"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?

Not sure what you mean by "post menopause" and " when it's all over and done with"....the effects of hormone deficiency can last forever . It's not a two year thing then that's it done and dusted for some women.

That does sound scary, in my family it is cancer. The family does carry the BRCA1 gene but fortunately I got the all clear on that one but it isn't just BRCA cancers, we seem to get all sorts. Genetics lottery isn't it.

It would be brilliant for you if they can sort out what benefits HRT would give you for Alzheimers. These things seem to move so slowly but the covid vaccines show what can be done if the money is there.

I hope you get some answers.

As can be seen on here if you dare to say you didn't have problems you are subjected to aggressive replies. No surprise if people who had no problems or few problems don't mention it.

It's a menopause board, not technically an HRT board.

Have a read of any thread that tries to discuss HRT-free/"natural therapies"/alternative routes through menopause - you're lucky to get more than one reply before the bone-pointing begins...

There is good and helpful knowledge there, but it is not a balanced discussion.

I do wish there was a stickied post explaining Vagifem and Ovestin, though. So many women don't realise the value or need of such, and suffer unnecessarily, or understand that they are not at all the same as "going on HRT" systemically.

Why ? Because women who expect menopause to be bad will likely have worse symptoms. Because women need to know how their actions affect how they will feel

Do you tell bowel and other cancer patients that - that they expect bad things to happen because they have heard so much about it recently so their cancer will be worse? What an awful thing to say.

You can selectively post all you like but shall we see what I actually said? I wonder if women who had difficult periods feel more positive about menopause? I mean if you fall into no menopause symptoms or mild ones and you've had 30 odd years of period pain, PMT, migraines etc you might just feel it's well worth it.

In case you are struggling with that I was specifically referring to women who have no menopause symptoms or mild ones and what they might feel about menopause if they've had 30 years of serious period problems.

I know you feel we can only discuss serious symptoms but it isn't up to you. I had serious period problems for years, I had an easy menopause and I feel very positive about my menopause and can you possibly open your mind enough to see that the combination of those two things might be why I feel positive about it and that other women with similar experiences might feel the same?

But, I don’t agree that menopause causes a lifelong hormone “deficiency”. This frames menopause as a disease that causes lower than normal levels of hormones hence a “deficiency”. This isn’t the case. It’s actually normal for your hormone levels and types to change during menopause because your body is no longer supporting fertility/child bearing functions. Your post is one of the reasons why this BMJ article titled Normalising Menopause was needed. The narrative in the media and by many profiteering private medical clinics has tipped over from the message that some women rightly need HRT to deal with peri-menopause and menopause into a message that menopause itself causes lifelong harm to all women and it must be counter-acted with HRT.

Menopause isn’t a disease like cancer is…how can you even think of them in the same way?

But, I don’t agree that menopause causes a lifelong hormone “deficiency”. This frames menopause as a disease that causes lower than normal levels of hormones hence a “deficiency”. This isn’t the case. It’s actually normal for your hormone levels and types to change during menopause because your body is no longer supporting fertility/child bearing functions. Your post is one of the reasons why this BMJ article titled Normalising Menopause was needed. The narrative in the media and by many profiteering private medical clinics has tipped over from the message that some women rightly need HRT to deal with peri-menopause and menopause into a message that menopause itself causes lifelong harm to all women and it must be counter-acted with HRT.

yes there are stock standard phrases that have appeared and are often repeated

deficiency is one and I’d add vital - vital for whom? All women?

Are these based on private fee based messaging or non-fee paying insight

It’s easy for marketeers to use phrases that push a product, often thought up by those with £ to gain

I don't agree that it frames menopause as a "disease" but it is certainly a condition that many women suffer from in varying degrees. If you feel that way about the media and certain clinics then that is your option. There are the obvious things that you refer related to the reproductive system but oestrogen fuels much more than that - the heart, the brain, your muscle mass and density and your mood. It's every woman's choice. I'm not a medical researcher - maybe you are? I'm happy to go with advice guidelines.

Let's go back to the original point of that post by @becausetrampslikeus shall we ? She said if women know too many adverse things about something whether a disease or condition then it may well mean that they dread it and so cope less well with it ? So that only applies to the menopause does it? It doesn't apply to other things that we hear about - bowel cancer, gall bladder removal, breast cancer, post partum depression, periods, dementia etc? That doesn't really make sense, does it?

www.drtinapeers.com This is another site that might be useful to some people looking for advice. I personally have used this doctor.

Not sure what you mean by "post menopause"?

Post-menopause is the period that begins after twelve months without a period, over 50, and lasts for the rest of your life.

