"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 threads have been dominated by go away to any question of long term impact, from pp who seems to have missed own aggression rather ironically

Finally it’s broader

No one should stop posting their way through menopause though

'Some of this thread reminds of me of the GP who said to his mental health patient "go away I don't have time for you today". Same sad attitudes being trotted out . Buck up and go away.'

I haven't seen that attitude at all. In summary it started by people sharing their thoughts and opinions, all very helpful. Some discussion on the absence of evidence eregarding hrt and dementia and then a lot of discussing regarding one person's sadly negative experience. That is not the norm though, I've lots of family and friends peri/post who take hrt prescribed by their gp no problem at all. Complaints need to be made to specific practices if there is an issue. A pp said the gov had 'giving up' on hrt when this is just not true they have people in post specifically to deal with increasing supply!

I am very pro choice but we must have the facts to make a informed choice. HRT will of course suit some women but not everyone and not everyone needs it, some do manage with lifestyle changes.

I did a lot of research before seeking HRT some years ago before the celebration influencers got on board.
HRT helped my symptoms but did not get rid of them. The worst symptoms were palpitations, insomnia and vertigo for which no amount of oestrogen had any effect.
Post menopausal your natural oestrogen levels bottom out so you are totally reliant on artificial oestrogen either absorbed through the gut or transdermally which is no where near as well control as the natural oestrogen your body produces. As a result you will have breakthrough symptoms.
I don’t want to burst anyones balloon but it is not the magic cure they harp on about. The trouble is once you are taking it there is nothing else available so most put up with the symptoms.
I see a lot of patients who are very excited about HRT but it can take months to get the dosage and type correct. My friend who is under the Newson clinic spent nearly two years trying to get it right and still has to go back regularly for tweaks when symptoms recur.

On a slightly different theme this is a retrospective meta analysis of women who have developed hormone positive breast cancer while taking HRT.
An interesting point that it makes is that much of the data previously available from drugs trials was for women who first started HRT after the age of 60. HRT was developed originally to try and reduce the increasing problem with osteoporosis and for women with premature menopause, prescribing for menopause symptoms came later.
The data is very interesting and worth a read.
Again I chose HRT despite the risk and would do again. However I would probably not take it for more than 5 yrs. The women in my family are long lived and none of them suffered with dementia or osteoporosis. We are the first generation to take the pill or have access to HRT, both my sister and I have had breast cancer ( no genetic cause) so I can only conclude it is environmental ie over exposure to oestrogen.
www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext

Where I live there is a shortage of GPs, I think there are probably shortages in many places. In my town and surrounding towns GPs have been retiring and no one to take over so one large practice is now covering a wide area. They are trying to manage things by having nurse practitioners, paramedics who can prescribe, doing lots of online consultations, HCAs trained up to do the blood tests freeing up nurses.

I'm sure they would love to recruit someone who is a menopause specialist but I'm not sure how easy it would be to recruit. We need more doctors and nurses and other HCPs.

Again the OP said she was worried about her impending menopause so it seems entirely appropriate to tell her it might not be awful because it isn't awful for everyone. I have never ner ner ner at anyone as I'm not a ten year old, I think people who need HRT should have it but I don't think it is fair to frighten people by only giving one side of the story.

The fact you had horrendous periods and a hard menopause means you weren't who I was thinking of when I said maybe women who had a symptom free or fairly easy menopause but difficult periods might feel positive about the menopause. Why wouldn't they if they, not you but the people referred to, felt their life was so much better as was the case with me, not you but me.

We do need more research and we do need better mental health provision. Probably loads of other things as well.

I hope your hands continue to improve, the main thing is you are getting better. I once saw a chiropractor for a problem I had walking after an uncomfortable pregnancy with a 10lb baby pressing on my hip. I said to my doctor how much it had helped but my husband thought it was mumbo jumbo. My doctor smiled and said "Who cares as long as your pain has gone."

Enjoy your champagne, for me it would be a nice bar of chocolate as I'm teetotal but a chocaholic.

Well it certainly wasn't me!

The OP not only said she was so worried about menopause that it had put her off career change in her 40s (is that really what anyone wants? Women to be told that they'll probably be useless from their mid-40s so no point bothering?), she also explicitly asked 'Anyone had an easy menopause?'. So it seems a bit unfair to be furious at the women who answered 'yes' and say they're gloating.

