Menopause misinformation harming women: Study

Michelle Wisbey

7/09/2023 3:50:16 PM

Researchers say personalised treatments and a new definition are needed to bring the once-taboo subject out of the shadows.

Woman lying in bed in pain.
Most women living in high-income countries do not receive effective treatment for their menopausal symptoms, the study found.

Menopause is something all women will experience, but most are still battling through ineffective treatments and a misinformation epidemic.
From night sweats and hot flushes, to anxiety, depression, and career-ending side effects, the symptoms can be severe and life-changing.
That is the conclusion of a new study, which found more than 85% of all women in high-income countries do not receive effective, regulator-approved treatment for their menopausal symptoms.
The Monash University research, published in Cell, is now calling for a systematic overhaul of the way menopause is treated in Australia, starting with individualised treatments and a new definition.
As part of the Menopause – Biology, Consequences, Supportive Care and Therapeutic Options study, researchers looked at more than 200 sources across 71 years to figure out what we know, and what needs changing.
Tasmanian GP and Australasian Menopause Society (AMS) former President Dr Karen Magraith told newsGP menopause is becoming a less taboo subject than it once was.
‘There is more discussion than there used to be, but there is also plenty of misinformation,’ she said.
‘Part of the misinformation has come with people wanting to sell products that don’t have an evidence-base and make money from the interest in menopause.
‘Another aspect of misinformation is the concept that if women just improve their lifestyle, all their symptoms will settle down.
‘Unfortunately, although healthy lifestyle is critical, it will not alleviate all menopause symptoms and some women need medical therapies, including hormone therapy.’
However, researchers say women are battling a widespread fear of these hormone therapies, stemming from decades of conflicting messaging and a lack of long-term studies.
‘Each treatment type has potential side effects and health concerns. Even the most effective and well-researched hormone therapy targeting oestrogen is far from a perfect solution for all,’ they said.
Dr Magraith said the risks and benefits of menopausal hormone therapy (MHT) have long been confusing for women and patients.
‘A few years ago, the risks were overstated, whereas now the pendulum has swung a long way and some people promote MHT for the prevention of heart disease, dementia and other conditions,’ she said.  
‘It’s important to come back to the guidelines, which say that MHT is not indicated solely for the prevention of heart disease or dementia.
‘MHT can be prescribed for treatment of menopausal symptoms and in some cases for treatment of low bone density.’
The research went on to suggest a new definition for menopause that references the ‘final cessation of ovarian function’, rather than traditional definitions which focus on menstruation.
They said this would encompass those without regular periods before menopause, as well as those who use contraception, including intrauterine devices (IUDs), and have hysterectomies.
It also found that while women’s symptoms vary widely, ranging from severe to none, there can be unseen impacts affecting their health.
Even if someone has no noticeable symptoms, the researchers wrote that women can still be burdened with ‘silent health consequences’ including bone loss or a higher risk of diabetes, cardiovascular diseases, and some cancers.
For GPs seeing patients experiencing menopause, Dr Magraith’s advice is to ‘listen to patient’s specific concerns and try to address those’, while at the same time think about longer term issues such as bone and cardiovascular health.
‘Not everyone will need MHT or other prescription treatment, but all women need good information,’ she said.
‘It’s tricky for GPs to offer comprehensive menopause care within the current Medicare structures. It’s not possible to complete a full assessment, discuss screening, health prevention and treatment options in a 15-minute appointment.
‘For patients to have access to good menopause care, the structural barriers to long consultations need to be addressed, so that all patients regardless of their background can get the care they need.’
The paper’s authors recommend regular exercise and maintaining a protein-rich nutritious diet as ways for women to reduce their likelihood of symptomatic health complications.
‘Recognition that menopause, for most women, is a natural biological event, does not exempt the use of interventions to alleviate symptoms,’ they concluded.
‘Optimising health at menopause is the gateway to healthy ageing for women.’
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Dr Helen Vibeke Webster   8/09/2023 7:33:15 AM

I wouldn’t move interstate. I’d retire.

Dr Ian   8/09/2023 4:03:22 PM

It was the Women’s Health Initiative Trial in 2002 that reported that in its trial of 160,000 post menopausal women over 15 years taking combination estrogen and progestin increased the risk for breast cancer ,heart disease ,stroke blood clots , and urinary incontinence .
Fear massively produced the prescription of Hormone Replacement therapy for a decade plus years .
Further research by organisations such as the North American Menopause Society statement in 2017 have found that the
Women’s Health Initiative Trial had a decreased sample number of women who were younger than 60 or less than 10 years from menopause , had under sampled women who had bothersome hot flushes and night sweats and included only one estrogen formulation 625mg of conjugated equine estrogen but now there new estrogen formulations that are more like the human bodies estrogen and are lower in dose .
This significantly lessens the risk of breast cancer over time but dramatically relieves hot flushes .