I think some count two years without a period, if still in 40s, but others don't.

I have to admit the suggestion of your mental attitude influencing the severity of your menopause really gets my back up. It's the kind of thing doctors say to my daughter about her hellish periods...how about going for a walk etc. The same dismissive way womens health issues are often treated. I couldn't get rid of my joint pain by channelling good vibes and I was expecting to sail through the menopause anyway, no intention of taking HRT, especially as I'd never coped with the contraceptive pill. Yet here I am, on HRT.

I do wish there was a stickied post explaining Vagifem and Ovestin, though. So many women don't realise the value or need of such, and suffer unnecessarily, or understand that they are not at all the same as "going on HRT" systemically.

My Mum would have benefited hugely from topical oestrogen, she's one who claims to have sailed through the menopause without even blinking, yet she has awful vaginal atrophy and associated bladder issues, plus ever spiralling anxiety. Unfortunately the leaflets inside these products would have you thinking it is the same as "going on HRT". But it absolutely should be stickied on the menopause board.

That mental attitude affects severity of menopause is not what was said or suggested, I’ve cut and pasted it below. What was said is that there is no universal experience of menopause and that womens expectations and experiences of menopause are influenced by societal factors. That studies have shown that negative expectations/societal attitudes lead to negative experiences. “Experiences” doesn’t refer to whether or not you get symptoms in varying degrees of severity, but rather to how you view and react to these symptoms. Experience is the subjective reaction to objective reality. It’s not the objective reality itself.

”Furthermore, a systematic review of qualitative studies found that menopause is experienced in different ways globally. Specifically, women’s expectations and experiences of menopause are strongly influenced by personal, family, and sociocultural factors.10 Even within countries, social factors modify the experience of menopause. A 2021 international scoping review found that social factors including systemic discrimination, racism, and sexism together with personal factors such as socioeconomic status and beliefs about menopause shaped the experience of menopause in migrant women.11 In the US, menopause is earlier, and vasomotor symptoms more common and long lasting, in African American than in white American women.12 The reasons for these disparities are not known but structural racism, inequalities, and ongoing life stressors may contribute.

Cross cultural studies show substantial geographical and ethnic variation in the experience of menopause.13 Whereas women in high income countries tend to report more vasomotor symptoms,5a review of menopausal women in 11 Asian countries found that body and joint pains were the most problematic symptoms, affecting 76% of Korean women and 96% of Vietnamese women.13 Only 5% of Indonesian women reported hot flushes.

Women’s experience of menopause is also strongly influenced by social values around reproduction and ageing, with positive or negative ramifications. For example, women tend to have worse experiences of menopause in countries where their value is predicated on youth and reproductive capacity and ageing is associated with decline.10 In contrast, in a critical review of midlife embodied change, women identified freedom from menstruation, premenstrual symptoms, and contraception as positive consequences of menopause.14 Where menopause marks the end of restrictions such as purdah during menstruation, menopause may bring freedom, elevated social status, and a “second youth.”15 Together, these findings argue against a universal menopause syndrome since women’s experiences are strongly influenced by social context and cultural beliefs and expectations.”

10.Hoga L, Rodolpho J, Gonçalves B, Quirino B. Women’s experience of menopause: a systematic review of qualitative evidence. JBI Database System Rev Implement Rep2015;13:250-337. doi:10.11124/01938924-201513080-00018 pmid:26455946
11.Zou P, Waliwitiya T, Luo Y, et al. Factors influencing healthy menopause among immigrant women: a scoping review. BMC Womens Health2021;21:189. doi:10.1186/s12905-021-01327-z pmid:33957910
12.Harlow SD, Burnett-Bowie SM, Greendale GA, et al. Disparities in reproductive aging and midlife health between black and white women: the Study of Women’s Health Across the Nation (SWAN). Womens Midlife Health2022;8:3. doi:10.1186/s40695-022-00073-y pmid:35130984
13.↵Haines CJ, Xing SM, Park KH, Holinka CF, Ausmanas MK. Prevalence of menopausal symptoms in different ethnic groups of Asian women and responsiveness to therapy with three doses of conjugated estrogens/medroxyprogesterone acetate: the Pan-Asia Menopause (PAM) study. Maturitas2005;52:264-76. doi:10.1016/j.maturitas.2005.03.012 pmid:30280959
14.Ussher JM, Hawkey AJ, Perz J. ‘Age of despair’, or ‘when life starts’: migrant and refugee women negotiate constructions of menopause. Cult Health Sex2019;21:741-56. doi:10.1080/13691058.2018.1514069 pmid:30280959
15.Flint M, Samil RS. Cultural and subcultural meanings of the menopause. Ann N Y Acad Sci1990;592:134-48, discussion 185-92. doi:10.1111/j.1749-6632.1990.tb30321.x pmid:2197940

As I said, I had horrendous periods.

