Yesterday, Medscape News UK published a news story about a study in The Lancet that encourages a new approach that moves beyond treating specific symptoms of menopause and towards a more holistic framework. I could not agree more.
However, the news story and the study make references to menopause being over-medicalised, which I find unhelpful.
In the UK, and thanks to much-needed recent media attention, menopause is finally becoming a topic of public discussion. Women are more aware that hormone replacement therapy (HRT) is not as risky as we were led to believe in the early 2000s, and that it can, where needed, provide relief from difficult symptoms.
But we are only just beginning to get easier access to HRT, and it was only a few months ago when women were rushing from one pharmacy to another, desperately looking for their out-of-stock prescriptions.
As a peri-menopausal woman myself, it took several appointments with my GP over 3-4 years, followed by a final demand when my symptoms began to significantly affect my quality of life, before I was prescribed medication. I have never felt satisfied with my menopause management. How could I with the barely 10 minutes and one symptom allowed me for each GP appointment? The GP has no time to give me evidence-based information about how I can manage my specific circumstances. And I’m jumping from one specialist to another trying to figure out the root causes of some of my aches and pains, sometimes asking if they could be menopause-related and receiving blank stares in response.
Saying that menopause is over-medicalised in this environment is simply disempowering. We need a healthcare system that provides holistic, individualised support for peri-menopausal women who need it. We need specialists who speak with each other and who can together guide women who are struggling through this transition.
Certainly, many women can and do manage their menopausal transition without healthcare support. Exercise, healthy sleep routines, nutritious diets, and a supportive social network are sometimes all that is needed.
But there are many women who, no matter what amount of exercise, healthy food, and positive attitude towards ageing that they have, will still face significant challenges.
The study and Medscape’s news report also mention cultural differences in perspectives on women’s ageing. “In cultures where women’s status increases with age, menopause can be easier,” said Rachel Lankester, founder of an information hub about menopause, speaking to Medscape News UK.
There are, indeed, some cultures where women become family matriarchs as they get older. But my experience as a woman of Arab culture is that this place of respect and authority is often limited to the household, and can follow years of struggle in the pre-menopause years due to domineering male family members.
Also, despite the perception among Western societies that women in Eastern cultures don’t struggle as much through menopause, the reality may be that those women are simply not free to mention their symptoms and struggles because the topic of menopause is so taboo in their culture. Or it could be due to a lack of data. The lack of awareness and experience we feel here in the UK from our doctors and close circles is magnified multifold in other parts of the world where menopause and women’s health are neither discussed nor researched.
Yes. We absolutely need a new framework for managing menopause where needed. Certainly, it would be great if we could all think of this process as a normal part of healthy ageing.
But the reality is that many women struggle through this phase and need adequate support. What we need are women’s health hubs that are easily accessible, take us as whole human beings and not as individual symptoms, and help us manage some of the symptoms we experience due to our specific physiologies.
Menopause isn’t over-medicalised. How could it be when it is not taken seriously enough by our healthcare system?
Nadia El-Awady is the news editor of Medscape UK. She has a medical degree from Cairo University, Egypt and a master’s in journalism from the American University in Cairo. She has worked as a science journalist for the past 25 years and is currently based in Leeds.
COMMENTARY
We Need to Keep Talking About Menopause
March 08, 2024
Yesterday, Medscape News UK published a news story about a study in The Lancet that encourages a new approach that moves beyond treating specific symptoms of menopause and towards a more holistic framework. I could not agree more.
However, the news story and the study make references to menopause being over-medicalised, which I find unhelpful.
In the UK, and thanks to much-needed recent media attention, menopause is finally becoming a topic of public discussion. Women are more aware that hormone replacement therapy (HRT) is not as risky as we were led to believe in the early 2000s, and that it can, where needed, provide relief from difficult symptoms.
But we are only just beginning to get easier access to HRT, and it was only a few months ago when women were rushing from one pharmacy to another, desperately looking for their out-of-stock prescriptions.
As a peri-menopausal woman myself, it took several appointments with my GP over 3-4 years, followed by a final demand when my symptoms began to significantly affect my quality of life, before I was prescribed medication. I have never felt satisfied with my menopause management. How could I with the barely 10 minutes and one symptom allowed me for each GP appointment? The GP has no time to give me evidence-based information about how I can manage my specific circumstances. And I’m jumping from one specialist to another trying to figure out the root causes of some of my aches and pains, sometimes asking if they could be menopause-related and receiving blank stares in response.
Saying that menopause is over-medicalised in this environment is simply disempowering. We need a healthcare system that provides holistic, individualised support for peri-menopausal women who need it. We need specialists who speak with each other and who can together guide women who are struggling through this transition.
Certainly, many women can and do manage their menopausal transition without healthcare support. Exercise, healthy sleep routines, nutritious diets, and a supportive social network are sometimes all that is needed.
But there are many women who, no matter what amount of exercise, healthy food, and positive attitude towards ageing that they have, will still face significant challenges.
The study and Medscape’s news report also mention cultural differences in perspectives on women’s ageing. “In cultures where women’s status increases with age, menopause can be easier,” said Rachel Lankester, founder of an information hub about menopause, speaking to Medscape News UK.
There are, indeed, some cultures where women become family matriarchs as they get older. But my experience as a woman of Arab culture is that this place of respect and authority is often limited to the household, and can follow years of struggle in the pre-menopause years due to domineering male family members.
Also, despite the perception among Western societies that women in Eastern cultures don’t struggle as much through menopause, the reality may be that those women are simply not free to mention their symptoms and struggles because the topic of menopause is so taboo in their culture. Or it could be due to a lack of data. The lack of awareness and experience we feel here in the UK from our doctors and close circles is magnified multifold in other parts of the world where menopause and women’s health are neither discussed nor researched.
Yes. We absolutely need a new framework for managing menopause where needed. Certainly, it would be great if we could all think of this process as a normal part of healthy ageing.
But the reality is that many women struggle through this phase and need adequate support. What we need are women’s health hubs that are easily accessible, take us as whole human beings and not as individual symptoms, and help us manage some of the symptoms we experience due to our specific physiologies.
Menopause isn’t over-medicalised. How could it be when it is not taken seriously enough by our healthcare system?
Nadia El-Awady is the news editor of Medscape UK. She has a medical degree from Cairo University, Egypt and a master’s in journalism from the American University in Cairo. She has worked as a science journalist for the past 25 years and is currently based in Leeds.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
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