To be absolutely sick of the ‘natural menopause is good’ narrative!

[Lightsideofthemoon]

This article was all over the media yeaterday:
https://unherd.com/2024/03/has-hrt-propaganda-misled-women/

It makes me so angry! Why is it that suddenly seeking treatment for symptoms in menopause being framed like this? In no other area of health is it considered acceptable to not seek treatment if you have debilitating symptoms. It’s utter misogyny.

Its ok for men in mid life to get treatment for their erectile dysfunction but women, ‘battle on through with some yoga and vitamins and stop complaining’

It reminds me a bit of the slightly toxic NCT ‘natural births and breastfeeding’ are the best way making any women who had a medical birth and couldn’t breastfeed an utter failure.

How is this narrative acceptable for women’s Heath? Menopause is absolutely fucking awful for some women - if you sail through with no symptoms, all power to you, but HRT is a lifesaver for many women.

@SuperstarDeejay no, I am saying that there has been a narrative shift. I believe that women should get proper healthcare support and this recent ‘get some CBT for your hot flushes’ narrative takes the emphasis away from getting the proper treatment women need.

I read most of the article - written by a GP and someone else with medical qualifications ( whatever that means) - perhaps that explains the repeated mention of hot flushes with little mention of the myriad of other symptoms like insomnia / low mood/ joint pain / brain fog. My GP was also only really interested in physical symptoms and since I wasn’t experiencing hot flushes all my other symptoms seem to be swept aside. That article was making claims that were not especially balanced or supported by evidence - cherry picking. The suggestion that women are taking their health advice from “ influencers” is rather patronising. It’s not like we have opportunity to discuss this much with our own GPS in our 5/10 minutes appointments so where are we supposed to go for our impartial information?
I’m not sure if a natural menopause is being pushed in the media or not because of one article like that though. I doubt I would have seen it if the OP hadn’t posted it

And why is that anything ‘natural’ has a picture of Gwyneth Paltrow’ to promote it?

She has ample free time to do yoga, pay for nutritionists, have duvet days in her massive room with a sea view in California where she can work on maintaining her lovely tan.

She’s not under any stress that means if she can’t perform she risks losing her job and house. Plus she smokes and has a troubling relationship with food (see her promotion of Bone Broth as an appetite suppressant).

I liked this comment.

@Divebar2021 I think it’s because I follow a lot of menopause people on ‘menopause Twitter’ it was being widely debated by both camps. I started following them because I was repeatedly fobbed off for 5 years by the doctor and it was desperation in the end to get information. It’s that too that winds me up- a lot of the influencers that the article refers to have been a lifeline for women like me, repeatedly fobbed off and not able to understand what was wrong with me! It’s about health education too - not propaganda as the article calls it!

@Lightsideofthemoon Stock was hounded out of her job at your institution. And I think her article in Unherd was spot on and very well written.

I think that the idea not everyone needs or wants HRT seems to have been lost recently.
There has been a massive push on it (HRT as a cure all) my friends and I are in our mid to late 40s and it seems like every illness we get is put down to menopause and the vast majority want HRT and are put on it.

I'm actually coping perfectly well with crazy periods, down to about 2 a year now so hopefully nearly there, a few aches and pains, a bit forgetful and hot flushes. The doctor has told me if I don't want HRT, which he is happy to prescribe then to make sure I lift weights to maintain bone strength.

I'm sure menopause is debilitating for some women, but it's OK for me. My mum had an easy time with it too so maybe it's genetic.

I think it's important that women know there is a choice but one view shouldn't be pushed over another.

I think both articles you've linked to seem perfectly reasonable and thoughtful discussions of complex issues.

WRT the menopause I'm one of the lucky ones, at 53 I still have regular periods and I've had no debilitating menopause symptoms. My Mum had a relatively late menopause and I'm clearly going to as well. But I've been told on here that I definitely should be taking HRT for preventative reasons even though I'm obviously still producing my own hormones and likely will be for longer than someone who has an early menopause will be told to take HRT. We are also constantly bombarded at work about the menopause and how debilitating it is. It feels like quite a negative narritive TBH, 'watch out for those middle aged women, they're all going a bit hysterical'.

I think it's important that debilitating menopause symptoms are treated appropriately. Doctors need to be better educated about women's health and there needs to be good quality research into the positives and negatives of every treatment. But the current popular narrative that suggests every woman over 45 needs medication is as bad as suggesting that we should put up and shut up.

I had to go private to get HRT initially because my GP was useless. Im very happy on HRT because it relieves the symptoms that were really impactful on my life. All options should be available to everyone but I'm not sure that's the case.

@Battytwatty yea, maybe. 2 sides to every story and all that.

I see no evidence at all of this 'narrative shift'.

In Ireland, after years of a complete lack of knowledge of menopause issues & HRT, following a public outcry by women, on a phone in radio show, where days and days were given over to women recounting their peri / menopause symptoms, finally the medical world woke up, offered training to GPs, and began prescribing HRT.

