The question of whether menopause has become over-medicalised is a topic of debate among healthcare professionals, researchers, and the public. The prevailing view of menopause as an endocrine deficiency has led to a "disease-based model" that leads to over-medicalisation of this inevitable life transition, according to the first paper in a major series published in The Lancet.
An approach that goes beyond the treatment of specific symptoms, to encompass a broad model to support women transitioning this life stage allowing women to make their own decisions without bias is more empowering
Natural Life Stage vs. Medical Condition
Menopause is a natural biological process that typically occurs in women around the age of 45-55. Some argue that it is increasingly treated as a medical condition that requires intervention rather than a normal life stage. There is also the consideration that due to the advancements in medical care, screening and treatments we now live more longer than past generations. Women may live half of their lives in Menopause with a decline in hormones. Women aged 45–55 years represent a highly productive group making an essential contribution to society and social structures. Women older than 40 years are the fastest growing sector of the paid workforce in HICs, and most essential and voluntary workers are women.
Hormone Replacement Therapy (HRT) history
Historically, hormone replacement therapy (HRT) was widely promoted as a treatment for a broad range of menopausal symptoms and even as a preventive measure for conditions like heart disease and osteoporosis. However, views regarding HRT use changed after publication of The Women's Health Initiative study in 2002. The study associated HRT with an increased risk of breast cancer, blood clots, and stroke, this led to a reassessment of its widespread use. Unfortunately some healthcare providers still have outdated views regarding risks. Patient information leaflets supplied with medication are also outdated and can cause some confusion and conflicting advice which can prevent women from continuing with HRT. Modern formulations contain very low doses of hormones in comparison the older formulations and can be absorbed trans-dermally resulting in much lower risks
Pharmaceutical Interests
The pharmaceutical industry has a significant stake in promoting treatments for menopause. Some critics suggest that this has led to the medicalization of menopause by framing it as a deficiency or disorder that needs to be treated, thereby expanding the market for medications and supplements.
Psychological and Social Dimensions Overlooked
The medicalisation of menopause can lead to a narrow focus on physical symptoms and pharmaceutical treatments, potentially neglecting the psychological, social, and lifestyle factors that also play a role in how women experience this stage of life.
Normal Symptoms
Many common menopausal symptoms (e.g., hot flushes, mood swings, and sleep disturbances) are normal, yet they are sometimes portrayed as conditions needing medical intervention rather than something that can often be managed with lifestyle adjustments, education, and support.
Need for Symptom Management
Menopause can be a challenging experience for many women, with symptoms that can severely impact their quality of life. In such cases, medical intervention, including HRT, can be beneficial and improve the overall well-being of women.
Increased Awareness and Better Access to Care
Greater medical attention to menopause can lead to better awareness, support, and treatment options for those who need them. It has also opened the door for discussions about other women's health issues that were historically under represented in medicine.
Specialist menopause services are becoming more easily accessible with highly trained clinicians with specialist training in menopause
Individual Choice and Agency
Some women prefer medical treatments to manage their symptoms. Having access to a variety of options empowers women to make informed choices based on their needs and preferences.
Recognition of Diverse Experiences
Not all women experience menopause the same way, and some have severe symptoms that require medical attention. The medical community's role in recognizing and validating these diverse experiences can be crucial.
Conclusion
Whether menopause has become over-medicalised depends on one's perspective on healthcare, individual autonomy, and the role of medicine in managing natural life stages. It may be more accurate to say that the experience of menopause should be individualised, with a range of options—including medical, lifestyle, and psychosocial support—available to those who need them.
Potential positive effects, such as better mental health with age and freedom from menstruation, menstrual disorders, and contraception may sometimes be overlooked .
The focus should be on empowering women with information, choices, and support rather than categorizing menopause purely as a medical condition or ignoring it altogether.
Please get in touch if you are struggling with Menopause and want impartial advice on what is the best fit for you
Regards
Amanda
