Do nothing at Menopause?

[maclen]

I believe I'm perimenopausal and I just wondered what happens if you literally do nothing about the menopause? Is it safe? You see some horror stories and it's giving me anxiety (which is probably peri anyway lol)...

This is from the recent IMS report on menopause and why it occurs -

Epiphenomenon (non-selectionist) hypothesis: menopause may merely be a by-product of our increasing maximum lifespan over the last few centuries, especially through the reduced incidence of infectious diseases

The effects of menopause isn't just an issue for those with nothing else to worry about.

On top of all the other shit, it is something that can actually be managed and pain reduced. It is a teeny tiny dose of hormones that makes a huge difference to many women. Not just for women with otherwise perfect lives.

Yes you explained it better than me though!

I don’t understand how we are happy to dish out contraceptive pills to girls 16 + many, like me stay on it for 20
years.

But a little top up with body identical hormones to replace what we’ve lost. And it’s ’unhealthy’ and we’re ‘medicalising’ menopause.

I am 51 - v healthy lifestyle of exercise, Mediterranean diet, good weight etc - thought I was sailing through peri and was resolved to do it 'naturally.' I'm the type who doesn't take a paracetamol unless I really have to.

And then the night sweats hit this summer. Two months of waking every 2 hours to soaked sheets and poor sleep absolutely floored me.

I didn't think there was much more I could do lifestyle wise, and was lucky to see a fantastic GP who recommended HRT, particularly with family history of osteoporosis and elevated cholesterol. The sweats stopped almost immediately and a month in I feel really great. Quite a few other little niggles that I hadn't associated with hormonal changes have also cleared up.

I agree that the perception of menopause as an illness is unhelpful but I see so many women putting up with debilitating symptoms when the current evidence suggests that it is pretty safe for most women.

I think it's because the former is convenient for other people (women are more likely to be available for sex for example) and the latter is beneficial to the woman's wellbeing.

(Was replying to delatron)

Yes true!

I know what you mean @OP, society has led us to believe that without HRT the menopause is impossible. Equally society purports the same to young women concerning the pill, but with different reasons and outcomes.

I agree with previous posters that HRT has many benefits, and equally that across the world many more women experience the menopause without medical support via HRT.

But equally Pharma companies play a very large role in research and also pushing for their own agenda. I say that as someone who wrote their PhD for a large almost mammoth international pharmaceutical company, and still have colleagues in the field.

I am mid 40s, and so far so good. I have a check up next spring, and will have a chat with the gynaecologist. But my mum didn't have any symptoms beyond being grumpy (ha ha ha), and I lead an active life. But I completely understand your stance OP on questioning.

Each to their own.

But with regards to big pharma and their agenda. Surely they fact that women have to beg their GPs for HRT and quite often they are denied means the impact of big pharma is diluted here.

I for one am very grateful that HRT is now body identical, which is different to the HRT years ago. And safer. We need these drugs developed to help people. 60,000 women in this country have considered giving up their jobs due to menopause symptoms. Many feel suicidal.

If you sail through the menopause then that’s great. (And it’s not just down to lifestyle- many do everything right and still get symptoms).

What has happened is that menopause has been brought out of the closet, like a lot of things that before were taboo and hushed up. (Or men made comments about 'the change'.) Very few women in the UK use HRT- around 15%.

There are possible reasons why there is no use of HRT in some countries (accessibility being one, lifespan being another) - and huge amounts of soy eaten in the east - but also perhaps genetic differences around why they have fewer symptoms.

Also, in China, women retire at 50. So holding down a job to pay the mortgage is not part of their experience if they are experiencing meno symptoms.

But equally Pharma companies play a very large role in research and also pushing for their own agenda. I say that as someone who wrote their PhD for a large almost mammoth international pharmaceutical company, and still have colleagues in the field.

There is NO research into drugs and meno now.
If you want to read the White Paper produced by the International Menopause Society this year, (it's just out) they say they wish there was more research, like double blind trials, rather than observational retrospective studies, but pharma are not interested and there is no funding.

