Authors: Amanda Thebe, Fitness and Nutrition Coach Editors: Romina Garcia de leon, Shayda Swann
Published: December 29, 2023
Women don’t have much agency when it comes to menopause, and that has to change. Historically, menopause has either been demonized or swept under the rug as something women should soldier on with. And this has done women a huge disservice. It has led to a massive knowledge gap that means women aren’t getting access to the help they need, either because they don’t know what is happening to them or where to turn.
We aren’t taught about menopause in school, it is hardly ever discussed in the workplace (thankfully, that is changing), and when it comes to advocating for ourselves within the medical community, women are more likely to have incorrect treatments or be completely dismissed by their GP. Why? Well, we know doctors receive very little medical training unless they opt into take it. And the result of this leaves women floundering.
Women are unfortunately at the receiving end of the WHI Study 2002, which boldly told the world that menopause hormone therapy (MHT) causes breast cancer. Even though those findings have been withdrawn, that statement caused a lot of damage. Doctors became hesitant to prescribe MHT, and that hesitancy still exists today despite the menopause societies recommending MHT as a safe treatment option for some menopause symptoms. And the people that suffer the most because of this are women with symptoms who are desperately looking for help.
Going to the doctors to advocate for yourself during menopause can be a minefield. If women simply don’t know that they're in perimenopause, they may just present with one or two symptoms and be treated for those symptoms without the doctor looking at the full picture. Alternatively, women might go to the doctor asking for help with what they know to be perimenopause, only to be turned away empty-handed or with a referral to a specialist because the doctor feels hesitant or uninformed about providing help. This type of negative experience leaves a lasting mark on a woman, who typically has to build up quite a lot of courage to ask for the help she needs. According to the American Association of Retired Persons (AARP), 80% of medical residents in the United States did not feel competent to discuss or treat women in menopause!
We need to help women know that MHT should be an option open for discussion so that they can see if they can be a candidate for the treatment of their symptoms. The MQ6 is a great tool that doctors can use to screen midlife women for menopause and find appropriate treatments. Many women who start taking MHT really feel the benefit and start to see improvements in their symptoms and, therefore, in their quality of life.
On the flip side of this, there is a pervasive message, especially on social media and within menopause online communities, from women who take MHT successfully to treat their menopause symptoms, and from some “celebrity doctors” that MHT is a panacea. This can lead to many women feeling excluded from the conversation because the truth is not every woman can or should take it. MHT is a powerful drug that doesn’t suit all women, especially those with contraindications. We all have a duty to make sure that the information we share about MHT and non-hormonal alternatives stay within the medical consensus statements.
These same platforms often talk about (peri)menopause as a disease or deficiency that must be treated with hormones and the bizarre idea that we weren’t meant to live past menopause in the past. This type of disinformation is very harmful during a vulnerable time of a woman’s life. It is essential to empower women during this time with accurate knowledge, so that they know that if they are suffering, there is help available to them, and they do not have to suffer. But that this is a life transition (for most women) which is meant to happen and that we can and do thrive in postmenopause.
From a personal perspective, I was relieved to be offered MHT by a very progressive doctor, only to have a very negative experience with it. Many years later, when I learned I had a sensitivity to hormones, it all made sense. During those 5 years, I often would flounder into deep depression or struggle with chronic cluster migraines every time I tried MHT. And I know I am not alone. Thankfully for people like me, or for others who can never take MHT, other pharmaceuticals do exist, and women should be given this information.
In an ideal world, if a woman is one of the 75% with moderate symptoms or 25% with life-altering symptoms, and they go to their doctor for help, they should be heard. They should have an assessment to make sure they are in perimenopause and then be offered the most appropriate treatment for them - which may or may not include MHT. Ultimately, menopause is a shared experience amongst all women, but we must be treated on an individual basis for our unique circumstances.