Janice Turner on the Menopause Industry

[Hagiography]

A thoughtful and timely article.

www.thetimes.co.uk/article/menopause-industry-is-misleading-women-mpmh29p08

That's very sensible. And no it's not for everyone. It does take time to settle though.

There seems to be fury at the suggestion that HRT may not be suitable for all.

Where's the fury?

In terms of suitability, beyond a reasonably small group of women where HRT is contraindicated (breast cancer but not all breast cancers), if women have symptoms HRT is suitable.

They may not all choose to avail of it.

The dosages & products may need adjusting, as with any regimen.

Bit suitability is not an issue, where symptoms present.

It may or may not (take time to settle). My symptoms improved almost immediately. I've spoken to many women who found the same.

To be fair, most of my aching did within 2 hours of the first patch. Other things took a little longer.

I'm also so very bloody tired of the old chestnut that women in older generations managed to cope without HRT, because it rides roughshod over so many variables, not least the fact that our physiology and our environment (which frequently overlap) have changed, and so medicine has had to change too.

It also fails to address the harms related to those women in previous generations who didn't have access to HRT. My granny suffered from osteoporosis. By the time she died age 92 she had a pronounced hump on her back, where her spine had collapsed and she had lost a good couple of inches in stature that she could ill afford to lose, as she was under 5ft tall to start with.

As for my DM, who didn't want to go on the HRT available at that time (made from mare's piss), she was a nightmare to live with for a good 10 years. Thank God she had me when she was in her 20s and I'd already left home, because she was hell on wheels - critical, mean, short-tempered, furious, impatient. It can't have been much fun for her either and it was awful for those around her. Having lived through that I vowed never to put my family through my own menopause.

There seems to be fury at the suggestion that HRT may not be suitable for all. Why is that?

There can be unpleasant anger on these boards, fortunately only from a few

A recent thread showed this re questions re long term health. But I actually think some good info was posted in the end which is useful.

I would like a lot more evidence to back up areas of concern, some has happened but it seems to be contradictory and inconclusive.

I think if you have strong symptoms it can make sense (up to the individual to decide), I would do the same if I felt symptoms were bad - but without anything too bad it’s more a grey area

in the same way as women take other women talking about how they gave birth, or how they chose to feed their babies as a criticism of their own choices, the anger on this thread over a woman wanting to have a conversation about HRT seems an extension of that.

While I do think the question of whether the menopause is being medicalised is interesting, in a way I'm more interested in why women perceive discussion as criticism (speaking as someone who wept when she stopped breast feeding her baby after 7 weeks and felt like a failure).

It’s not fury, it’s fear it will be taken away. Many women have had to fight long and hard, against misinformation and doctors who are out of date, to get the treatment they need.

More long term studies would be v welcomed and better access to info for women can make informed decisions.

Eg hrt protects against colon cancer.

There's also supposed to be a new medication coming out that breast cancer patients can take to help with many of the symptoms.

Thanks, that makes a bit of sense.

I'm really interested to read the BMJ article, too. And I do think it's clear we need a massive sea change in how women's health is treated (as if women are default males with irritating and inconsequential anomalies like our entire reproductive systems).

It is equally as bad to over-medicate as it is to under-medicate. What is needed is for women to be listened to, taken seriously, high quality research undertaken, etc.

It is equally as bad to over-medicate as it is to under-medicate.
I'm not sure where your concerns about 'over-medicating' come from with regard to HRT.

If women have symptoms, they should be prescribed HT, if they wish it, and it's not contraindicated.

There is no risk of over-medicating.

There is still a massive challenge for many women to be seen, and prescribed HT, and there is also the issue of availability of the medication.

I'm not sure where your concerns about 'over-medicating' come from with regard to HRT.

surely leaving women on medication permanently and not displaying any curiosity about what that might mean for them in the long term is not a good thing? feels as lazy as failing to show an interest in the symptoms in the first place, no?

I'm a bit gobsmacked at this

As for my DM, who didn't want to go on the HRT available at that time (made from mare's piss), she was a nightmare to live with for a good 10 years. Thank God she had me when she was in her 20s and I'd already left home, because she was hell on wheels - critical, mean, short-tempered, furious, impatient. It can't have been much fun for her either and it was awful for those around her. Having lived through that I vowed never to put my family through my own menopause.

