Focus on positives of the menopause, doctors urge

Researchers point to potential damage of HRT, though critics say many women need medical help

THE menopause can set women free, doctors have argued, as they called for an acceptance of the “natural life stage”.

Writing in the British Medical Journal (BMJ), the researchers said “medicalising” the menopause by offering hormone replacement therapy (HRT) could be harmful to women as it has a “narrow focus” on symptoms and could fuel “negative expectations” of the menopause. HRT could also increase women’s anxiety and apprehension about this “natural life stage”, they added.

Instead, society should change the narrative and emphasise the “positives” of menopause, “such as freedom from menstruation, pregnancy, and contraception”, the authors wrote. The research comes as women have faced difficulty accessing HRT in the UK due to recent supply and manufacturing problems, as well as a significant increase in demand. Prescriptions for HRT in England have doubled in five years, according to official statistics.

The team of researchers, from the Royal Women’s Hospital, Victoria, Australia, King’s College London, University of Colorado, US, and Western Sydney University, said the narrative around menopause should “actively challenge gendered ageism”. “Normalising ageing in women and celebrating the strength, beauty, and achievements of older women can change the narrative and provide positive role models,” they argued.

Critics said it was “astonishing” the BMJ would publish an article which suggests women “just get on with it”.

Caroline Nokes, Conservative MP and chairman of the women and equalities select committee, said: “None of us expect HRT to reverse ageing, but we do know it can help alleviate symptoms of the menopause.

“If hot flushes, night sweats, unbearable itching, insomnia, and anxiety can all be avoided, then I am astonished the BMJ is telling us to just get on with it.”

The new analysis applauded recent developments in the UK, such as the menopause entering the school curriculum and celebrities speaking about their experiences. Dr Paula Briggs, chairman-elect of the British Menopause Society, agreed the menopause should not be over-medicalised, but said: “Some women experience very extreme symptoms, which impact on their ability to do their job.

“You can’t just say to these women, ‘it’s fine, it’ll sort itself out, it’s fantastic that you don’t need contraception, you’re not having periods’.”

Dr Briggs said each woman’s case should be taken individually.

In a separate BMJ blog, Dr Rammya Mathew, a London GP, hit out at the socalled “Davina Effect”, and the backlash GPS have faced, after Davina Mccall’s Channel 4 menopause documentary.

The programme reported that “caseloads” of women had suffered after GPS told them they didn’t need HRT.

Dr Mathew said: “I don’t deny that individual women have been let down, but challenge the point about GPS’ competence. Many things are wrong with UK general practice, but the quality and calibre of our GPS is one of the few things we can still celebrate.”