"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?

Yes thank you. It’s so good to see such misconceptions debunked on here. I encounter it a lot and it gets a bit tiring.

@Discovereads
You insult us intellectually. Don't you think that most mumsnetters who are interested in menopause, HRT, are bright intelligent well read investigative have looked up and considered HRT and other possibilities and all other "health promotion" as well?

other natural things that you can do, more exercises, and cutting down alcohol etc. do you think most of us haven't considered this? I think you'll find we have.

Yes, it says that. Perhaps you missed the part where they are specific about what about medicalisation that they are objecting to?
“The message that menopause signals decay and decline, which can potentially be delayed or reversed by hormonal treatments, persists and is reinforced by the media, medical literature, and information for women, often driven by marketing interests. Marketing menopause as a disease is a lucrative business: the industry manufacturing unlicensed “compounded” bioidentical hormones accounts for around 28-68% of all menopausal hormone therapy prescriptions in the US with an estimated worth of around $2bn.17 Other unregulated treatments are also marketed using the medical model that depicts menopause as a deficiency needing treatment. Women who see this marketing might understandably believe that menopausal hormone therapy is important for maintaining long term health.”

I agree with this report.
Menopause is being massively over-medicalised. Well actually, not necessarily menopause itself. It's more the medicalisation of unpleasant feelings in women.

I'm mid 50s and I started going through the menopause at age 48, so I'm pretty familiar with the common symptoms. I've chosen to ride it out, because I tried HRT and gained half a stone in a month, so I'm not doing that again. But for those who are menopausal and want treatment - go for it!
However, as a GP I can see that the whole "HRT is the elixir of life and will stop you getting old" mandate has gone way too far. I have women in their 20s, who have regular periods and no flushes/sweats etc, wanting HRT because they must be "peri", because sometimes they're tired or they argue with their boyfriend, or they feel fed up and low. What they're actually experiencing is a whole variety of things - depression, tired with a new baby, bad relationship, bullying boss - a million possibilities. What they are not is bloody menopausal! But the media has told them they must get HRT from their GP at all costs.
It's madness.

What does this have to do with the article we are discussing? I’ve not implied any such things.

@ElenaSt - have you considered that you might’ve been particularly lucky; that others are particularly unlucky, and that some are in the middle?

I eat well and exercise daily (plus big weekend hikes). I take natural remedies for my chronic arthritis, and sage for hot flushes.

The other symptoms I was experiencing were making me feel suicidal.

Am I really supposed to not accept medical help because other women don’t have the same experience of menopause as I do?

If I was a conspiracy theorist I'd think Davina was paid by HRT manufacturers. There are certainly some rich people getting a whole lot richer now that she's told a nation of women they'll shrivel up and die without hormone drugs!
Maybe Davina should have been given the job of promoting Covid vaccines, then the uptake would have been loads better!

The message that menopause signals decay and decline

Where is this message though? I didn't get it prior to getting perimenopausal symptoms & I didn't get it since.

It's offensive to say that women are being sold a myth about menopause = decay & decline. I don't believe we are. We are though in many cases experiencing a range of changes that need to be supported and mitigated by hormonal therapy.

My female GP didn't listen to me at all. I only got HRT when I had lost my husband and my job due to extreme symptoms.
It was a bit late then.

There is a menopause “gold rush” going on per the Guardian where companies are preying on womens insecurities about menopause to make cash. It’s a thoughtful article:
www.theguardian.com/lifeandstyle/2022/jan/26/from-vaginal-laser-treatment-to-spa-breaks-its-the-great-menopause-gold-rush

When pp say it’s shown to reduce dementia, bone loss and heart issues (?) what specifically are they basing this on?

However, as a GP I can see that the whole "HRT is the elixir of life and will stop you getting old" mandate has gone way too far

this is my take. I am definitely feeling pushed, through media, davina, here, that I should be asking for HRT regardless of how I feel. That I will end up old before my time, with osteoporosis, joint issues, vaginal dryness etc if I don’t start HRT. That I might be fine at the minute but I will be storing up long term issues by not asking for HRT.

there doesn’t seem to be any consensus about what to do if you’re like me, over 50, regular periods, and feeling well.

there needs to be a clearer statement- hrt for everyone of menopausal age, or only those with issues?

what is needed is more research into what is best practice.

