Janice Turner on the Menopause Industry

[Hagiography]

A thoughtful and timely article.

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

@DivorcedAndDelighted I think what you say is true... HRT is not marketed nearly as much as alternative stuff.

@JoodyBlue I have not found irritability has improved and in fact am more irritable. But it's early days so might settle.

The thing is there are alternatives for women who wish to balance their hormones without medication. I've balanced mine naturally. I was really suffering in December - but back to normal now after taking a whole body approach which has set my body up to age healthily as well. I've used specific nutrition to impact and support my hormones favourably and allow them to function as they should. I've also taken charge of stress which underlies so many of our menopause symptoms (this is not spoken about sadly) and changed parts of my life and put myself first and I have to say I'm on fire & not afraid of menopause at all now. I can really say, I'm thriving!

The menopause board is a bit of a mess. I’m not sure if there are posters pushing messaging or not - given the high £ market rate and the audience here it could be happening, whichever way questions are often aggressively shut down and misinformation isn’t countered.

A thread on feminist board where it’s women-centric not marketing led seems better.

There seems strong consensus that it’s main use is for symptoms and should be accessible, I don’t think many would disagree

The phrases I see and question is the idea that it is vital - vital for all women?

Also re dementia - this has grown legs and is repeated but evidence is lacking and in some cases carries small increase in risk

re osteoporosis - again who just those at risk? Or all

Lucie, glad to hear you're doing so well.

I'm not sure I'm convinced about there being a massive industry in alternatives to HRT. This sounds a little bit like there being a 'breastfeeding industry', which is patent nonsense (- and a DARVO set up, I expect, by formula companies.)

Thinking about it, even the phrase 'alternatives to HRT' suggests that menopause must automatically in every case be treated in some way, when for many if not most women there will be no need.

This is not at all to suggest that the women who need it shouldn't have it, btw, but I'm interested in the message that all women should be given HRT, which I have seen suggested. HRT was used to treat symptoms; its now becoming suggested that women will suffer if they don't take it. The shift is palpable.

The 'alternatives' that I've seen suggested are lifestyle measures - cut down on alcohol, eat more protein, drink water, etc

Alternatives to HRT - usually means dietary changes, supplements that you can buy OTC, either starting, changing or increasing amount/type of exercise, things to aid sleep like wool duvets, cool pads, etc.

Argument that all women need HRT - as I understand it, all women are at risk of osteopenia/osteoporosis in later life if they do not go on HRT. It may be that some women are at more risk than others for hereditary, personal health or dietary reasons - I'm not sure about this - but it was one reason why I wanted to go on HRT as I have osteoporosis in my family. I remember Dr Newsom also talking about heart disease and dementia risk, but again I'm not sure what the science says about this.

This is exactly the kind of thing I mean! We need clear information on this.

Generally I refer to the NHS, but I've got into a stramash on the menopause board before because that is apparently not the correct thing to do; we should apparently instead listen to experts who know better than the NHS. These experts, though, are private doctors who charge large sums of money to assess and prescribe HRT.

With osteoporosis HRT can help
Afaik all the data compares women on hrt for menopause - likely with symptoms- with those not on hrt

To my way of thinking this could confound factors relating to diet and exercise - you are more likely to need hrt with poor diet and exercise and more likely to get osteoporosis- untangling the different effects has not been attempted

And I would like research not sponsored by hrt selling companies

as I understand it, all women are at risk of osteopenia/osteoporosis in later life if they do not go on HRT.

it’s the all women part that sounds like we should all be using it regardless of symptoms

This is where I’d like more discussion

'Losing bone is a normal part of ageing, but some people lose bone much faster than normal. This can lead to osteoporosis and an increased risk of broken bones.

Women also lose bone rapidly in the first few years after the menopause. Women are more at risk of osteoporosis than men, particularly if the menopause begins early (before the age of 45) or they've had their ovaries removed.'

www.nhs.uk/conditions/osteoporosis/causes/

The other thing that bothers me is that there seems to be a risk of HRT being used as a universal answer for things like osteo, when there may be a need for other approaches/medications:

www.nhs.uk/conditions/osteoporosis/treatment/

Women on hrt also can also get osteoporosis

Form my point of view it's hard to have a consensus as everyone's biological make up and life experiences (nutrition, exercise, weight, hormones, stress, sun exposure for vit d, pregnancies etc) are very different. Anorexia in teen years predisposes you to greater risk of osteoporosis for example.

