Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: laszla on June 16, 2022, 12:19:38 AM
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https://www.theguardian.com/society/2022/jun/15/doctors-warn-against-over-medicalising-menopause-after-uk-criticism (https://www.theguardian.com/society/2022/jun/15/doctors-warn-against-over-medicalising-menopause-after-uk-criticism)
Davina's recent documentary seems to have irked the doctors. This article looks at a new paper just published in the BMJ opining against the 'medicalisation' of the menopause.
I found the whole thing hugely disappointing, particularly the comments of the (female) doctor at the end - pretty much dismissing the widespread concerns raised in the documentary and generally these days about many GPs' incompetence surrounding the menopause and HRT.
It certainly didn't take long for a backlash to set in after a few years of awareness raising.
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I must admit, I can see both sides, and we should avoid over-medicalising a natural process. It is important to take responsibility to maintain regular exercise, health eating, etc.. If I remember this correctly, Davina did address this in her first doc., although I don't remember it in the second, however, we're not children, and I think it can be assumed that by the time we hit menopause we know this. I couldn't survive without HRT as it has made such a difference to my anxiety, mood swings, and depression.
What is really annoying me at the moment is the Tena menopause advert. There is no way I could use the dryer in the loos to dry my armpits - I'd just melt!
Basically, we all experience menopause differently, and some need more help that others. If we need help, we shouldn't have to fight for it.
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I just read the article and i agree that the menopause should be seen as a natural phase of life. I wanted to embrace the positives like life experience, confidence gained, more enjoyment and interests when not focused on looks. I learnt a lot and change my lifestyle to much healthier. However, hot flushes were so persistent and constant. I suffered for 5 years before i went the HRT way and the HRT saved me. I assume that most of us on HRT would stop if we knew that the symptoms subsided.
I am a bit concerned with recommendations to use the HRT as a preventative measure, as many of us know, there is no HRT formula that fits all. Why to disrupt the balance if that's not necessary?
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The whole 'is it natural' thing is just ridiculous. Why are we even having that discussion?
Do we discuss whether we should allow people to die of cancer because it is a 'natural' process? Or perhaps we should not replace hips and knees with artificial sockets because those are 'not natural' either. In fact, perhaps we should all just go back to living in thatched hovels and wearing wool clothes and whilst we roast bison over an open fire - because that's much more 'natural' than modern day life, right? So it must be better for us?? Wait though... is creating fire natural? Because no other species creates fire. Maybe we just have to hunt animals and devour them raw, tear their flesh with our teeth..... because that's the most 'natural' thing... I mean - cutlery isn't natural, is it?
Death is the most natural thing. So is disease. Does that mean we should embrace death and disease??
Sorry but the 'it's natural' thing is a complete red herring and ridiculous line of discussion. Natural schmateral. Who cares.
The conversation to be having is about determining what is optimal and whether the benefits outweigh the risks for your current and future health.
Frankly I think the truth of the current situation goes like this: The medical establishment doesn't easily turn around 180 degrees and go from 'smallest amount of estrogen for the briefest time' to 'you must all take this for your future health permanently'. It is going to take years for this creaking ship to turn around. There is going to be a gradual climb-down. It won't happen overnight.
Second, the BMS is scared of personalities like Dr Louise Newson carrying more weight and influence than they do. They are supposed to be the Official Body, not an individual doctor who has a tremendous platform and following. They can't just repeat everything she advises, only after she has advised it. That just makes them look like they are trailing after her. They have to assert some different stance and take issue with her in some way. It's politics and it sucks. You'd hope they could all put politics aside and just focus on science.
Third, there are already HRT shortages from increased demand. If they told women that actually most women really should take this stuff for their future health, there would be fisticuffs at dawn outside pharmacies and women doing dodgy deals down back alleys or selling organ parts for patches or something. It would be anarchy. So until they can actually meet the demand and supply it to everyone, they can't recommend that almost everyone take it without society falling apart ;D which it kinda already is, but that's a whole other subject ;D
So you gotta read these conservative 'women get back in your box, crane your necks in, check yourselves' articles with these issues in mind. I might now get evicted from here for saying all this, but there we go ;D
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Joziel, it is absurd and while I agree that the underlying mechanism behind these attitidues and comments is as you say the result of defensiveness/pride/keeping face etc., I am surprised at the dismissiveness with which these doctors are publically articulating their counter attack with some very woolly comments about 'medicalisation' and 'natural' this and that (and extra disappointing that they are women).
It is insulting to fail to recognise how many women are let down/ignored by GPs for menopause support - practically every day on this forum someone posts about how their GP tried to give them anti-depressants/come off HRT/refuse to prescribe tesosterone etc etc.
