Janice Turner on the Menopause Industry

[Hagiography]

A thoughtful and timely article.

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

i take topical oestrogen because I have vaginal atrophy caused by menopause. If I didn’t take it my vulva would itch constantly, my clitoris would shrivel, my vulval skin would thin, split & bleed & id be at very high risk of UTI & prolapse. I haven’t had sex since sept 2020 as even with topical oestrogen it’s impossible. However, I had no idea this was even a thing until it hit me 18 months ago so it seems to me that we’re still not talking about all aspects of the menopause anywhere near enough

I havent read the article but to answer your point I would say 'because they are having problems getting hold of it'

I say 'they' , Im not really sure who 'they' are but there will be supply problems for a while I think and I would imagine views are going to be pushed forward to challenge the narrative that its needed. Theres been a lot of progress in terms of celebs and media letting women know about how necessary it can be for some, more openess about it, but that has led to a huge increase inn people asking for it and challening GPs who dont or wont provide it.

I dont take it but Im still learning about whether I need it, I know full well I wont get the help I need from my GP, they wont even test for peri menopause, I need to know for example what advantages and what delivery system or what levels I need, No GP is going to go through the effort of letting me know that. My worry is that the advantages it might bring, it might bring back my migraines which have significantly decreased during peri menopause

Anyway I digress, I think articles like this are designed to disparage the requests for it

yes indeed, I'm very aware that everyone is different and no one size fits all

i do however think we should bear in mind that we live in a capitalist society, and if there's no interest in buying medication, there are no profits for drug companies.

people who take life long medication are ideal from the perspective of a pharmaceutical company.

The menopause (and we've used that word throughout this thread to mean the period in woman's life when menstruation ceases, so despite your kind correction, I will continue to use it in that way) is normal. In the article that kicked off this discussion, a woman was advised to effectively never go through it. If doctors are routinely giving this kind of advice, I find that concerning, and I'd like to understand what their basis for this is.

that sounds very, very difficult, and I too had no idea this was a thing. I'm just sorry the topical oestrogen isn't helping more

No, I wasn't being goady. The poster had said the mother didn't want it, but the implication was that she should have had it because she was difficult to live with. One of the things that I find concerning is an idea emerging that women are not able to age without being required to treat symptoms of ageing. Almost like there is a responsibility to take medication if it is available. I do think each to their own. I am not arguing against HRT, but against the assumption that it SHOULD be taken. There may be many reasons why a woman doesn't want to.

There is no risk of over-medicating.

Well, that's a sweeping statement. There are contra indications. There are slightly increased risks for some types of medication and some conditions.

The risks may be small; that does not mean they do not exist and it's inaccurate to to say there are none.

www.nhs.uk/conditions/hormone-replacement-therapy-hrt/risks/

I think the symptoms that poster described in her mother are not general aging, they are anti social, aggressive behaviours which need treatment. There is a massive difference between those two things

If we were talking about those behaviours in a man who could seek treatment but either refused to do so or there was a narrative that he should just be tolerated because he shouldnt be made to 'appease' others, there would quite rightly be outrage.

Are the risks from HRT higher than those from the pill?

the behaviours described were "critical, mean, short-tempered, furious". I don't read that as anti-social or aggressive necessarily. From the point of view of the mother I would not have taken it either, because of the brutality of the production methodology of premarin.

@bellac11 are you making an argument for compulsory medication for women who are not nice? I am finding this incredible.

This exactly. I went through it with nothing because the options were premarin which no way and patches that made me into bitch woman on speed. I got through, TBH after pms and period pain BY COMPARISON it was a walk in the park. I think though that being open about menopause, how it can be difficult for women that there are way more symptoms than hot flushes, should not be conflated with medication being the only solution or that women can only get through it if they have the special bedding/vitamins/ online coaching yadda yadda yadda. We are not poor suffering weak entities who cannot function without drugs, we are not a marketing target group. We will choose what we need whether that be medication or yoga. I do think that the warning against medicalisation or monetisation is valid. There is a very fine line between giving women the information about what is available and making them feel that its essential for everyone.

Tell that to someone with epilepsy.

Or diabetes, or heart disease or any number of issues that can kill without life long medication

I have always found this a very strange thing, this judgement of people who take medication. But of course what you'll find when you dig down into is they dont judge people with epilepsy/diabetes and what not but they will judge people for medicating illnesses that also come with some lifestyle supports for them

MH is a classic example of this. Yes lifestyle supports can aid recovery or management of symptoms, yes some MH issues can be short lived, or have remission phases but for some people and for some MH illness, some people will need life long medication and even then they may still suffer. Im sick of seeing comments along the lines of 'you should seek therapy' or equivalent, for many people they have had a wide range of therapies already throughout their lives and medication is just something they need to manage to live effectively

I sort of get this. I would not take premarin, just no way. As I said above, the patches which were the only alternative made me that out of control rage filled woman. It wasn't some kind of liberating epiphany of non appeasement, it was pretty much out of my control, like the rage took me by the scruff of the neck snd shook me. Inwasn't nice to be around when the rage hit and it wasn't nice being me either. But enforced medication? Absolutely not!

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?