As I said upthread, you get this on threads where people ask for good birth experiences too - women who feel furious at their very existence and that any woman posting on them is smug and is somehow undermining their own terrible experience. Same with breastfeeding, but I never see this to the same extent on other topics - what is it about female health that makes people feel like this? Is it because it's so historically underresourced and ignored that women feel on the defensive about it from the off?

@Angrymum22 I agree with your post because you are highlighting how much we actually don't know. The intricate links!
I was warned no longer than 5 years based on what is known now but I haven't even thought that far ahead yet. I don't want/hope not to take long term medicine but the information just isn't there yet for me to make decisions ie all the questions I Iisted previously See how it goes. But if medicalisation helps get those answers (maybe more research) for me and other women well that will be good.

Saying that women in Japan have less menopause symptoms because of their society's attitude to menopause . The society I grew up in (my generation) was that the menopause was nothing. That's why I am so shocked to find out what I am experiencing is probably due to the menopause. So there is absolutely no way you can say the physical symptoms I'm experiencing are link to pre conceived notions I had about the menopause. I would say the same for most of my cohorts. It is insulting particularly because of the lack of knowledge and research into what is actually going on inside our bodies.

Unless you are saying that my Dr linking them to the menopause is just being trendy/following society norms? Again my Dr went there last and then went to HRT last.

It would seem though that MN has noticed the derision and personal attacks by posters on here and have acted accordingly deleting several posts.

HRT was developed originally to try and reduce the increasing problem with osteoporosis and for women with premature menopause, prescribing for menopause symptoms came later.

That's not what I understand to be the case at all. It was developed in the 1930s and 40s, and approved in the US in the 1940s as a drug to alleviate menopause symptoms such as hot flashes and vaginal dryness.

womenlivingbetter.org/the-history-of-hormone-therapy/
www.womenshealthnetwork.com/hrt/history-of-hrt/

I did ask and the GP practice gave me two names of GPs who dealt with period related issues more. So not quite menopause specialists but women related. Not sure if that’s going to be helpful yet

It’s a missing piece of the puzzle - either pay at a clinic, and it’s likely HRT will be in mix or try luck with GPs

I’d still prefer NHS though

Louise Newson explains in her videos why we should continue onto HRT for the rest of our lives. Well worth a watch on YouTube. An unexpected benefit for me was curing my dry eyes. As a long term contact lens wearer with extremely short site this is such a relief.

A trend
Perhaps they didn't have bad enough periods
Not busy enough lol
Hype
A placebo
Own fault
Society's fault
Wrong doctors
Too fat
Don't do enough training
Should have done this
Should have done that
It's just natural [to live half your life on crutches?]

I've recognised I'm angry - several times. I'm fucking seething and you get this fuckwittery chanted back at you - just for wanting to feel remotely human.

I wasn’t directing it to you tbh

Eggroll is the poster who reacted very aggressively on this thread after very reasonable question was asked

They went on the attack for whatever reason, it was their issue

Not all experts believe this, so it's important to get a balance of professional opinions before making an informed decision about duration of therapy.

'I did ask and the GP practice gave me two names of GPs who dealt with period related issues more. So not quite menopause specialists but women related'

Yes that's what I meant, not a meno specialist as patients would be referred to a specialist for issues like premature menopause or if they had pre existing medical conditions meaning hrt may be contraindicated. Rather a dedicated hrt hcp like we have nurses and drs who have a particular interest in cardiac or respiratory issues at GP practices.

Anyway the profile of hrt and menopause is definitely higher, that is encouraging.

Yes I forgot the dry eyes in my long list. I also got red lumps on the inside of my eyelids. Similar to styes.

I wish she would bother to include scientific references as to what studies/data she is basing her advice on. I’ve read through her entire website and her educational publications and she never cites any references whatsoever. It’s just unprofessional.

@ancientgran thanks here's hoping :-)

I think because we are expected to be gorgeous, fertile and serene at all times…

do you remember Tom cruise wanted Nicole Kidman (I think) to be quiet during childbirth? Scientology I believe.

its very cultural talking about menopause - it’s just not spoken about in some groups and that percolates

hrt products are used for osteo treatment - which is why we talk about it being used as a preventative rather than when bones are already crumbling. But as we know from this thread that doesn’t seem to be the nhs approach

You can ask which GP in a clinic has done meno training and ask to book with them. It’s a one day course that some go on. A large city practice might have one but not sure about small practises.