As PP have said, it’s entirely up to you & how you’re affected by menopause

for me the absolute worse thing, and something I had no idea was ‘a thing’ was vaginal atrophy. I’d heard the euphemism “vaginal dryness” and thought it wasn’t that big a thing. Oh was I so wrong

the endless itching, thinning vulval skin, shrunken clitoris, UTI, constant need to wee. I had no idea what was going on - I thought it was thrush or an infection or STI. Nope! Just the impact of oestrogen loss. Now I have topical HRT & moisturisers and it’s all under control but I suffered for a year before I finally knew what it was.

so keep an eye on your body, diet & exercise are important but above all make sure you’re informed. Hopefully you’ll sail through it but if you don’t, you need to know what your options are

I think it is because while the oral contraceptive pill can increase the risk of clots it doesn't increase the (small, nevertheless present) risk of cancer that HRT can. Also the benefits of preventing unwanted pregnancies will seem more of a public health issue perhaps than say reducing the effects of meno.

I'm all for HRT if women are informed and understand that no it hasn't been proven to reduce the risk of dementia, in fact some studies have found the opposite to be true and while it protects against osteoporosis that is only while being taken. Athough I do believe that @jinglingspringbells has mentioned on other threads some info that may suggest that it can last longer.

As we've seen on this thread, some women think if you don't have any issues whilst in peri or the couple of years post last period then they've sailed through it however the bone issues, continence issues etc often raise their heads much later down the line.

It's just a case of hedging your bets. If someone's dm is fine, without osteoporosis etc then there is every chance they might be too but it is a tough decision to make.

Just because you've tagged me @Janiie :)

HRT and bones- the effects may last longer once women stop, but the main point is that bone loss is stopped when using HRT (or even rebuilt). someone who uses HRT from 50-65 (as an example) will have more bone than someone who didn't by the time that woman is 65 (and therefore be at less risk of hip fractures etc as they reach their 70s and 80s.)

The Pill - the risk of BC with the Pill is there.
It's far higher than HRT, by many times.
HRT has a risk of 0.4% (4 women per 1000 in a year based on the older types of progesterone.)

I had no idea about bc and the pill!

Interesting about osteoporosis. If only we could fast forward 20yrs and see what the impact of the current surge in hrt will be, much less in the way of fractures you'd hope.

Yes the pill has a higher risk of breast cancer @Janiie and I’m glad we’ve cleared up the osteoporosis angle. So important.

I did read that the rate of hip fractures in women went up after the WHI study when millions of women came off HRT.

I think what is important is that we just educate ourselves. There’s so much misinformation out there about HRT.
The risks of breast cancer are very small. There are many things that carry a greater risk such as alcohol and being overweight.

The data is based on the old synthetic form of HRT too. The newer body identical HRT is even safer.

I am 58 and take nothing for the menopause

@JinglingSpringbells there is no PUBLISHED research into drugs & menopause, BIG difference. Not all research is published, most is kept as company information. Not all research leads to big projects and investments for investors. Furthermore there are regional interests, what interests/affects the UK market doesn't necessarily and always interest, say the German pharmaceutical or US market, based on demographics and the health care system. The Pill is a very good example of this, as is baby milk powder. As basic as it is, those things all affect women's lives.

@JinglingSpringbells *at the moment.

While oral contraceptives do carry a small increased breast cancer risk, I think it's probably perceived differently because (generally!) women taking the Pill are younger. Barring a genetic predisposition the average woman in her 20's and 30's is at low risk for BC so a small increase in that risk isn't perceived as alarming.

By the time we reach our 50's our individual baseline BC risk has increased exponentially so even a small increased risk might be perceived as more of an immediate concern.

I remember being on the Pill in my early 20's (many years ago!) and having friends tell me that they'd never take it because "it causes cancer". So the stigma has always been there!

@HorribleHisTories15 Would you be able to detail more about the research you did?

I was quoting the International Menopause Society White Paper (2024) which says there is no research or any plans for any. By that they means randomised trials of different types of HRT or HRT/placebo with very large numbers of women. (I can link to the paragraph if you want to see it.)

@JinglingSpringbells so I should link to published papers and intellectual property which could get me into trouble, or so that you can discredit it on MN? That's ok, I've linked accessible papers on here before, and I remember the outcome quite well. As they say, knowledge is power, and I am more than happy for us both to continue with what we know. More women (from all cultures and all classes) need to enter into STEM research for more diversity of thought and approach, at all levels. I came on to this thread to show support to the @OP, not to shout others down about their knowledge.

I'm not sure coming onto a thread and hinting darkly at Big Pharma involvement in pushing HRT and then refusing to link to any research is massively helpful.

I had no symptoms of the menopause and so did nothing. No need. Not everyone is negatively affected by it, despite what the media says.

Same for me. I have just started of evorel 50 patches and utrogestan 100mg daily