Right, back to my raw bison.
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https://www.bmj.com/content/377/bmj-2021-069369/rr?fbclid=IwAR2XTlSWiMtPM9EmVvnKbsgNCXIaz8D-9ZmrX3d_XDPK-UPLLClVBwLObq8
Nice response from Louise Newson and others in the BMJ.
Great posts, joziel and laszla. They could usefully describe menopause as "inevitable" rather than "natural".
JP x
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Oh Joziel! I couldn’t agree more!! I wish there was a like button!! Everything you said is absolutely bang on.
The constant narrative that this is ‘natural’ let’s not medicalise a natural process, is just a crock of s*** that doesn’t get used when men have a problem, it is *only* used as a response to women. The moment we start having a decent conversation about HRT & menopause we get the pick me women and the defensive GP’s going on about this natural process crap again. Child birth is natural but we have plenty of help with that! It’s just a really lazy argument that ignores the physical and mental impact of menopause on a lot of women. Women are already afraid and embarrassed to discuss it and these responses make that worse. They should be ashamed of themselves.
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Great posts!
Just had a look at the BMJ article and the Competing Interests.
Two of them from what they have declared, appear to have conflict of interest!
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Jozial you summed it up perfectly. Quite frankly there was nothing natural about having my vagina on fire, in pain, sore and itching impacting my mental health for a whole year before I was finally given local oestrogen! It has been widely reported that GP’s used to only receive 3 hours training on the menopause, this may have now increased, but generally a majority of the medical profession certainly don’t have a good understanding unless they take a specific interest in it. It infuriates me.
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I couldn't read it all, such rubbish they do spout. From an Australian ........
If ladies don't require treatment for peri-menopause symptoms then why do so many visit their GPs/Health Advisors across the World? If the issue gets into the main stream Media women are going to look up and realise that they no longer have to suffer.
Writing in the British Medical Journal they said there was an urgent need for a more realistic and balanced narrative which actively challenges the idea that menopause is synonymous with an inevitable decline in women’s health and wellbeing, and called for continued efforts to improve awareness about the symptoms and how to deal with them.
That would be how exactly? As stated, Life is natural. So R arsenic, digitalis .......... ::)
I wonder why the Guardian even bothered to print this other than to encourage readership. What I read: 2.5 paragraphs B4 exasperation took over, seems to be garnering more readers than being a balanced view. Which GPs - in the UK or where?
Good that all GPs are being made aware of our needs. Perhaps if we had a list of those who won't prescribe HRT etc., we can avoid them!!
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I actually do expect this from the guardian, used to be a reader but their disdain for women has been clear to me for some time.
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Some excellent responses to the BMJ article (see link above kindly provided by Joanipat), of which two, thankfully, are from right-minded GPs.
To sum them up:
Louise Newson refers to the authors’ comments as “medical gaslighting”;
Kate Muir (producer of Davina’s docs who has undertaken considerable and, crucially, recent research) draws attention to the ludicrously outdated studies upon which the authors base their text;
GP Helen Purser gives some non-menopause examples that illustrate the absurdity of the ‘unnatural’ brigade – eg. a patient deciding to stop all medications as they are ‘unnatural’, ascribing angina symptoms to ‘cultural conditioning’, being ok with dying younger because it’s ‘natural’ etc.
GP Andrew Coward (who is anything but!) merits quoting at some length for the crucial argument he presents:
“At the start of the 20th century women lived till 50 years on average, had 4 children, were broadly not in the workplace and died from pneumonia or TB. Now women live to 81, have 1.75 children, the vast majority work, and die from dementia and vascular disease. This begs the question of how we define “ normality” for women in terms of birth, periods, work, menopause, or mortality. Is it normal for 65% of dementia patients to be in women? Is it normal for 10% of women to quit their jobs as a direct result of the menopause with fatigue, anxiety, and brain fog particularly problematic?
Could it be that this modern phenomenon of living almost half your female life without oestrogen is the cause for both excessive disease and disabling symptoms?
As a man I am relieved that male hypogonadism is not normalised because it presents with distressing symptoms such as lethargy, sleep disturbance, low mood and decreased strength and is entirely treatable with HRT in the form of testosterone. […] I am surprised that the BMJ published this without asking these questions to Hickey et al as of prime importance unless, of course, you have slipped unconsciously and indirectly into the all pervasive world of male entitlement.”
Round of applause from me. I also liked this tweet in response to the Guardian article “Pushback from doctors trade group BMJ when the group represented by them is questioned. Medical misogyny is alive and well”.
Hopefully there will be more replies and this degrading (to women and the medical profession) article will simply accelerate and strengthen the drive to parity.
