same, we don’t have enough information yet but I’d much prefer NHS clinics with dedicated specialists

Not sure if the training is there even

😂😂😂

Experiences of peri and menopause are so wide ranging. For me, if it hadn't been for media messages about treating peri-menopausal symptoms I wouldn't have sought the HRT which has saved my mental health (and probably that of my 3 dcs and my dh too). I was feeling suicidal at points and I'm a grin-and-bear it type usually.
I'm happy to pay Newson and save the NHS a bit of money as I can afford it, and it's probably saved my career so I can keep paying for it!

@Reallyreallyborednow, the best observational study I've seen is open access, you can read for yourself, about possible HRT mortality benefits to low/non symptomatic.

Note: the benefit observed was only for combined not oestrogen-only, a 9% reduction in mortality risk (not huge) but they nicely tried to adjust for some common underlying conditions. Then they found no significant interactions of HRT type or age at initiation with other morbidities or lifestyle factors such as hypertension or smoking, which means that the effect of HRT on the hazards of all-cause mortality were the same across different patient subgroups.

That would result if there was a lot of imputation (my laptop won't open the supplemental file to see how much imputation exactly). Like all observational studies, long list of Limitations to it.

I don't keep up with all the HRT research because I don't care. HRT fans waffle on about different types of HRT available now & not in past: since that study is about past, so the types of HRT available now may be less or more mortality-reducing.

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.

It's insulting and ridiculous to suggest that all women who don't take HRT will turn into not very nice people. It's part of what drives ageism against women. Maybe your mother and MIL just would have been like that anyway. Is everyone on HRT suddenly a lovely person? obviously not.

Also this thread has examples of people saying that you'll get osteoporosis if you don't take HRT. It's not as simple as that and it's also quite victim blaming. Women can feel under a lot of pressure to take HRT nowadays. That doesn't seem right when I think of many in my nan's generation for example who seemed happy enough without it (and she didn't get osteoporosis.)

Note: the benefit observed was only for combined not oestrogen-only, a 9% reduction in mortality risk

seems to go against

‘For oestrogen-only users, an increased risk of developing Alzheimer's disease was seen only in the shortest exposure category of less than one year (adjusted odds ratio 1.11, 1.02 to 1.22), with no associated risks for longer term exposures. For oestrogen-progestogen users, however, we found statistically significantly increased risks for the longer exposures (adjusted odds ratio 1.11 (1.04 to 1.20) for five to nine years;’
www.bmj.com/content/374/bmj.n2182

and is why asking why people make statements is more useful than go away and Google as from earlier

To the average woman who isn’t a research scientist the information will be complex and mixed

I said if you have family history of osteo you should know about hrt. Get scans, do weight bearing exercise and eat calcium. Treatment for osteo includes hormone replacement. At the moment hrt isn’t recommended as a preventative. In 10 years that might change. We need these conversations however alarming they are.

Osteo is known as a silent killer because people don’t understand it or see it. It isn’t on the news and having stand up to cancer tv shows. But it is awfu so the more women know about it the better.

breast cancer risk is the scary one

the stats are for a 50 year old peri woman with a ‘safe’ bmi who doesn’t smoke taking patches for under 5 years increases her risk of breast cancer by 0.025%. That is info given by GPs.

compare that to the same woman who drinks 14 units of alcohol a week. The increase risk for breast cancer is 25%. Again given by GPs.

if you have family history or are worried about breast cancer (aren’t we all) stop drinking

the stats are for a 50 year old peri woman with a ‘safe’ bmi who doesn’t smoke taking patches for under 5 years increases her risk of breast cancer by 0.025%. That is info given by GPs.

'for under 5 years'

One of the issues that hasn't really been answered is how long you are meant to take HRT and what happens when you stop taking it. Presumably with your risk above, this increases if you take it for over 5 years.

Often it's said ' well the risk's less than drinking' as if everyone drinks.

Although Newgirls your stats re drinking and breast cancer risk are scary

I am genuinely pleased if people do not suffer through it. But this attitude is fucking smug and seriously lacking in empathy!

In particular this stikes me as stupidity to blame everything on the menopause when many 'symptoms' that I read about on the internet that women have mostly appear to be related to diet and exercise, and just generally getting older.

I am very fit, very healthy, very healthy diet. Ran, BMI 23, healthy diet. Nothing lifestyle wise could have been improved. Both befoe Peri hit and now. My menopausal symptoms were crippling feet/achilles/tendon pain, utter exhaustion, brain fog and anxiety. HRT has taken away all the pain (back running 40km a week), I have energy, my brain works and I have started a new, much higher level role because I have the brain capacity and confidence to do so.

So in your book I should have just ignored all my symptoms, been in pain, miserable, given up work (was seriously considering it as I thought I had early-onset-demensia), stopped exercising as it hurt too much and accepted it as my lot because I was "getting older?" Really? Fuck that.

Or, I take HRT and have a fulfilling happy life, contributing to taxes, my work, my family life and keeping body and soul fit and well.