British Medical Journal says most women do not wish to have menopause medical treatment

The menopause is at risk of being “medicalised” into something that always needs treatment, experts have argued.

Writing in the British Medical Journal (BMJ), researchers said most women actually do not wish to have treatment such as hormone replacement therapy (HRT) unless their symptoms are severe.

They argued that the “message that menopause signals decay and decline” is widely reinforced but only serves to make women “expect the worst”.

They wrote: “Medicalisation and its narrow focus on symptoms may fuel women’s negative expectations of menopause and influence what physical and emotional experiences they attribute to menopause.”

The experts, including from the Institute of Psychiatry at King’s College London, said research suggests that “negative attitudes and expectations before menopause predict the likelihood of distressing menopausal symptoms.”

They added: “We argue that medicalisation 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.

“Medicalisation tends to emphasise the negative aspects of menopause and, while effective treatments are important for those with troublesome symptoms, medicalisation may increase women’s anxiety and apprehension about this natural life stage.

“Changing the narrative by normalising menopause and emphasising positive or neutral aspects such as freedom from menstruation, pregnancy and contraception, together with information about managing troublesome symptoms might empower women to manage menopause with greater confidence.”

During the menopause, women may experience hot flushes and night sweats, sleep problems, changes in mood and aching muscles or joints.

But the researchers said these symptoms are “usually time limited”, while their “nature and severity vary substantially between women and within the same woman over time”.

They also argued that medics should “normalise the physical changes of menopause” and “provide reassurance about symptoms and their likely time course”.

Other suggestions in the paper are a focus on diet and exercise, using mindfulness and perhaps undergoing cognitive behavioural therapy to reduce stress and challenge negative perceptions.

In the UK, a shortage of HRT has led to an increased focus on the menopause.

Celebrities such as TV presenter Davina McCall have also raised awareness.

Dr Paula Briggs, chair elect of the British Menopause Society, said: “I agree that the menopause is not a deficiency state, but rather a life stage which can be managed in different ways.

“Care should be individualised and ideally women in the UK should be supported with good quality information from reputable sources on which to make their decision regarding menopause management.

“However, for some women menopausal symptoms have a huge impact on how they function.

“Hormone replacement therapy is the most effective treatment in eligible women, but women should not feel that they have to use it.

“There are many excellent GPs in the UK offering women’s healthcare. In an ideal world women would access their care from their GP with the support of specialists for mentorship, education and research into new treatment options.”