Menopause called natural process that shouldn’t be ‘medicalized’

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Overemphasizing the negative aspects of menopause maybe be harmful for women, an Australian professor of obstetrics and gynecology says. Photo by Peter van der Sluijs/Wikimedia Commons

June 15 (UPI) — Menopause is a natural part of aging, and older women will become empowered to approach it with greater confidence if positives such as freedom from menstruation, pregnancy and contraception are emphasized.

They also need balanced information from their clinicians about how to manage troublesome symptoms.

That’s the message to the medical community underscored by Dr. Martha Hickey, an Australian obstetrician/gynecologist, in a commentary published Wednesday in the British Medical Journal.

Such “medicalization” of menopause “risks collapsing the wide range of experiences at the average age associated with this natural process into a narrowly defined disease requiring treatment,” lead author Hickey and her colleagues wrote.

“Menopause is a normal event in women’s lives,” Hickey, a professor of obstetrics and gynecology at the University of Melbourne and the Royal Women’s Hospital in Victoria, Australia, told UPI. “Although many have symptoms, most manage these without recourse to medical treatments.”

“Overemphasizing the negative aspects of menopause may be be actively harmful for women,” she added. “Those who expect to have problematic symptoms are more likely to have them.”

In high income countries, menopause usually occurs around age 51, although the range is wide; it often occurs earlier, between the ages of 46 and 48, on average, in middle-lower income countries, the commentators said.

There is no universal experience for women undergoing menopause. A 2021 global survey found that 16% to 40% of women experience vasomotor symptoms, such as hot flashes, night sweats, sleep difficulties, mood changes, and aching muscles or joints.

The authors stress the importance of social and cultural attitudes, noting that women tend to have worse experiences of menopause in countries in which their worth hinges on youth and reproductive capacity, and aging is associated with decline.

Dr. Jen Gunter, a San Francisco-based obstetrician/gynecologist and author of The Menopause Manifesto, told UPI that Hickey’s commentary is needed “to balance a lot of dominant voices talking about menopause as a disease or hormone deficiency.”

Women experience a wide range of menopausal symptoms, some of which should be treated, Gunter said. But it’s just as inappropriate to medicalize this stage of a woman’s life as to do so with pregnancy and talk only about terrible potential complications of birth that are not reflective of most women’s experiences.

At first, women’s symptoms were dismissed, and then hormone replacement therapy became the standard, Gunter said. When physicians reduced prescribing hormones, “we stopped talking about [menopause] in the office, and that’s wrong.”

Now, she said, clinicians need to be doing a better job of educating women about the signs of menopausal transition and providing information on more than hormone replacement therapy in a positive way.

She said she spends a lot of time on social media, where “a lot of people are talking about menopause as a death sentence” — a supposedly feminist stance that’s actually similar to how menopause was described in the 1800s.

“If everything you hear in society is negative about your body, you may have amplification of your symptoms,” she said. “The answer isn’t going to the extreme of medicalizing it … and we have a wealth of treatments available.”

Hickey works with an organization that aims to help employers actively support women’s transition to menopause in the workplace.

“Embracing diversity in the workplace is not new, but recognizing that menopause is an aspect of diversity is new,” Hickey said.

“We are encouraging employers to see the benefits of retaining skilled and experienced workers who are often women, particularly in essential jobs like health and education,” she said.

“In the United Kingdom, around 30% of workplaces now have a menopause policy,” she added.

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