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[Sage 🍃]

https://www.thelancet.com/series/menopause-2024

Edited: This link is more specific than the previous one.

[CrispyChick]

I'll start. I agree woman deserve better.

Not sure I agree that menopause has been over medacalised. In fact, in my case, it took years of fighting, plus every test under the sun (at great cost to the NHS) before my GP would consider my issues are hormonal.

And, being in peri, with massive fluctuations and a very sensitive body, HRT does not work for me at this stage. No other 'medicine' has been offered.

I wish perimenopause was more medicalised.

This article makes it sound like we can all just embrace it and get on with it.

That's kind of what I've had to do, but at what cost? I'm off my work, I can't look after my elderly parent, I can't help my teens. I'm not functioning.

Plus - and this will be controversial, I'm sure, I believe that years and years of taking the pill (because, let's face it, that's chucked at us from our teens), has caused my body to be so sensitive to hormonal changes! With that in mind, I don't think we're comparing natural menopause with how natural meno used to be for previous generations.

[Sage 🍃]

CrispyChick,

I suspect you only had time to read the Editorial.

The articles include 'An empowerment model for managing menopause', 'Managing menopause after cancer', and 'Optimising health after early menopause'. 

If you are not interested in learning about managing menopause after cancer and early menopause, you could read at least 'An empowerment model for managing menopause' before starting the discussion. It's a descriptive review, not a techy or biased view of the menopause.

[Sage 🍃]

CrispyChick,

I suspect you only had time to read the Editorial.

The articles include 'An empowerment model for managing menopause', 'Managing menopause after cancer', and 'Optimising health after early menopause'. 

If you are not interested in learning about managing menopause after cancer and early menopause, you could read at least 'An empowerment model for managing menopause' before starting the discussion. It's a descriptive review, not a techy or biased view of the menopause.

Just quoting myself (double post). And to add that there are 4 (not 3) free articles, this one is also free and very useful for women in perimenopause 'Promoting good mental health over the menopause transition'.

[CrispyChick]

  oh. I feel told off for starting the discussion after only reading the editorial. 

[bombsh3ll]

Thanks for sharing!

I also disagree that menopause has been overmedicalised - I believe there are many women taking a cocktail of medications for multiple disparate symptoms and problems all stemming from hypoestrogenism.

My mum for example is on medication for high blood pressure, high cholesterol, arthritis and osteoporosis, and has a metal plate in her wrist - she thought hormone therapy was "unnatural".

I also think that citing the prevalence of a condition as a reason for not treating it is bonkers, eg menopause affects 50% of the population so we shouldn't treat it.

Death is also natural and affects 100% of people so should we not bother saving anyone's life from any cause?!

[Sage 🍃]

oh. I feel told off for starting the discussion after only reading the editorial. 

I'm sorry if you feel that way. Editorials express the editor's opinion, and discussing opinions is a fruitless effort, given that every person is entitled to have an opinion, and that it can change after consideration of the facts. Discussing the facts themselves is what science is about.

At the risk of sounding like CLKD, would you care to reply in the other thread? This is a double post.   

[Sage 🍃]

Thanks for sharing!

I also disagree that menopause has been overmedicalised - I believe there are many women taking a cocktail of medications for multiple disparate symptoms and problems all stemming from hypoestrogenism.

My mum for example is on medication for high blood pressure, high cholesterol, arthritis and osteoporosis, and has a metal plate in her wrist - she thought hormone therapy was "unnatural".

I also think that citing the prevalence of a condition as a reason for not treating it is bonkers, eg menopause affects 50% of the population so we shouldn't treat it.

Death is also natural and affects 100% of people so should we not bother saving anyone's life from any cause?!

You're welcome!

I understand your point of view, but one thing does not justify the other. 'Taking a cocktail of medications for multiple disparate symptoms and problems all stemming from hypoestrogenism' is an overgeneralisation. If multiple symptoms and problems have arisen solely from hypoestrogenism, which I don't think can be proven unless for medical conditions like premature ovarian insufficiency or surgical/chemical menopause, I doubt that any doctor would refuse oestrogen as a therapy. Most troubling symptoms occur in perimenopause when oestrogen levels fluctuate and therefore can't be due to 'hypoestrogenism'.

The conditions you mention (high blood pressure, high cholesterol, arthritis and osteoporosis) are multifactorial, they develop as a result of multiple genetic and environmental factors. Low oestrogen may contribute to these conditions, which doesn't mean they stem from hypoestrogenism nor that oestrogen therapy will control them all.

'I also think that citing the prevalence of a condition as a reason for not treating it is bonkers, eg menopause affects 50% of the population so we shouldn't treat it. Death is also natural and affects 100% of people so should we not bother saving anyone's life from any cause?!' 

I don't think this is accurate, the editor is not saying that menopause should not be treated because it affects 50% of the population or because it is a 'natural' process, or are you referring to one of the articles? That's the problem with discussing opinions (editorial), they are not about specific facts, they are one interpretation of a complex subject involving many different facts.

[SundayGirl]

Thank you for posting this Sage.

This forum has gone from a 'menopause support' forum to a 'you must take HRT at all costs or you will suffer' forum.

As for the discussion about menopause being overmedicalised, I am firmly in the YES IT HAS camp. Now I'm not saying that as it's a natural process, we should all just get on with it. There will always be a small percentage of women who need assistance dealing with what they perceive to be hormonal symptoms. HRT is a choice after all, not a medical necessity - you won't drop dead if you don't use it.
 Neither is it a panacea for all ills.

This bit jumped out at me and it says a lot:
The prospect of universal treatment of a large section of the female population is clearly a glittering commercial prize for the pharmaceutical industry

[Nas]

I need to read this article, particularly the section around menopause and cancer ( which is pertinent to me).

It’s strange you should mention that HRT is a choice and we won’t drop dead if we don’t use it SundayGirl. That is exactly what a young male GP said to me, when I first raised the issue of HRT to him. I only asked for it because I couldn’t drive my car due to debilitating anxiety. That wasn’t a valid reason apparently! 

[SundayGirl]

You asked for HRT just so you could carry on driving???

Anxiety stems from numerous causes not just hormones and can be a complex disease.

In this particular case, I think the GP was right.

[CLKD]

Women have been known to take their lives due to menopause symptoms 

[Nas]

You asked for HRT just so you could carry on driving???

Anxiety stems from numerous causes not just hormones and can be a complex disease.

In this particular case, I think the GP was right.
[/quote

Yes I did! My periods stopped and anxiety, along with bladder problems, kicked in. They were my first symptoms. I needed to drive due to where I live. Having never suffered from anxiety previously, in my case, it was purely hormonal!

[Seasidegirl]

Please could someone explain what "over medicalising of menopause" actually means?  We hear this a lot and I'm not sure I understand what exactly it is supposed to mean in this  context.   

My anxiety appeared when I was peri and vanished as soon as I took HRT.   I nearly quit my job,  I'm the main breadwinner in our family, anxiety is a massive deal.    Let's not be judgemental about the symptoms of other women,  surely we're better than that. 

[CLKD]

I think that some medics will keep prescribing - I remember many years ago that a friend moved her parent into a nursing home, some how all the meds were left behind.  The new GP went through all the conditions and the parent ended up on 2 meds rather than several: because in order to counteract side effects, something had been prescribed to - counteract the side effects  and I think this is common in many specialities.

There was no joined up thinking with this parent over about 15 years .......... mayB due to short appt times, mayB simply not looking at the patient has a whole person ........  .