"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?

IME women - even older ones - do not necessarily make more understanding GPs when it comes to menopause. Mine was very dismissive and patronising. It was actually a younger female GP who was more helpful.

@HappypusSadpus where did you get all that info from?
I had full hysterectomy at 40 straight on hrt but didn't get on with it and I have to be careful with estrogen
So I don't take hrt and have not really struggled
But I asked dr if i should for other benefits , like bones I knew but i never knew the rest ? I read some risks ?

I have had an easy menopause. I think it's over, last period 24 months ago, so don't presume the worse flashbac. The only change I have noticed is that I am more sensitive to alcohol, but I'm battling through that!
I have said on a previous thread that I'm struggling with the idea that mid-life women need medical intervention for simply getting older. I am no less capable than I was at 35.

This was me too. I'd never had anxiety like this before, it was like i was constantly on high alert, my stomach churning. With the hot flushes, sleepless nights, headaches and exhaustion HRT absolutely has saved me. I'm glad some women sail through the menopause but I haven't (I also have endometriosis so I guess it's no wonder.)

Cured my dry eyes too.

Pretty sure this is the same type of narrative which says you might find a coil fitting uncomfortable. It's better for us as women to have open and honest conversations about these big life events. I'm proud my organization have a group to support women through menopause, even if I sail though and don't need help.

As far as I can see from posts here many women have to fight for medication, I can't see evidence it's being offered up to everyone indiscriminately.

It is just so typical isn't it. Women have to fight to be treated for every single "womens" health issue; painful or heavy periods, endometriosis, fibroids, miscarriage care you name it. And the one time people are actually talking about menopause and talking about how to help women and we're suddenly over medicalising it.

You couldn't fucking write it

As a mid-50s female, I was very pleased to see this article. Menopause IS over medicalised, because it is a normal life stage and not an illness. There are some women who have specific symptoms & need treatment. But an awful lot of women don't, and yet the current fashionable narrative is that everybody absolutely must take HRT and that we should all be terrified of menopause. I waited a very long time for it to happen to me and I'm relieved & delighted - no more periods, for a start.
Maybe, instead of trying to push all of us to be medicated against our will, it's time to actually treat people as individuals and thus accept that it's not a "one size fits all" thing? That would be progress.

I believe women should have full choice re HRT and am pleased to see the more open discussion about menopause but I have been appalled by some of the "take HRT or you will shrivel up and die" publicity and do think it is worth having a discussion about over-medicalising.

Luckily I did not have terrible problems as I am in the generation of women who were told HRT was dangerous and only for use if unavoidable then we are through symptoms and out of the "window of opportunity" for health benefits now. I find it fascinating that, in my experience, most women in their 60s seem to claim to have have few or mild symptoms and very few needed HRT yet the women going through peri and meno now seem to be claiming more severe symptoms and needing more treatment. Has something changed or are women encouraged to treat at a lower threshold?

It's really interesting that women in some other countries, like India and Japan, do not suffer the same as here so would be good to know why and if there is useful info for women who cannot or choose not to take HRT

They can be right that it's important not to over-medicalise menopause, and the opposite of not under-medicalising it be equally important.

The issue of over-treating crops up all over medicine and can be a very hard balance to strike.

I’m still deciding, I should book an appointment really

I got as far as asking which GP was best on peri-menopause issues

There’s a very interesting book called ‘Oestrogen Matters’

We didn’t used to live this long - women used to die before the menopause . There are many issues (that may not be apparent) to living for many years with very low levels of oestrogen.
Bone density issues, heart disease, dementia…

I seem to have passed through it without much trauma. I do get a bit hot at night. Not taken anything for it but do try to eat a good diet.

Do any countries use it across the female population to greater extent and do they have different outcomes with dementia etc?

if anyone knows

Who is trying to push for women to be medicated against their will?

If you don't need HRT, great. But it's not a test of character, if you need it, have it. If anything it's been under prescribed in the past

Let's not forget the menopause is a perfectly natural process, experienced by women for thousands of years.

Yes modern medicine can ease the symptoms, and yes it is pretty grim. But it's def not the norm to routinely replace hormones that are naturally changing.

There is a balance to be struck

No they are saying that menopause is natural and that the narrative is currently too negative and is bordering in treating menopause like a disease causing unnecessary fear and anxiety in women. That it is a medical issue and medication used for “troublesome symptoms” plus balanced information would empower women to better manage their menopause.

Its like everything else eg everyone experiences period pain in various degrees etc etc. I have come through it relatively well and without taking hrt or anything else. I've been lucky. I wouldn't not change my career because of it.

