University news

Researchers from the University of Glasgow have contributed to a new Lancet 2024 series which warns about the overmedicalisation of menopause, calling for a new approach to how society views menopause and supports women as they age.

A new approach to menopause that better prepares and supports women during midlife is needed – going beyond medical treatments – to empower women using high-quality information on symptoms and treatments, empathic clinical care and workplace adjustments as required, says a new four paper series published in The Lancet and co-authored by Dr Jenifer Sassarini, Honorary Clinical Senior Lecturer at the University of Glasgow.

The Lancet 2024 Series on menopause argues that an over-simplified narrative of menopause as a health problem to be solved by replacing hormones is not based on evidence and deflects attention from the need for substantial societal shifts in how menopause, and midlife/older women in general are viewed and treated around the world.

The Series highlights how some groups, such as those who experience early menopause or cancer treatment-induced menopause often do not receive optimal care. In addition, The Series questions the assumption that menopause often causes mental health problems and identifies specific at-risk groups who may need additional support.

The authors argue that a change in the narrative to view menopause as part of healthy ageing would reduce stigma and overmedicalisation, empowering women to navigate this life stage, acknowledged and supported by clinicians, researchers, workplaces, and wider society.

Series co-author Dr Jenifer Sassarini, from the University of Glasgow and consultant at NHSGGC, said: “People with cancer are more likely to experience early menopause or menopause symptoms due to treatment. This may cause psychological distress and impair quality of life. Women often report a lack of centralised care and access to safe and effective treatments for symptoms of menopause after cancer treatment.

“More patient friendly models of multidisciplinary care are needed that manage common symptoms in one place. New treatment options are needed for menopausal symptoms, particularly for those avoiding MHT. For those who can safely take MHT after cancer, clinicians should ensure this is offered.”

Series co-author, Professor Martha Hickey, University of Melbourne and Royal Women’s Hospital (Melbourne), says “The misconception of menopause as always being a medical issue which consistently heralds a decline in physical and mental health should be challenged across the whole of society. Many women live rewarding lives during and after menopause, contributing to work, family life and the wider society. Changing the narrative to view menopause as part of healthy ageing may better empower women to navigate this life stage and reduce fear and trepidation amongst those who have yet to experience it.

“The experience of menopause differs for every person. Our Series calls for an individualised approach where women are empowered with accurate, consistent and impartial information to make informed decisions which are right for them over the menopause transition. This may include taking menopause hormone therapy (aka HRT) for symptoms such as hot flushes and night sweats, which can range from mild to extremely debilitating, after a discussion with their doctor about the risks and benefits. Whilst some women may also choose psychological therapies such as cognitive behavioural therapy to reduce the psychological impact of hot flushes and night sweats and improve sleep.”

The authors also call for more research into aspects of menopause that are a priority for women. For example, a global Menopause Priority Setting Partnership is underway across more than 40 countries to develop a new, patient-focused research agenda.

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Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk

First published: 5 March 2024