"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?

The davina 2 programme covered this - have a watch

ongoing research in Oxford and Cam uni too - was in the news. If I can find a link will share

Not in the link shared? It talks about people with Alzheimer’s over 70?

are we reading the same thing? Seems a very limited study.

www.themenopausecharity.org/2022/04/25/can-hrt-help-protect-against-alzheimers-and-dementia/

more reading!

Oct 2021
Ellen Grant, Physician and medical gynecologist.
Susan Bewley, Professor emeritus (honorary) in obstetrics & women’s health.
Elizabeth Price, Physician and microbiologist.

MHT Increases Dementia Risks
www.bmj.com/content/374/bmj.n2182/rr
(MHT= Menopausal Hormone Therapy…simply another term for HRT)

“Vinogradova et al’s retrospective case-control study shows an association of taking combined MHT for 5-9 years or 10+ years with 11% or 19% increased risk of Alzheimer’s disease respectively.(1) It is well known that women have twice the risk of Alzheimer’s Disease compared with men, plausibly because many take exogenous progestogens and/or oestrogens as contraceptives or MHT. It is already known that MHT increases the risk of dementia: the Women’s Health Initiative Memory Study (WHIMS), a randomised trial for the “prevention of dementia”, instead found 4 years of combined MHT doubled the incidence of dementia in women over age 64 years.(2) A pooled analyses of combined and oestrogen-only MHT produced a 76% increased risk.”

1. Vinogradova Y, Dening T, Hippisley-Cox J, Taylor L.Use os menopausal hormone therapy and risk of dementia: nested case-control studies using Q Research and CPRD databases. BMJ2021;374:n2182

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

2.Shumaker SA, Legault C, Rapp SR et al., WHIMS Investigators. Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: the Women's Health Initiative Memory Study: a randomized controlled trial JAMA. 2003 May 28;289(20):2651-62. doi: 10.1001/jama.289.20.2651.

Studies looking at whether replenishing oestrogen levels using HRT can reduce women's risk of dementia have been inconclusive and contradictory. For example, some studies of women who were already using HRT during menopause found that their risk of dementia was lower than those not on HRT. However, other studies found no strong evidence for this. There is some evidence that HRT may even increase dementia risk.

This would be the key part. The massive long-term studies into HRT have not shown any reduction of dementia, as some had hoped. It did not prevent dementia, in the women studied, ie. In some studies it increased the risk.

‘Women taking hrt 73% less likely to get dementia’

this is more recent than the studies the Alzheimer’s society are quoting? Which also seem to be based on women who wouldn’t have used the products GPs prescribe today?

the AS don’t seem to be very up to date which is frustrating. Who knows which to trust?

The bit in bold doesn’t seem to tell us anything. Some women were ok and some weren’t. Hopeless.

The link that @Newgirls posted is a very recent study. There is new research out all the time and that means we don’t need to rely on old and out of date studies.

It’s like a jigsaw and we don’t have all the pieces yet but more research is being done.

I do agree we need more research and fast though.

How can we discount a recent study of 400,000 women? The results from that are very interesting.

The bit in bold doesn’t seem to tell us anything. Some women were ok and some weren’t. Hopeless.

Well, it tells us a lot if we know how to read it.

As does the fact that no government's guidelines for menopausal management suggest using HRT for preventing dementia.

Both @Newgirls study and the Vinogradova one I posted are from 2021, but have contradictory results.

My reaction too. Just as we as a society are becoming more willing to discuss the issue, BAM! Here comes the BMJ to dampen our hopes.

We’ve covered this - it’s across all age groups not just longevity

Yes we know that, but the intelligent question is - will they, and when? And should we hold off taking hrt and waste time protecting our brains? Those with Brian fog and memory loss and family history of dementia need to know.

more research and fast please

Two studies - the one on the Menopause Charity site study and the Vinogradova one I posted are from 2021, but have contradictory results.

If there are contradictory results in 2021 should the Menopause Charity show both or is it ok to select one, or can a vested interest be a factor? The founder’s clinic brings in high fees

How do other charities deal with this, it’s quite close a relationship and reminds me of pain management market - which I’ve found hugely interesting recently

more research and fast please

We've covered this. Large lengthy studies - which are what is needed to provide any sort of data worth taking serious note of - are extremely expensive. Even if a new one of these was started today, it would be decades before results were in.

And that’s the problem. It’s too late for me, the menopause is rapidly disappearing in the rear view mirror.

To be honest if you are getting symptoms like brain fog surely taking Hrt would make sense anyway?

I've got brain fog from covid, plus exhaustion and a horrible itchy skin condition and breathlessness. I'm hoping it will all go, I think it is getting better but very slowly. I do sometimes worry that whatever covid has done to my brain will mean I'm more likely to get dementia but there isn't much I can do about it. I can't do anything about the other symptoms either, no one seems to know what to do.

'We've covered this. Large lengthy studies - which are what is needed to provide any sort of data worth taking serious note of - are extremely expensive. Even if a new one of these was started today, it would be decades before results were in.'

2002 was the last larger scale whi study, I believe since found to be flawed however it was 20 yrs ago! I think we really could have expected large scale studies since. Studies may be expensive but so is the care of women with osteoporosis and dementia. Wouldn't it be cost effective to spend on research and save generations costly nhs treatment. The fact they don't does make me wonder if it wouldn't have such a massive impact on osteoporosis and dementia care afterall. Who knows. It'll be the current 20/30yr olds who will possibly be the best informed when they reach peri.

That is true of pretty much anyone in the health world - Alzheimer’s trust included.

Well yes quite

lots of posters here seem to ignore that the symptoms of meno (albeit that is a very reductive labelling) are signs that something isn’t right in the body - not just a
passing phase

Yes I think this is interesting

thankfully increasing numbers of GPs and specialists in bone health and dementia are calling for more research as they see firsthand the issues with these

the nhs needs to focus more on preventative health but with the state of our gov and nhs right now that doesn’t seem hugely likely

anyone interested in womens health should be pushing for better politicians

That is true of pretty much anyone in the health world - Alzheimer’s trust included

Who do you mean? Are there other charities where the founder has private clinics?

iirc the founder is Louise Newson and stands to gain a lot if a charity is set up to appear as a more impartial front and can promote the research that works in favour of the service provider

It reminds me of the pain clinics and the intertwined set up between impartial and £

I recommend Empire of Pain of anyone is interested in how connections can build markets

The findings of the WHI and the Million Women Study did not indicate any particular value in HRT for dementia prevention. The ongoing Women's Healthy Ageing Project at the University of Melbourne, which has studied women over a thirty year period, has not found any significant links to HRT and better outcomes for dementia.

If you are actually interested in preventing dementia, you would be best following the suggestions of dementia researchers.

They suggest there are 12 modifiable risk factors: less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and low social contact, head injuries in mid-life, excessive alcohol consumption in mid-life, and exposure to air pollution in later life.

Wow are we really quoting the debunked WHI study from 1998? Jesus wept.