Why we should normalise the menopause and focus on the positives, say experts

·Lifestyle Writer, Yahoo Life UK
·5-min read
Menopause happy woman. (Getty Images)
Experts say menopause should be depicted as having both positive and negative aspects. (Getty Images)

Menopause affects everyone differently, and so each person's decision to have treatment for it or not should be based on what's right for them.

But one international group of experts have argued that treating the menopause as a deficiency needing treatment is inaccurate and that "medicalisation" fuels negative expectations and perceptions that could be unhelpful for some women.

Menopause is used to describe the time period when women or people who menstruate stop having periods and can no longer get pregnant naturally.

While it technically refers to the day you haven't had a period for 12 months consecutively, it is often used to depict the whole transition, from noticing changes or experiencing menopausal symptoms.

Menopause and medication

Menopause medication. (Getty Images)
Some may choose to take HRT for menopause, and some may not. (Getty Images)

Some women who suffer from hot flushes and night sweats, for example, may benefit from menopausal hormone therapy, known as HRT. But, while there is no universal experience, most women prefer not to take medication unless their symptoms are severe, according to research published in the British Medical Journal.

The authors, including Professor Myra Hunter, of the Institute of Psychiatry, Psychology, and Neuroscience at King's College London, see an "urgent need" for "a more realistic and balanced narrative that challenges stigma around ageing in women". This includes preparing them for expected changes and recognising the menopause as a natural process with both positive and negative aspects.

Read more: Menopause sex: The surprisingly hot truth

Oesclim Transdermal Patch Containing Estradiol. (Photo By BSIP/UIG Via Getty Images)
Different ways of taking HRT include tablets, skin patches, gels and vaginal creams, pessaries or rings. (UIG Via Getty Images)

They argue that social and cultural attitudes contribute to the varied experience of menopause, with medicalisation fuelling the worst of the expectations.

For example, "the message that menopause signals decay and decline, which can potentially be delayed or reversed by hormone treatments, is often reinforced by the media, medical literature and information for women, often driven by marketing interests," they write.

Furthermore, medicalisation and its narrow focus on symptoms may contribute to women's negative expectations of it, and influence what physical and emotional experiences they attribute to it, they believe.

Menopause can mean freedom

A detailed review of factors affecting attitudes towards menopause found women had a more optimistic view of the menopause once they'd been through it, compared with their perceptions before. This suggests "negative socially mediated expectations do not always match the reality of women’s experiences".

Despite this, the positive aspects of menopause – which include freedom from menstruation, pregnancy, and contraception – are rarely discussed in medical literature, they point out.

This comes after reports earlier this year showing that shortages of HRT are leaving some women battling insomnia, and other troubling health problems.

But to make the field more balanced, authors of the newly published research call for, "Normalising ageing in women and celebrating the strength, beauty and achievements of older women" as this "can change the narrative and provide positive role models".

They acknowledge those who have raised the profile of menopause through media campaigns and within the workplace, the fact it is now included in the UK secondary school curriculum, the development of menopause policies and resources for employers and more.

"Though outcomes of these policies will need to be carefully tracked, continuing to raise awareness through public health and education campaigns can support women to expect – and enjoy – more positive experiences of menopause," they write.

Read more: Shortage of HRT is leaving women battling insomnia

Woman consulting about menopause. (Getty Images)
'Menopause management should be individualised,' says Paula Briggs of the British Menopause Society. (Getty Images)

Prescribing HRT

In her regular column, Dr Rammya Mathew addresses the criticism of GPs that she says ensued after a documentary series on the menopause by Davina McCall reported that "caseloads" of women had suffered at the hands of their GP after being told they didn't need HRT, or that they weren't menopausal.

"I don’t deny that individual women have been let down, and I applaud Davina for raising awareness of what’s often still considered a taboo subject in society," she says.

But she adds that "the more nuanced truth is that many U-turns have been made regarding the safety of HRT, which have had a lasting impact on practitioners’ confidence in the available evidence".

She says that women's symptoms can't always be attributed to the menopause, and although the benefits of HRT outweigh the risks in most women, this is not always the case.

"Many of my female patients claim that I’ve given them back their sense of wellbeing after we’ve discussed the menopause and reached a joint decision about HRT," she says, concluding, "I’m sure that GPs all over the country are doing exactly the same and receiving similar positive feedback".

Read more: Carol Vorderman experienced 'deep, overwhelming depression' during menopause

Watch: Menopause: Hormone replacement therapy could become available over the counter

'Menopause management should be individualised'

Paula Briggs, Consultant in Sexual and Reproductive Health at Liverpool Women's Hospital and Chair Elect British Menopause Society offers her perspective.

"Menopause management should be individualised," she tells Yahoo Life UK. "This is a life stage, which should be dealt with in a holistic manner and whilst some women cope without HRT, others need treatment."

In order for women to make informed decisions, Briggs says they "need to be able to access the correct information and ideally this should be provided by the NHS or Royal Colleges and National organisations which are well-established and trustworthy".

Read more: The secret of Lorraine's successful sex life at 61

In terms of HRT, she reassures that "for otherwise healthy women, the risk associated with HRT is minimal, especially when treatment is commenced in the perimenopause," but adds, "however, other things are important such as smoking cessation, diet and exercise".

"Personalised healthcare has the potential to ensure that women are supported to make the decision that's right for them to manage their menopause," she says. "This will depend on many factors including the patient's medical history and the impact that their symptoms are having on their quality of life.

"Suggesting that most women should manage the menopause without HRT is an extreme concept, as is the concept that all women should have HRT. Women should have information and support to make the right decision based on their individual circumstances."

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