Peri is shite for me, mainly because it makes my adhd ten times worse for 10 days out of 24. Oestrogen and dopamine are very interconnected. I can't afford to lose nearly half my life struggling with worse ADHD alongside hot flushes, fresh acne and now growing a fucking moustache to add insult to injury. I will be going to the meno clinic v soon and begging them to do something to save me.

Well I sailed through menopause with just the odd hot flush and some night sweats. 61 and still
Working in a reasonably responsible job.

We didn’t used to live this long - women used to die before the menopause

No, this isn’t true that women naturally popped their clogs before menopause like we all had a expiry date on our mortality clocks. Someone’s (not you probably the author of the book you mention) been misinterpreting life expectancy statistics. Pre modern public sanitation and midwifery, so so many women died young in childbirth. This artificially lowered the average life expectancy- which is calculated as an average age of death. But, the truth is that if you survived the much higher dangers of childbearing, you most certainly went through menopause and lived for many years into old age.

It took me 10 years to get HRT. I had developed migraines, palpitations, dry eye, osteopenia, severe nasal reflux with pollen allergy (self diagnosed after six years of visiting GP with extreme coughing every year in the early summer). Not to mention approximately six hot flushes every hour twenty four hours a day. I found myself driving on the wrong side of the road once and gave up work shortly thereafter. My mother and her mother both died in their early seventies following hip fractures due to little falls. I can now sleep all night. No migraines, no palpitations, no hay fever. I hope my bones are stronger. My plantar fasciitis improved in days. I can work and contribute to society again. I’m slim, eat well, don’t smoke and don’t drink silly amounts of alcohol. Am I over medicalised?

Sorry for the length of this but I really want to get the word out there.

I'm now 61 and I'm seeing a noticeable difference between those of my friends who've been on HRT and me, who came through the menopause relatively easily to start with only now to hit a wall. I don't have any chronic health issues: I'm not on any other medication. I'm not diabetic. I've been pretty lucky with my health.

On a purely superficial level, none of my friends on HRT have suffered things like hair loss, a massive increase in facial hair and so on. I've never had to think twice about my hair before, but it is now baby-fine, lifeless and my parting is growing gradually wider. It's demoralising, as is the beard I now have to pluck every day. I try to remind myself these things are only superficial and it shouldn't matter, but it does.My skin, which was always good and which I never had any problems with, is now dry and extremely sensitive. I've had to start using Avastin, a topical hormone cream, to deal with vaginal dryness: the skin's become quite fragile. I've also for the first time in my life had UTIs, because the dryness affects the uretha too, which can become irritated.

Unseen, but increasingly debilitating, is the stiffness and aching. Everything from my fingers and wrists and shoulders (both shoulders have frozen since menopause and it lasts about 18 months before wearing off) to my ankles aches. There's a tendency to arthritis in my family and the menopause seems to have really brought it on. I try not to 'oof' when I get up from a low chair and I work really hard at trying to disguise the discomfort but I'm constantly reminded of how my body has changed. I've never had back pain in the past and I've also been quite straight-backed, but now I'm aware of that curvature of the spine and shoulders that one sees in older people developing.

I don't notice my peers on HRT having to hide their aches and pains. I've tried talking about it and they have their mobility issues, but they seem to revolve around hip and knee pain, the result of wear and tear, and not whole-body changes.

Back in my 50s I'd planned this period of my life to be full of activity. I'd heard that once women were through the menopause they got a great surge of energy back. It hasn't happened to me. I'd planned to be travelling and going on treks around the Grand Canyon and Yosemite and walking mountain trails in the Alps and at the moment that just seems like a crazy dream. I'm seeing a physio, I'm trying out anti-inflammatory diets. I don't know how much of this is hormone-related, but I do think it's a massive part of it.

I have an appointment with a private clinic to discuss whether it's too late to start taking some form of HRT. I'm not expecting miracles but if it can help with half my symptoms it'll be fantastic.

I'm really not interested in hearing from men, who don't go through this, that we need to be careful about over-medicalising the menopause.

What utter bullshit. No one is 'over-medicalising' the menopause

from my point of view, as someone who is 50’s but so far no symptoms of menopause, there does seem to be a recent push that all women need HRT. That HRT has benefits to bone density, muscle mass, and pretty much slows down the effects of age.

i’ve asked on several menopause threads whether HRT would benefit someone like me and I have been told why wouldn’t I protect myself against all these post menopausal issues.

so that’s what I take to mean as over medicalising. I would find it useful to know if I can go through menopause with no intervention without affecting my long term health.