But the media has told them they must get HRT from their GP at all costs

Bollox. The media is not telling 20 yo olds they are perimenopausal & in need of HRT.

When & if those cases arise, the patient can have the details clarified.

By far, the issue is with women who are perimenopausal but not getting the necessary treatment for the debilitating symptoms they have.

I too would have been in the 'ride it out' camp, reluctant to take hormones. I hadn't really put on weight, but digestion was a big issue plus bloating. As soon as I started HRT, that resolved & shape-wise, as I exercise intensively, daily, I was back to my usual shape, toned abs again. Superficial perhaps but my bloated tummy had really bothered me.

Haven't rtft, it must've been mentioned, but it's not all about treating symptoms. Low levels of oestrogen cause bone thinning, cognitive decline, heart problems and more. To supplement oestrogen is vital in menopause to help reduce risk of these. It's not the whole story saying "well I sailed through with nothing and I'm fine..."

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

Just my experience. I went on HRT 12 years ago as I was flushing every 20 minutes day and night. I was struggling to work and struggling to sleep. 7 years ago I had to stop due to another health concern. The hot flushes came screaming back after a few days. Currently, I am cutting down slowly and it's fine - no hot flushes and I suspect if I continue to cut the dose slowly then they won't return. My dr is lovely though, and has told me I could take HRT for the rest of my life, if I need to.

I can see it’s a big untapped market worth a lot

But I still can’t get certainty on some claims - some posters do seem sure though so I’d be interested to hear more re dementia etc

And I always wonder if it did prevent some big issues later on why it wouldn’t be an easy fix in terms of cost reduction to NHS

Even if they couldn’t afford it we might see stronger messaging with information based on proven reduction

You’ve had that answered in other menopause threads Marsha. What’s your agenda?

Haven't rtft, it must've been mentioned, but it's not all about treating symptoms. Low levels of oestrogen cause bone thinning, cognitive decline, heart problems and more. To supplement oestrogen is vital in menopause to help reduce risk of these. It's not the whole story saying "well I sailed through with nothing and I'm fine..."

so every female if menopausal age should be given HRT? Even if no issues?

this is my question.

This is just nonsense. I can't believe you typed it.

What programmes like Davina's and discussions on the national airwaves have done is bring attention & focus to a poorly known & discussed issue, and offer a way for women to advocate for what they need.

Each woman is an individual. So what works for one, won't work for another. But it is the ability to have the conversation and access HT that is important.

I see it all the time. The Davina episode definitely was.

“Sailing through”

until you’ve reached 60 or so how do you know? Hormones continue to fluctuate and decline for life not just a year or two of ‘symptoms’

The word menopause is a misleading word based on defining women around their fertility. It isn’t a ‘pause’, a gap, a year. It’s a gradual and forever change and health issues related to hormone changes can become evident later in life.

the more women read about their own health the better

there needs to be a clearer statement- hrt for everyone of menopausal age, or only those with issues?

With respect, you can do the research as it applies to your own specific circumstance yourself.

If you are well, without symptoms & happy as you are, for me, I'd be reading & informing myself but would be unlikely to take HT.

You might choose differently.

Yes more research is needed - as it is for everything. Recommendations change, in every phase of life.

But there's a significant amount of easily accessible information now to allow to decide what you want to do.

We can't expect to be 'told' what all women should do.

I have recently come through menopause quite easily and I did find a lot of the recent narrative unhelpful

Women leaving work, unable to cope , needing special extra support ...

Yes some do and should be entitled to support but many don't, and I have suffered enough over my life with peoples negative perceptions of women as the hormonal inferior class of people - this latest narrative reinforces that stereotype

Women careers suffer because they might have babies and now once they have had babies they will be menopausal wrecks - gee thanks

And there is a big focus on hrt and medical support - yet there is a clear strong correlation between exercise, diet and weight and menopausal symptoms that is glossed over - many women don't like to admit their choices have made menopause a problem.

Yes people should be able to access HRT if needed but can we achieve that without implying all women will become incapacitated with menopause

so every female if menopausal age should be given HRT? Even if no issues?

Of course not. Women are individuals and can make up their minds based on available information.

We do this for many other areas - in pregnancy, to treat ongoing conditions.

We don't need to be told, we need access to reliable information

If a 20 year old woman makes an appt - that is rare in itself - and you dismiss her as having boyfriend issues, you really need to think about what you are doing in your role 🤦‍♀️