CLKD – I like the idea of a register of GPs who won’t prescribe HRT without good reason – something along the lines of those rogue landlord databases ;)
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Well Done U ! :medal: tnx for explaining in detail.
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Great laszla, they’ve got some nerve.
‘Trade Group’ that made me laugh ;D
Rogue doctors it is then CLKD! X
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Yep - if it weren't so hot I would fire up that charabanc and be on my way to nag at No 10. However ;D
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Oh that cheered me up reading that laszla, thank you!
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Yes thank you. I am so incensed after that Guardian article. Does the BMS et al not realise that all they will do, is lose the faith and trust of women??
I already don't trust them now for the latest advice and research, I read the research myself and wouldn't take their conclusions. They need to turn their creaking ship around and get with the times.
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Agree Poppytoast, it’s so deeply offensive the way they’re discussing us, and they wonder why women avoid the GP. I’m actually so mad today I’m going to write a scathing letter to my old GP surgery to tell them exactly what I think about how they treated me. I think women are too nice overall about it and it’s time to voice our anger about the way we are treated in health care. It’s enough now. Has anyone read, Invisible Woman by Caroline Criado Perez?
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Just looked at the reviews on Amazon for the book ATB, will be buying it.
Perhaps we could all write letters to the BMS telling them what we think!
X
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Yeah I’m thinking the BMS deserves to be flooded with letters. Every member here should write. I’m sick of this disgraceful lack of respect for women.
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Its ok for some people to say its a natural process & to not medicalise it, but when your suffering with menopause symptoms, you want all the help that you can get.
Arthritis could be seen as a natural disease because it mostly is caused by wear & tear, but we still treat it? So how is menopause any different?
My lady GP when i told her i think i have hormone problems, as i didn't think it was perimenopausal, barely looked up from her computer screen & said I'll give you AD. And i was like, no i don't want them. And i specifically asked to see the GP who deals with this problem.
I left my GP even more confused & desperate.
If it was a man's problem, I'm sure it would be taken more seriously. Controversial i know but its how i feel.
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https://thebms.org.uk/wp-content/uploads/2022/06/Looking-at-HRT-in-perspective-Helping-women-make-informed-choices.pdf
In the same BMJ edition, good comment...... link above from BMS....... which balances the rather ridiculous article "Normalising Menopause" by M.Hickey(BMJ article)
I am a lay person, business women who has been following the BMS and Menopause matters for 20 yrs....... use HRT!
The BMS have done a huge amount to promote better treatment for menopause over the years much of their work must be unpaid.
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A further three replies have been posted to article and it's interesting that 6 out of 7 are adamantly opposing this infuriatingly regressive piffle. I'm curious to see how many more responses there will be and which way they'll lean.
ATB - I suspect rather than being too nice about it we've been brainwashed into 'ladylike' submission !
Thanks for the link Katy, will check it out.
Sheri, your being fobbed off with unwanted AD when wanting to get hormone support is all too common - and isn't it interesting how the ubiquitous and often inappropriate prescription of antidepressants to middle aged women isn't commented on when criticising the 'medicalisation' of menopause - as if antidepressants weren't massively more 'unnatural' than body identical HRT which most in this country are on (with all respect for those that genuinely benefit from ADs if and when the hormonal route has been explored).
I try to be hopeful that this drivel will strengthen the collective resolve to make progress.
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'piffle' that's a good Norfolk word ;). My Dad would say it with force ;D when he really wanted to swear ;D
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CLKD - it's a word I've always liked when needing to express indignation - particularly in reference to the unfounded and biased utterances of 'experts' which is very much the case here!
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"Has anyone read, Invisible Woman by Caroline Criado Perez?"
Got it in front of me on my desk and have read it :)
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I couldn’t agree more with the post by Joziel. This very discussion is taken up by Dr Jen Gunter in the menopause manifesto. I would highly recommended this book. I listened to the audio book version.
I have been going through peri menopause since my late 30s. I suffered infertility as a result. I was told at age 34 by fertility drs that I had a very low egg count and I would have an early menopause. My gp did not seem concerned. Then in my early 40s my periods stopped for 4-6 months at a time. At age 43, this year, after demanding that I needed something due to horrendous symptoms I was given treatment. My fsh was 103. I’m currently trying to find something that works for me. Nothing yet.
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Let us not forget that it is extremely 'natural' for men to get flaccid willies and no erections as they age...
Yet they can buy Viagra over the counter.
Just so they can have sex.
Call me cynical, but is this also the reason that women can only have testosterone for low libido? So that they still want to have sex with these men who are getting their Viagra over the counter?
Patriarchy, alive and well in 2022.
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Ha! Yes Joziel!