by Menopause is not a disease and is “over-medicated”, experts have said.
High-income countries, including the UK, often see menopause as a medical problem or hormone deficiency disorder with long-term health risks “best managed by hormone replacement (therapy)”, they said.
But, worldwide, “most women go through menopause without the need for medical treatments”, said the experts, including from the Royal Women’s Hospital in Melbourne, Australia, and from King’s College, London.
They argued that there is a lack of data on whether menopause causes health problems or simply aging.
For example, although bone density is known to decrease after menopause, “it is not certain whether menopause in middle age increases other chronic conditions such as diabetes, dementia or cardiovascular disease”, they said.
In a first paper in the Lancet Series on menopause, the experts said: “While symptom management is important, a medical view of menopause can be disempowering for women, leading to overtreatment there and overcome possible positive effects, for example better mental. health with age and freedom from menstruation, menstrual disorders, and contraception.”
The team said that it is difficult to distinguish how women feel when they are going through menopause from other things going on in their lives, such as looking after children, work, and caring for elderly parents.
Issues sometimes attributed to menopause – such as changes in mood, brain function and sexual problems – may actually be caused or worsened by stressful life events, they said.
Instead, they argued for a “new approach” to menopause based on “health empowerment”, in which women are given the knowledge, “confidence and self-determination to self-manage their health” and to make informed decisions.
They point out that there are other methods of dealing with symptoms like hot flashes, including cognitive behavior therapy (CBT) and hypnosis, arguing that CBT has been shown to have little or moderate effect on cutting hot flashes. , night sweats, sleep disturbances, depression. , anxiety and fatigue.
Practitioners should also look at women’s lifestyles, such as sleep, alcohol intake and smoking, which can make symptoms worse.
Although hormone replacement therapy (HRT) has been shown to improve sleep, memory, and concentration in women taking it for hot flashes, it is unlikely to have any effect on women without hot flashes, they said.
And although the risk of bone fractures is reduced, evidence shows that these benefits can diminish five years after stopping HRT.
If women need HRT, the experts said physicians should “provide realistic information about the likely effects of treatment, the possibility of residual symptoms, and the possibility that symptoms may return when treatment stops”.
Another paper in the Lancet Series found no evidence of an increased risk of mental health disorders in women going through menopause.
“Based on sparse data, we found no compelling evidence that risk of anxiety, bipolar disorder, or psychosis is universally elevated across the menopausal transition,” the team said.
Co-author of the series, Professor Martha Hickey, from the University of Melbourne and the Royal Women’s Hospital, said: “The misconception of menopause as a medical issue that leads to a continuing decline in physical and mental health across the whole of society should be challenged .
“Many women lead fulfilling lives during and after menopause, contributing to work, family life and society in general.
“Changing the narrative to view menopause as part of healthy aging may better empower women to approach this stage of life and reduce fear and anxiety for those who have yet to experience it .”
She told a briefing that the team claims “menopause is not a disease”.
She said: “In a society where there are very strong feelings about aging and women, this is a disease that is thought of as decay and decay.”
Dr Lydia Brown, from the University of Melbourne, said: “While it is certainly true that some women have very negative experiences of menopause and benefit from hormone therapies, that is not the whole story.
“The reality is much more complex and varied, with some women reporting neutral experiences and others emphasizing positive aspects, such as freedom from menstruation and menstrual pain.
“Menopause is a cultural moment, and this is an opportunity to recognize it as a natural part of healthy aging for women that is not to be feared, with the right preparation and support.”
Dr Louise Newson, GP and menopause specialist who runs Newson Health, said: “Menopause is a collection of symptoms; it is a cardiometabolic and inflammatory condition that leads to an increased risk of numerous diseases.
“Menopause has been ‘medicated’ for years – including antidepressants, antipsychotics, painkillers, sleeping tablets, anticholinergics to treat bladder symptoms, and heart medications to lower cholesterol, reduce blood pressure and control palpates.
“The first-line treatment for menopausal symptoms is body-equal HRT…
“Studies have shown that when women are given the right dose and type of hormones, their symptoms improve, and they have a lower future risk of many long-term inflammatory diseases associated with menopause. -includes diabetes, cardiovascular disease, osteoporosis, dementia and depression. as well as an early death.”
She added: “Talking about menopause as a ‘natural transition’ or part of ‘healthy ageing’ ignores the real suffering of many women with menopausal symptoms.”
