A GROUP OF medical experts writing in a new series of articles for The Lancet journal have called for a reappraisal of how societies view menopause and the treatments prescribed for it.
The experts argue that menopause should not be treated as a health problem to be solved by hormone replacement, saying that this approach deflects attention away from “the need for substantial societal shifts” in how menopause is viewed and treated around the world.
In the editorial that accompanies the series, The Lancet says that commercial companies and individuals have “over-medicalised” menopause by casting it as “a disease of oestrogen deficiency”.
The series also highlights how some groups of women, like those who experience early menopause or have it induced by cancer treatment, are often given suboptimal care.
The authors question “the assumption that menopause often causes mental health problems” while acknowledging there are some at-risk groups, such as those who experience severe hot flushes and night sweats, or those recovering from cancer.
An issue of concern identified by the authors is the prevalence of companies marketing therapies for people experiencing menopause.
“Unfortunately, commercial interests, such as organisations who are marketing menopause products to consumers including pharmaceutical companies and private providers, have strongly influenced media messaging about menopause and menopause hormone treatment (MHT),” they said.
The authors argued that through this messaging “the small but serious risks of MHT are often downplayed or ignored”.
They also argue that menopause should be viewed “as part of healthy ageing”, in order to reduce stigma around the life stage.
One co-author of the series, professor Martha Hickey from the University of Melbourne, said:
“The misconception of menopause as always being a medical issue which consistently heralds a decline in physical and mental health should be challenged across the whole of society.”
“Many women live rewarding lives during and after menopause, contributing to work, family life and the wider society. Changing the narrative to view menopause as part of healthy ageing may better empower women to navigate this life stage and reduce fear and trepidation amongst those who have yet to experience it.”
She said the Lancet series calls for “an individualised approach where women are empowered with accurate, consistent and impartial information to make informed decisions which are right for them over the menopause transition”.
Another of the series’ co-authors, Dr Lydia Brown, also of the University of Melbourne, said that while it is the case that some women have “extremely negative experiences” of menopause and benefit from hormone therapy, “that isn’t the whole picture”.
“The reality is much more complex and varied, with some women reporting neutral experiences and others highlighting good aspects, such as freedom from menstruation and menstrual pain,” she said.
She added that menopause is having “a cultural moment”, and this presented an opportunity for it to be recognised as “a natural part of healthy ageing for women which, with the right preparation and support, is not something to fear”.
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