Yes, I think so. I trained as a health researcher. There are so many professional researchers and medical professionals (different roles, and only sometimes overlapping!) who really have a driving passion to know what works and what doesn't. Britain is a world leader in medical research - the NHS makes it possible for us to do really large scale research that is difficult to standardise elsewhere. There is a lot of interest in menopause currently, and every reason to think that we'll see some good research. In the UK much research is funded by non-profit institutions and the government, but research from pharmaceutical companies can also be useful as long as there is full disclosure and good practice is followed eg registering trials in advance with a commitment to publishing the findings no matter what they are.

Im finding it incredible that you would try to put words into someones mouth but there you go.

If it is of interest I have found I am more snappy and irritable on HRT. Similar to PMT. So far the only benefits I notice are possible reduction in joint pain and better sleep and hopefully hidden benefits preventing osteoporosis. . Disbenefits are irritability and the faff. If it wasn't for osteoporosis I would not take it.

I find the marketisation of menopause very interesting, but from a different angle. A year or so ago I started looking into my options. Boots had a leaflet about menopause. It was full of suggestions of supplements and skincare products I could buy. Didn't mention HRT. Holland & Barrett have plenty of things to sell for menopause, from supplements & skincare to foods. My Facebook feed has plenty of adverts for mindfulness for menopause, natural menopause, workshops, supplements, cooling clothing, special bedclothes, etc.. I've been given books about natural menopause full of ideas for things you can buy which might ease some symptoms. Many of these "natural menopause" sources disparage "big pharma", which wants to, shockingly, sell me drugs.

I had a consultation with a private menopause specialist at Newson Health, while waiting for my NHS menopause clinic appointment. They both recommended the exact same thing, which was estrogen gel plus Mirena IUD. The estrogen gel cost about the same on private prescription or NHS prescription charge, about £10 a month - a fraction of what I could easily spend on "natural menopause" products. I think I read that most commonly used HRT products make very little money for the manufacturers.
So yes, menopause is being marketised, but the demand for HRT seems to be mostly led by women asking for it. In contrast, what is marketed to us via advertising are alternatives to HRT.

come along now, I'm trying to have a considered discussion about medication for the menopause and obviously not talking about medication for conditions like epilepsy

<sigh>

DivorcedAndDelighted I was reflecting on just that when I first saw the article.

The real "menopause industry" that may be exploiting women is the alternative medicine/ supplement / coaching one.

There's as many people and companies making a huge amount of money out of it without using hrt.

A friend was seeing a menopause coach who was basically giving life tips, and some supplements, thinking hrt was "problematic medicine." It was only after both I and another friend pointed out transdermal body identical hrt is "natural" that she ditched all that and the huge bills.

I was rattling with supplements; Dh commented that it was the most expensive "illness" he knew of.

I have the rage at the moment, and I can assure you I’m not enjoying being ‘not nice’. It isn’t just shit for the people around me, it’s absolutely awful for me too. I got furious with a make up pencil lid the other day FGS!

It isn’t just a matter of being a bit grumpy and being outspoken. It’s not refreshing to speak my mind. It is completely irrational fury which makes me feel like a monster. I have had to stop reading the news as everything makes me angry, I’ve turned into Victor Meldrew!

This anger is what has made me go to the doctor and request HRT. I have had awful joint pain and foggy head for about 18 months, but the anger is the thing that has made me pull my finger out and do something.

No. Body identical, that being transdermal oestrogen and micronised progesterone (utrogestan which can be taken orally or vaginally) is safer.

I found hrt to have an antidepressant effect.

This book goes into all the studies and benefits to date. I found it fascinating.

(Also mentions impact of pb on womens brains too)

https://www.amazon.co.uk/Oestrogen-Matters-Hormones-Menopause-Well-Being/dp/0349421773/ref=mpssa111?adgrpid=69648715196&gclid=Cj0KCQjwkruVBhCHARIsACVIiOwQtShhpcRQ-hpha2BiN4-PaZcIkLOyB13HyTsCu6rX32XtMn9lJysaAkR7EALwwcB&hvadid=345406846953&hvdev=m&hvlocphy=1006948&hvnetw=g&hvqmt=e&hvrand=4986736387922403927&hvtargid=kwd-507278138596&hydadcr=168800_1798495&keywords=oestrogen+matters+book&qid=1655706147&sr=8-1

HRT doses transdemally are far lower than the oral medication of the contraceptive pill.
Also, you are only replacing that which was lost, not giving a dose of something already there to try and alter a cycle.

@JoodyBlue I agree and so did my DM (who loves horses), and that's why she wouldn't take it.

I disagree about 'appeasing others' though. My DM's menopause symptoms made her awful to live with. I know it must've been hard for her too, so when I felt those 'red mist' type symptoms myself and realised that I was entering that phase I knew I wanted to do something about it.

Menopause affects us all differently and clearly many women welcome the changes that come with it, but for me that feeling of my emotions being out of control and serious anger constantly bubbling below the surface was unacceptable (among other things too, which are all well-known symptoms). We should all be able to make an informed choice about how we want to manage our own menopause. I'd welcome a leaflet being sent to every woman on her 40th or 45th birthday by the NHS explaining the symptoms of menopause and what the treatment options are for women who wish to treat it.