Not the best analogy but with hypothyroidism, Some people need to have very suppressed tsh to feel well, others feel awful and need it to be less.

If in peri and meno you're not experiencing symptoms perhaps you don't need it. Clearly there's a lot more research needed which will take time.

The alternative marketing is bigger than lifestyle changes. It's special menopause vitamins, soya isoflavones, black cohosh, ginseng and various essential oils. Other stuff too I can't quite remember. So, it's very real.

The first time I heard about HRT was from a couple of women I knew who used it. The Davina doc for sure and one other doc I can't quite remember who did it.

As I have said I hate the faff and would rather not take it but am in a high risk group for osteoporosis. Some people are evangelical about HRT and I guess if it helped them as much as they say then I can understand it. Of the 4 (only) 4 women I know who use it 2 were evangelical and 2 were meh.

I am aware of treatment for osteoporosis as family member has it. I am hoping to slow down the decline. And I do take Vit D and calcium

[merail] I'm about to have an OT grumble about the quality of the advice that has been available for osteoporosis.

A lot of the advice has been daily walking etc. being sufficient. Long story short, a comparatively short time ago, it became apparent that slight women are literally too light to generate the force impact that is necessary to lay down bone in the way that had been assumed.

So, some of the public health advice had not taken physics + the diversity of the adult human female force into sufficient account.

Now, for quite some time, public health has advised strength training as well. However, there is still a mass of misunderstanding around this and it hasn't been taken up on a sufficient scale.

[/merail]

I'm dipping into the chapter on bone density in oestrogen matters.

Bone density can be increased pre menopause through exercise and diet. It can't post menopause unless on oestrogen.

It goes on to explore the huge industry around osteopenia which is where bone density tests show slightly reduced. Osteopenia is a "debated disease", as it's felt the levels are normal. However it seems it's not bone density but "flexibility." And it seems many osteoporosis drugs eventually lead to greater risk of fractures. It doesn't seem to reverse the condition.

The chapter is complex exploring the different drugs but the take home is summarised here:

Embarrassing not a merail at all.

Really useful advice. Women should be doing weights their whole lives then really.

I'm v slight, hypermobile, hypothyroid and definitely in peri. Horrific symptoms. V worried about bones as have also been on a bit too much thyroxine recently. I'm getting all the oestrogen I can and if needed testosterone, and going to start weight training.

My saving is that I did a high impact martial art from late 20s to late 30s 🤞 and used to cycle a lot.

This is another good quote about the pharmaceutical industry's race for osteoporosis:

Sorry to hear about your symptoms, Warrior. What is the book author, please?

Weight training does sound like a good idea.

As you said, though, there are so many different factors and variables for each woman. I'm finding the suggestion that all women should take HRT from peri-menopause til death way too broad brush to be plausible.

estrogenmatters.com/

From my point of view Women should be encouraged to continue to think about strength over weight/ slimness etc their whole lives. (And Pilates.) it needs to start young.

I think some people wear a weighted vest to walk for osteoporosis. Strength training is difficult when you have arthritis. I swim regularly but that is not weight bearing enough - you can use paddles to create resistance but it ain't that much.

I could write another [merail] about weighted vests, the suitability of them for women (appropriate design for the female form in re: where you place the weights), and how straightforward it is to don a vest depending on a range of issues (pregnancy, shoulder problems, arthritis in affected joints), how much they break down the skin depending on duration of wear time etc.

Please do!

We've introduced weights for pe at school (send - many have hypermobility and fitness issues.) I asked the OT if light ankle weights might also be an idea and she was v enthusiastic.

What a load of old cobblers. Life for women has changed immeasurably in the past 40 years. It's all very well to go in about it being the elixir of youth but for many women including me it was a life saver. I've never been in such a bad way in my life until perimenopause struck, bleeding so heavy that meant I couldn't leave the house, and I just felt SO UNWELL and not myself.

Back then a baby when a woman was in her 40's was quite unusual now it's commonplace. Menopause was hard enough for me with a couple of (fairly well behaved) teenagers, I can't begin to imagine what it would be like with a couple of pre-schoolers and a full time job.

@EmbarrassingHadrosaurus yes I would be interested too. I have arthritis in shoulder so have not used a weighted vest for that reason. I read somewhere that ankle weights are a bad idea too but can't remember where or why. I think it was something to do with distribution.