Is the argument that women should take HRT for the sake of those around them? I honestly thought one of the joys of old age was being able to become a little less appeasing of those around you.

As for the the "mare's piss" when I read about that it seemed to me to be one of the most inhumane practices I have ever heard of. Pregnant horses kept deliberately thirsty to extract their urine. Seriously - no symptom would allow me to buy into that. Not one.

Where is this happening?

I'm in Ireland, and it isn't here anyway, in my experience.

And I'm really puzzled why you think if women are doing well on HT, there's any issue with them continuing.

I have hypothyroidism for example & I take levothyroxine. As long as my bloods remain in normal range, I will take it. It's not suggested that because I'm in normal range they consider reducing it or stopping it.

From my own perspective I'm reviewed every 6 months, then annually in relation to my HRT. Why do you think this isn't happening?

I didn't really want to do HRT. I don't have the typical symptoms. In fact I feel clearer headed and have been more successful at work. I used to get terrible PMT which I think had a profound impact on me.

But, I have osteopaenia and family history of osteoporosis and have arthritis with increasing pain. So, reluctantly I have started hrt. In the past few weeks I think but am not sure that pain has reduce. I hate the faff of the gel etc...

I do think there might be something in the article and have read similar and they resonate. But I do think each woman doesn't makes the decision lightly and they do what is necessary for themselves. Let's trust women to do that?

Is the argument that women should take HRT for the sake of those around them? I honestly thought one of the joys of old age was being able to become a little less appeasing of those around you.

Are you being goady? Or do you really think this?

It's not about becoming 'less appeasing', and why women would need to worry about this at one stage of life above another puzzles me.

How can it be a life well lived to experienced such debilitating symptoms as that poster described her mum having? For both her & those she has relationships with - they matter too. On the radio programme I've mentioned, one woman talked about actually wanting to kill her husband - who she loved - such was the rage she felt due to peri menopause.

it's possible that it's my prejudices talking. I loathed hormonal contraception, felt it stopped me being me.

the idea of spending the rest of my life taking hormones generated from outside of me to deal with something normal also seems jarring.

being on medication indefinitely is not generally a good thing, surely?

I do think each woman doesn't makes the decision lightly and they do what is necessary for themselves. Let's trust women to do that?

I couldn't agree more. my concern is will the medical profession be interested enough to do the studies to be able to give women the information they need to make an informed decision?

I loathed hormonal contraception,

I did too, and had bad side effects

being on medication indefinitely is not generally a good thing, surely?

Where do you get this idea from? If it's needed, it's needed. No issue.

Where do you get this idea from? If it's needed, it's needed. No issue.

I think you and I have very different attitudes to medication

Why is this such a concern of yours?

There's plenty of information available now, to equip women.

There's always more research being done - not necessarily by 'the medical profession', perhaps by pharma, or researchers.

That's how medical & other matters revolve. Life, in general in fact - research & evaluation of lived experience will lead to new recommendations.

It's not an attitude!

It's a fact - I need levothyroxine daily. There is no issue with me taking it for life - because I need it!

Other medications eg an abx will be needed for a short period eg until an infection clears, and it would not be advised to take it beyond that.

It's all about need - that's the fact.

I’m probably where Bernard is, and would like more information re long term outcomes.

I don’t think that’s an odd thing to want

But I rarely take medication, and have low symptoms - I can see why others feel differently

many people get stranded on anti depressants or pain killers.

there is extensive form among doctors for doing what is easy rather than what is right for people in the long term.

there's no one size fits all, but the menopause is a transition from one state to another. I can understand needing temporary medication to deal with the transition, but I can't understand skipping the transition altogether.

the menopause is a transition from one state to another.

It isn't actually - the menopause refers specifically to a point one year after the last period.

It's not comparable to anti-depressants - although perhaps it is, on reflection. If ADs are warranted, due to symptomatic evidence, they can be taken. Some people will benefit from longitudinal use. Others less so - and that's because the symptoms of depression can or may be alleviated by various therapies.

The same can't be said of my need for levothyroxine. I need the medication, full stop.

Same with HT - the issues are caused by hormonal fluctuations or imbalance. Taking HT addresses this - for women with symptoms.