"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’m sure some women do not need medication for menopause, but many find it life changing when they do start on medication due to the nature of their symptoms. Surely being informed and if needed not just being given medication for the symptoms like anti depressants and actually the cause is better for all around.

I’m 43, seeing some changes in my periods: cycle changes mainly, some more pmt, cyclical headaches etc. Nothing to crazy yet but I’m doing my research, so much more is available now and there are positives for us to go onto HRT should we need it and my older sibling has just gone onto HRT with very positive results.

YES!

Incidentally those same little blue pills were “accidentally” discovered to have a hugely positive effect on PMT, but as women and their comfort isn’t (so “they” believe) worth as much money commercially as limp dicks, no serious studies have been set up. Ffs.

Wow - 2022 and women are being told how their bodies should and will behave during menopause and we can all just live with it!
I’m 48 and suffered for nearly 3 years of symptoms that changed me and saw me struggle terribly through life. I kept being told I was too young for menopause, turns out they were wrong, but it seems like it took forever to get diagnosed and find the right medication.
Menopause isn’t a lifestyle choice.

My sister was fine and barely noticed hers in her 50s. Mine began in my late 30s and it was horrendous. I'd be dead without HRT. That's not hyperbole. I felt the difference from my first dose of HRT within a couple of hours, it was like coming back to life. Everyone is different.

I've now read the BMJ article in full & I agree it's shocking & utterly dismissive of women's experience.

The utterly patronising suggestion that if women could think positively about peri / menopause changes, they would be less affected is quite unbelievable.

I didn't think for a moment that I would have the issues I started to have in my early 40s. My mother is firmly of the 'it's all fine, nothing to see here' camp about everything she experiences & I blithely assumed anything menopause related wouldn't affect me. I had never had too much bother with PMT, straightforward pregnancies, so was completely blasé about it.

When I realised my symptoms were likely to be perimenopausal I went to my GP who is usually great. She did a blood test & said hormone levels normal. I didn't know then that that wasn't any indicator. She asked if my periods were regular. Then she said most likely my symptoms were due to the stress I was under (single parent, no support, nightmare ex, busy job). I thought this sounded reasonable & off I went. I went back at least twice more in a 2 year period. Same story. I was exhausted, unable to cope, feeling like I was out of my body all the time, digestive issues, and really not wanting to be 'there' any more. The other issue was with all of that I was unable to properly deal with my nightmare ex, job & financial issues.

Last summer, on an RTE (Irish TV) phone in show a woman rang in to share her experience of the menopause. It opened an utter floodgate. They spent the next two weeks exclusively listening to calls from women. Some were heartbreaking - a woman in her 70s who had felt suicidal due to menopausal symptoms since her 40s. A menopause expert here came on & was excellent.

GPs were overwhelmed with women looking for appointments. They had no training & many started courses overseas & lobbied the Irish College of GPs to provide courses.

I remember crying listening to women saying exactly the same as me.

Anyway I went back to the GP, and she was open about having had no training. She then started me on HRT and I saw an improvement in a day. It has changed my life.

The point is that GPs were not adequately trained & didn't know how to deal with these issues. The article & Guardian comments speak to their defensiveness - but that's a poor position for them to take. They did get it wrong - but that's a training issue.

And finally, the lifestyle point is so annoying and infantilising. I have always exercised, a lot. I'm slim, my diet is broadly good. I still exercised when I felt awful.

I do agree that approaches to peri / menopause should be holistic but to suggest some mindfulness & more exercise is a panacea that silly women have not thought of is really ignorant.

The one good thing about my GP was she took note of all my symptoms as I described them on each visit. When I went back for my review at 3 months, she read them out to me. I couldn't believe the list of what I'd told her. Almost all of the issues were resolved / greatly improved. She said she likes to do that with patients as a way of evaluating how successful the HRT has been. I really could not believe what I'd coped with for that period of time.

• small correction - it was on an RTE radio programme, not TV, just for accuracy!

Sorry but no man (doctor or otherwise) has the right to form an opinion over a woman's lived experience.

Leave that to the experts lovely boys: Women.

Don’t stop plans to improve your life because of anxiety over what may or may not happen. I did a degree in my forties leading directly to a career change and now in fifties am glad to be in a job I like. Plenty of women have a straightforward menopause just as plenty of women have straightforward puberty and pregnancy. You tend to hear about the ones which aren’t straightforward which maybe skews one’s idea and maybe leads to the impression that everyone has fertility problems, pnd, pmt etc. same with the menopause.
That said, if you do suffer symptoms that are debilitating, there is help. I take HRT because I thought I was going mad as I approached 50. I didn’t care about flushes but all the other stuff like aching joints, anxiety, moodiness and cognitive impairment made my life a misery. My mother had very early dementia and I thought I was the same. HRT changed all that and now the problems are gone and I feel normal. I live in the North and have never had problems with unsympathetic doctors or getting supply.if you get an unsympathetic doctor, ask to change. Good luck.

My menopause was reasonably OK. The only unpleasant symptom I had was hot flushes. They really are dreadful, though. The OP's quoted article says:

A separate study of UK women who were experiencing hot flashes found that those with negative beliefs about menopause were more likely to rate these symptoms as “troublesome”

Troublesome?!? They are hellish! It's not about what you 'believe', or your attitude towards menopause, it's what physiologically actually happens!

Whilst I believe that menopause is an entirely natural phase of a woman's later life, and really we should all go through it with hardly any symptoms at all, I feel poor diets, depleted soils and way too many additives in foods are contributing to the symptoms many of us go through. This is something that badly needs addressing.

