Menopause: It’s becoming a campaign. The staggering lack of information, research, training and clarity among the medical establishment and the population in general is out of the bag. Noon’s Kate Muir is in part responsible for this – her piece about menopause is one of our best-read posts.
Kate has a book coming out on the subject, but also a TV programme: Sex, Myths and the Menopause, a documentary for Channel 4 with Davina McCall and Dr Louise Newson. The three of them spoke to Noon ahead of the programme to highlight some of the key issues.
There is so much jaw-dropping insight – in fact Davina calls it “the pandemic of injustice” around menopause, treatment, education of GPs and under-resourcing of women’s health on the NHS. Highlighting injustices in the way older women are treated is, of course, at the core of what Noon is about. No surprise then, that Noon’s expert on midlife health for women Dr Nighat Arif is also a key contributor to the documentary.
A new app for menopause
The first “wow” moment is that Dr Louise Newson, foremost menopause specialist in the UK, admitted: “As a menopause specialist and a GP, I didn’t recognise or diagnose my own menopause symptoms” – this despite seeing 1,500 women a month at her private menopause clinic. To try and help women and their doctors join the dots, she has just launched a new App called Balance. Often menopause symptoms can be amorphous – such as low mood, depression, migraines, hot flushes, sleeplessness. Too often women and GPs don’t piece the jigsaw together. Misdiagnosis is endemic. “A staggering two thirds of women are given anti-depressants rather than the HRT they need when they go to their doctor,” said Davina McCall.
How women’s health is treated differently
The next message that lands loud and clear is the disparity in treatment between men and women who present to the NHS for hormone treatment. Dr Newson explains that it is only as we are all living longer that women have survived beyond the menopause.
The evolutionary aspect of menopause
When we were hunters and gatherers and many women died young in childbirth, living without the hormones we need to make us feel well — what Newsom calls the “oil in the engine” — wasn’t much of an issue. But now that women are commonly living to 90 or 100 – just look at the Queen, still going strong at 94 – many of us may live nearly half our lives beyond menopause.
The exaggerated risks of HRT
“Women need Hormone Replacement Therapy to feel well,” Dr Newson says. “The risks around increased incidence of breast cancer have been over-egged. Taking HRT reduces a woman’s chance of osteoporosis, cardiovascular disease and even more importantly dementia. The increased risk around breast cancer is equivalent to the risk in being a little overweight, not exercising enough or drinking more than two units of alcohol a week. The benefits of HRT in terms of how we feel and our more general health are huge but too many women do not understand this.” Particularly striking is Newson’s nugget that “HRT is better for heart disease than taking statins.”
She continues: “As a GP, you wouldn’t try to manage hormone-related conditions such diabetes or thyroid problems without giving the patient insulin or thyroxin. Women need HRT to manage the menopause. The disparity in treatment between men with testosterone deficiency – who are given hormone replacement no questions asked – and women going through menopause who cannot get this treatment on the NHS – is a scandal.”
Addressing the stigma around menopause
Coupled with the double standard in medical treatment is a stigma around menopause. Describing her own hellish journey through this, Davina McCall said, “There is so much shame around menopause and there shouldn’t be. Not all women have kids but all women will be menopausal.”
Menopause problems of Black women
Another contributor, fashion designer Karen Arthur, makes the observation that if levels of ignorance are high amongst white women, for more diverse communities like her own the situation is even worse. “Black women never see information about the menopause illustrated with anyone who looks like them, there is a concerning lack of knowledge and so many people suffering in silence unnecessarily.”
GPs don’t get menopause training
The panel all agreed that GPs should have mandatory training on menopause. They currently don’t. A campaign founded by Diane Dianzebrink calling for better information, treatment and training (follow the hashtag #makemenopausematter is starting to make waves. Let’s all be part of this new movement for change. Women deserve better: We are half the population and we all go through this.
Let’s all be part of this new movement for change.
Dr Nighat told us: “Women from all cultures and backgrounds need to understand that the menopause is not a taboo subject. Symptoms such as hot flushes, night sweats, mood swings, brain fog, irritability, lack of confidence, tearfulness, anxiety, palpitations, irregular periods, lack of libido, vulval irritation, recurrent urinary track infections, itchy skin, aches and pains are all menopausal symptoms. A woman experiencing these symptoms but still having periods is defined as being in the perimenopause phase.
“Menopause is defined as one year without a period. I see and hear of too many women being told they are not menopausal based on the fact they still have a period and we need to correct this myth. You can still have periods and still have menopausal symptoms. Perimenopause can start as young as 40, therefore women need to be supported by joining up the dots and by making sure that any hormonal changes she is experiencing are managed by a doctor.”
Time to change the game
HRT needs to be seen as a game changer preventative treatment when it comes to women’s health. The data suggests 20% of women leave the workspace in their perimenopausal years due to lack of support and treatment. This endless lack of awareness around women’s health has to stop or else the glass ceiling will continue to be unattainable. The time has come to recognise that we saw our mothers suffer in silence. I will be damned to see my daughter do the same.
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