Experts say menopause is not a disease as symptoms warning issued

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The menopause is not a disease and is being “over-medicalised”, specialists have warned.

Around the world, “most women navigate menopause without the need for medical treatments”, the specialists, together with from the Royal Women’s Hospital in Melbourne, Australia, and King’s College London, mentioned.

High-income nations, together with the UK, generally see menopause as a medical downside or hormone-deficiency dysfunction with long-term well being dangers “that are best managed by hormone replacement (therapy)”, they mentioned.

They argued there is a lack of information on whether or not well being issues are attributable to menopause or just by ageing.

For instance, though bone density is identified to say no after menopause, “whether menopause at the average age increases other chronic conditions such as diabetes, dementia, or cardiovascular disease is uncertain”, they mentioned.

In a first paper in The Lancet Series on the menopause, the specialists mentioned: “Although management of symptoms is important, a medicalised view of menopause can be disempowering for women, leading to over-treatment and overlooking potential positive effects, such as better mental health with age and freedom from menstruation, menstrual disorders, and contraception.”

The workforce mentioned that how girls really feel when going by way of the menopause might be troublesome to distinguish from different issues occurring of their lives, such as caring for youngsters, working, and taking care of aged dad and mom.

Issues which are generally put right down to the menopause – such as adjustments in temper, mind perform and sexual issues – may truly be triggered or made worse by these aggravating life occasions, they mentioned.

Instead, they argued for a “new approach” to the menopause based mostly on “health empowerment”, the place girls are given the information, “confidence and self-determination to self-manage their health” and make knowledgeable selections.

They recommend there are different strategies for coping with symptoms such as scorching flushes, together with cognitive behaviour remedy (CBT) and hypnosis, arguing that CBT has been proven to have a small to reasonable impact on reducing scorching flushes, night time sweats, sleep disturbance, melancholy, nervousness and fatigue.

Medics must also take a look at girls’s existence, such as sleep, alcohol consumption and smoking, which may make symptoms worse.

While hormone alternative remedy (HRT) has been proven to enhance sleep, reminiscence, and focus in girls taking it for decent flushes, it is “unlikely to have any effect in women without” flushes, they mentioned.

And whereas it cuts the danger of bone fractures, proof exhibits these advantages can dwindle 5 years after HRT is stopped.

If girls do need HRT, the specialists mentioned medics ought to present “realistic information about the likely effects of treatment, the potential for residual symptoms, and the possibility that symptoms could recur when treatment stops”.

A second paper in The Lancet Series discovered no proof of an elevated danger of psychological well being problems for ladies going by way of the menopause.

“On the basis of scarce data, we found no compelling evidence that risk of anxiety, bipolar disorder, or psychosis is universally elevated over the menopause transition,” the workforce mentioned.

Series co-author Professor Martha Hickey, from the University of Melbourne and Royal Women’s Hospital, mentioned: “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 informed a briefing the workforce is arguing that “menopause is not a disease”.

She mentioned: “In a society that has very strong feelings about ageing and women, this is a disease which is thought to herald decline and decay amongst them.”

Dr Lydia Brown, from the University of Melbourne, mentioned: “Whilst it’s certainly the case that some women have extremely negative experiences of menopause and benefit from hormone therapies, 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.

“Menopause is having a cultural moment, and this is 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.”

Dr Louise Newson, a GP and menopause specialist working Newson Health, mentioned: “Menopause is more than a collection of symptoms; it is a cardiometabolic and inflammatory condition which leads to an increased risk of numerous diseases.

“Menopause has been ‘medicalised’ for years – including with antidepressants, antipsychotics, painkillers, sleeping tablets, anticholinergics to treat bladder symptoms, and heart medications to lower cholesterol, reduce blood pressure and control palpations.

“The first-line treatment for menopausal symptoms is body-identical 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 numerous long-term inflammatory diseases associated with menopause including diabetes, cardiovascular disease, osteoporosis, dementia, and depression as well as early death.”

She added: “Talking about menopause as being a ‘natural transition’ or part of ‘healthy ageing’ ignores the very real suffering of many women with menopausal symptoms.”