The message is what these women doctors were commenting on and the message about the little blue pills is different. There aren't loads of programmes warning men how awful it is going to be when, not if, they get ED. The pills are there, there is information out there so if people need help they can go to GP and I think they can even buy them without a prescription but for women the message is that the menopause will be awful,life is over, brain fog, hot flushes etc is going to happen and people like the OP are being scared by that.

Yes let us have information, yes destigmatise it, yes let women who need medication get it but have the balance as well that for some of us it is a liberating time, no more painful periods and no more migraines for me and probably others, no more contraception.

At the moment it feels a bit like women who dare to say it wasn't a big deal for them are treated like traitors to the sisterhood because they dare to be honest about their experience.

The doctors who wrote the article appear to be post menopausal women.

A question for those who know - I had a general impression that some of the symptoms, like hot flashes and things, would eventually go away once the menopause was over and hormones had settled down etc.

So if you start HRT at some point in, say, your early 50s as your periods are starting to get less frequent and you are getting some hot flashes etc - does the HRT then kind of postpone that, so that you go through the same thing in your 60s, when you're less able to cope with them for other reasons? Or is it not true that they go away eventually anyway, so that by taking HRT you are at least saving yourself several years of feeling rubbish?

My doctor is likely to be one of those who won't want to medicalise it, so I doubt I can ask her - she's very much a 'wait and see how it goes' person about everything. And I'm interested in doing anything I can that might prevent dementia, primarily, but also joint aches and stiffness etc, which I already suffer from, and possibly osteoporosis, which my Mum might have.

The no more painful periods was a HUGE relief for me. I never had a period without being incapacitated. I was counting down all my reproductive life for them to be over. So even with hot flushes (which did calm down after a couple of years) I felt so much better without that happening every month.

But surely you can appreciate that other women have different experiences? Me - I was hot flushing every 20 minutes day and night. I was struggling to work and quality sleep was impossible. HRT was a complete life saver for me.

Don't apologise, this can't be said enough as it is such a common misapprehension. Wars also skew the figures e.g. when you look at how many young men died in 1914-1918 it will change the figures with the Spanish flu pandemic further altering the stats, just like your example of the Great Famine. Both my grandfathers fought in WWI and survived into their 80s which was about 30 years more than they could expect when returning from France.

Doctors are the luck of the draw aren't they. I had a hysterectomy (ovaries also removed) in my 40s. My doctor really pushed HRT but I said I'd wait to see what happened and nothing did so I didn't have it.

I do wonder whether some women lack self awareness of their symptoms, my mum would claim she sailed through menopause and didn’t even notice it happening, whereas I would say my teenage years were blighted by her mood swings, screaming over trivial things and controlling behaviour. My older siblings think she is a angel but they’d already left home when it started.

I do wonder whether some women lack self awareness of their symptoms

I wondered that, so I asked DH and my workmates and they said I was just the same. I would say that I was never subject to hormonal fluctuations before the menopause - no PMS, periods as regular as clockwork, some of them being painful, but not unmanageable.

I seem to be in the minority here. I didn't get the anxiety or brain fog and I had a few warm flushes. However, I did get some horrific migraines, but these are in the past.

At 63 my hair is thinner and I have osteoarthritis in my foot, but I have no other issues.

Love this quote from newson in the rebuttals

Telling them what they’re experiencing is just normal part of ageing is frankly medical gaslighting.

This , in spades.

I'm currently waiting for my meno clinic appointment. I'm several years into meno but held off on HRT because of cancer risk factors, which have now been debunked. I'm over the worse but still want to get back to proper sleep, protect my bones and brain, and give me back my sadly missed libido. Why shouldn't I get that 'treatment' if it's available and safe, even if it is an inevitable part of getting older ?

I was lucky enough to have very few problems through menopause and now find it a fantastic bonus, principally because I used to get regular bad headaches and they are now rare. I carried on working in a fairly heavy-duty job without amicable relations with everyone, so I hope I wasn't exhibiting mood swings etc without knowing it.

I believe that a lot of women think they are sailing through menopause - I had symptoms that weren't the typical hot flushes that I'd associated with menopause. I was back and forth to the GP and it was a good few years before anyone made the connection and gave me HRT. I thought I was having heart trouble!
Lots of thing occur in nature. We still treat them. I don't see why menopause should be any different. If you don't want it, no one is saying you have to have it. But you should be made aware of all menopause symptoms and offered the choice.

Another one who didn’t read the article and is outraged for no reason. They did not at advocate keeping women uninformed or in the dark:

“Balanced, evidence based information about the spectrum of normal changes to expect over the menopause transition—in both clinical and community settings—may help women prepare, empower them to manage menopause and instil confidence in navigating this life stage.

For example, perimenopausal and postmenopausal women randomised to a psychoeducational and health promotion programme showed greater knowledge about menopause, more positive attitudes, less discomfort, and greater engagement in healthy habits compared with those who did not participate.”

Thank you. People often misunderstand average life expectancy statistics, even authors of books who should really know better.

Does any woman need telling by a doctor that not having periods anymore is nice? I think we're all aware of the upside of being post menopausal.
Personally my stress levels were through the roof when I was getting heart palpitations and thought I was in danger of having a heart attack.
And I thought my anxiety levels were normal - I had no idea until I started HRT, just how anxious I had been about everything. It's debilitating to live like that!

"Medicalisation tends to emphasise the negative aspects of menopause and, while effective treatments are important for those with troublesome symptoms, medicalisation may increase women’s anxiety and apprehension about this natural life stage. "

That quote is from the article itself.

1)Medicalisation tends to emphasise the negative aspects.
2)Medicalisation may increase women’s anxiety.

I'm not sure I agree, on either point.

Some of the posts on this thread are very offensive. Implying we haven't read the article. I have.
No one said one size fits all, no one says HRT suits all. The point is we are supposed to have choice.