I was one who finally benefited and it was utterly transformational. It changed my life, I can't believe how bad it was for so long.

However, I do see a tendency to see HRT as the only thing women need to consider. It is also important to check for any underlying issues, and to still be conscious of lifestyle choices, including weight management, and especially exercise, which so many women in their 40s & 50s are woefully uniformed about.

@Lightsideofthemoon

oh ok - I follow Dr Newson ( did I get the name right?) and a couple of menopause related accounts on Insta but haven’t seen this discussed. I was turned down for HRT because of my weight so I’m slogging on at 53 without it and very much against my will. I have seen a couple of accounts on TT banging on about Yam cream which seems to be making the most outrageous claims but I don’t know how much reach that would have.

I get you OP, there does to an underlying tone to some of the commentary that women are just vacuous idiots who were mostly managing fine with “the change” until some celebrities told them it wasn’t ok and now they’re all after HRT (which we don’t have enough of). I’ve certainly seen it said on here that women take HRT fir vanity reasons about keeping young

the reality is GPs still have next to no training on menopause and related issues. The fact that something 51% of the population will experience is not a mandatory part of GP training is bloody outrageous

I sometimes think maybe I'm the only person who can't wait for menopause. I'm fast approaching 50 and in peri (odd hot flush, a few headaches) but periods still going strong and I absolutely can't wait for them to stop. Nearly very month, especially through the winter, the day before my period my immunity drops and I get horrible cold sores.
I literally cannot wait for the cold sores and the periods to stop. Menopause can't come soon enough for me. I definitely won't be feeling lucky if I'm still getting periods at 53!

“the reality is GPs still have next to no training on menopause and related issues. The fact that something 51% of the population will experience is not a mandatory part of GP training is bloody outrageous”

@Theeyeballsinthesky exactly. I was offered anti depressants more times than I can count because it was the only answer - as it goes, low dose Ad’s for 1 week a month is a treatment for PMDD but I was never offered that as they didn’t acknowledge that it might be my hormones.

It’s the lack of proper education combined with HRT being fobbed off as propaganda that is failing women.

@Lightsideofthemoon I hadn't previously seen the article about ageing and cosmetic surgery, I've just read and enjoyed it.
I see you say you previously worked with Kathleen Stock, it is widely understood that she was very badly treated there.

@takemeawayagain yea, I would like mine to stop too!!!

it seems like every illness we get is put down to menopause and the vast majority want HRT and are put on it.

I agree with this too.

HRT is vital for some women, and I'm its strongest advocate. It really saved me, as I said.

But there's a risk of every issue being attributed to peri / menopause. I'm hearing of situations where no bloods are done before prescribing HRT. You clearly don't need bloods to check hormone levels but you do to check for any other issues - iron or vitamin deficiencies, under/over active thyroid. These are particularly likely as part of hormonal changes during menopause years, and only prescribing HRT is not enough.

@SomeCatFromJapan yes an awful lot has been reported about Kathleen stock. Not all of it accurate either.

What does that mean?

The article is calling for a balanced approach and I think it raises some really interesting points. It's basically saying that for some women HRT is their best choice but HRT is not a 'cure all' and it's wise to be well-informed.

I'm glad that more light is being shone on menopause but at the same time, as a woman I don't want to be patronised because of it. Over the years most of us will have been patronised at some point when expressing an opinion - 'Oh, is it your time of the month, dear?'

I can see the same thing happening with menopause - 'it's her hormones'. Or maybe it's not, maybe I am a forthright woman, have strong opinions and know what I want?! Don't tell me it's my 'hormones'.

I think the point the article is trying to make is that the medical world can be ruled by misogyny and what better way to shut up the 'shouty, ranty women', than to give them some pills.

It's also VERY careful to say that if you need HRT, please take it but explore all your options too - your body, your choice.
^
That's how I read it anyway.^

I was wondering if we need a naming change

Menopause and -problematic menopause for when it moves from something that half the population go through to something that does require specific medical intervention. - could that help?

So yes menopause is normal but for some people it goes a bit wrong ? ( we don't know if it's going wrong at all when people have symptoms but that's another question ) I just wonder if separating the two things might make it easier to get it in the syllabus of med school / taken seriously

@midgetastic yes maybe! It’s also this idea that doing something naturally is always the absolute best - but like I said about natural births- it makes women who struggle feel a failure! I had one very medical birth with all the drugs and couldn’t breast feed. And then one very natural and could breast feed. I felt such a failure the first time round not being ‘able’ to do it naturally like the rest of my NCT group.

I thought that was quite a good article. I am actively investigating HRT for some health problems I am having, but I totally agree that the pro-HRT narrative in the media is overly simplistic.

@midgetastic This makes sense to me.
Like childbirth. A natural process that will go smoothly for many woman and life threateningly wrong for some.
Bit of a clunky analogy sorry!