Over-medicalising menopause is ‘unhelpful’ for some women, experts warn

Women’s health experts are calling on healthcare professionals to take a more balanced approach to the menopause, which avoids over-medicalising the ‘natural event’.

Writing in the British Medical Journal (BMJ), the experts state that not all menopausal women will require treatment, and assuming so could lead women to expect the worst.

Research shows that women with negative expectations are more likely to have troublesome symptoms, so it is important that there is a shift away from a focus on symptoms and towards the positive outcomes, such as freedom from menstruation, premenstrual symptoms, and requirement for contraception.

Normalising ageing in women

The experts are also calling for greater public awareness, as this will help women to better prepare for the menopause and learn how to optimise their health.

An awareness campaign would also help to reduce stigma around menopause and ageing. This is particularly important in cultures where women are valued for their youth and fertility, as menopause is often seen as synonymous with decline.

The writers praise the work that has already been done in the UK to improve this awareness, including teaching about menopause in sixth forms and colleges, introducing menopause policies in the workplace and creating online resources for employers.

“Normalising ageing in women and celebrating the strength, beauty, and achievements of older women can change the narrative and provide positive role models,” they write.

Healthcare practitioners shouldn’t be afraid to be prescribe HRT when necessary

Dr Rammya Mathew adds that GPs and other healthcare professionals should be aware of the latest trial data when it comes to prescribing hormone replacement therapy (HRT).

She notes that there have been many U-turns regarding its safety, and this has dented the confidence of some practitioners’ when it comes to prescribing it.

To ensure that the right decision is made for patients, Dr Mathew says, GPs should have open discussions about the menopause and reach a join decision about whether HRT is necessary or not.

“My experience is that as GPs we spend a lot of time reassuring women that the plethora of symptoms they are experiencing are explained by the menopause and not a sign of something more worrying. Over the years we are also offering HRT more readily, but many women still feel apprehensive about it, even when we try and put the risks into context for them,” she said.

Empowering women to make informed decisions

In a linked editorial, Haitham Hamoda and Sara Moger of the British Menopause Society (BMS) say that for most women with problematic symptoms, the benefits are likely to outweigh the risks.

Healthcare professionals should therefore take an individualised approach and make the patient aware of the latest unbiased, evidence-based information, thereby empowering women to make informed decisions.