What you are saying here is you are allowed to gloat about your marvellous time and you give no shits about those that have had a horrendous time. Well, great. I personally am concerned with those that don't sail through it and yes I'm going to tell people who keep throwing their fucking fantastic menopause into our faces because I couldn't fucking walk with mine.

Why do you feel going 'ner ner ner' at people is in any way constructive?

Women’s experience of menopause is also strongly influenced by social values around reproduction and ageing, with positive or negative ramifications. For example, women tend to have worse experiences of menopause in countries where their value is predicated on youth and reproductive capacity and ageing is associated with decline.10 In contrast, in a critical review of midlife embodied change, women identified freedom from menstruation, premenstrual symptoms, and contraception as positive consequences of menopause.14 Where menopause marks the end of restrictions such as purdah during menstruation, menopause may bring freedom, elevated social status, and a “second youth.”15 Together, these findings argue against a universal menopause syndrome since women’s experiences are strongly influenced by social context and cultural beliefs and expectations.”

Yes my inability to talk up the stairs was definitely impeded by the cultural expectation of being able to walk up the stairs. And not by the lack of bone strength.

And you wonder why we tell you to fuck off with this bollocks.

That’s not what it is saying. Your anger is blinding you. You can say “fuck off” all you want but you’re 100% misunderstanding the text.

Sone people are so wrapped up in their own misery they can't see the bigger picture and furthermore it seems are quite happy to spread myths ( menopause is awful) that are more likely to make other people miserable too

Honesty is needed not scare stories
Fact is needed not anecdotes
Proper help is needed , not just HRT

Of course some people will sail through menopause just as some sail through life with easy, light periods and no PMT. For those of us who hit menopause like a fist to the face, these doctors can fuck right off.

I managed with the all over the place flooding periods and slight moodiness that it started with no problem, bit annoying but managable. Suddenly I was getting overwhelming hot flushes (ha, such a massively crap name for what is essentially your whole body consumed with heat like a furnace that you can't escape) literally every 20 minutes to the point where I could focus on nothing else. I run my own professional practice and have two teenage sons and a household to run. This was followed by depressive moods leaving me almost suicidal, general apathy and loss of motivation, completely fucked up sleep, forgetfulness, anger, eczema, aching joints, sudden weight gain and many more smaller things that get side lined with the big stuff. I managed a few weeks of the hot flushes before begging my GP for HRT. Within a week most of those symptoms had gone, only the sleep problems remain - I say only, I'm exhausted every day because of it. If someone wants to tell me to just accept it as a normal process I have to put up with when there are drugs available to make my life bearable instead, then I have some short sharp words for them.

You just told me my hellish experience is a myth.

Why do you think we get angry - women have had years of screaming about how bad they are and they get patted on the head and told to calm down.

This is in your face honesty. And you can't cope and have to tell me 'proper help is needed'. What help exactly? Crutches? Anti-depressants so people don't feel so depressed about the pain and lack of ability they are suffering? A chairlift [Don't think I didn't consider that it might be my next option. At age 45].

Women experience actual physical bodily issues due to the lack of hormones. This can last for 40-50 years. It isn't a societal pressure to be told that we still have to work for another 25 years before retirement and how we going to do that it is an actual reality.

Eat more sweet potatoes? Just stop drinking coffee, that should sort it out.

I say fuck that shit and I get called abusive. You want us all to pipe down and shut up and so people can post their little 'studies' about 'pressures' that are influencing us. What a fucking joke.

@AlisonDonut
Get over yourself. You’re not every woman. You can’t speak for all of us. No one is discounting your personal experience, it’s you who is insisting your experience is universal to all women. That’s why you think the studies done on the experiences of tens of thousands of women is ‘bollocks’ and are saying ‘fuck that shit’ because you are refusing to acknowledge that there is no universal experience of menopause.

I have to speak for myself as if I left it to you lot you'd talk the establishment out of HRT completely and women like me, who I have said many times over, are the ones who are ignored, refused testing, refused treatment and suffer the consequences, will carry on being treated as if it is all a myth.

Or a trend.

Or we were not busy enough.

Or we didn't have bad enough periods to enjoy it.

Or we should just shut up because we aren't all women and the women that really need to speak up are the ones with no symptoms.

I've never once said it is universal, I'm countering the bollocks that is spouted, as to why we are making such a fuss about it.