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Friday, September 20, 2024

WOMENS HEALTH

The Menopause Society launches Making Menopause Work™ Initiative

THIS IS A UNION ISSUE

Unique educational and designation initiative based on new science-based Consensus Recommendations to help employers retain workers and recoup $1.8 billion in lost workdays by supporting menopausal women in the workplace

The Menopause Society

CHICAGO (Sept 13, 2024)—Menopause is a natural life transition occurring when many women are at the “top of their game.” Unsupported menopause symptoms drive up employer healthcare costs and cause roughly $1.8 billion in missed workdays. To help employers retain these valued workers and build cultures of well-being, The Menopause Society launched Making Menopause Work™ based on new science-based Consensus Recommendations. The Recommendations are published online in Menopause, the journal of The Menopause Society.

“More employers—from large corporations to small organizations—are supporting workers during menopause,” Dr. Stephanie Faubion, medical director of The Menopause Society and director of the Mayo Clinic Center for Women’s Health, said today at The Menopause Society’s Annual Meeting in Chicago.

“But more menopause-supportive workplaces are urgently needed,” Faubion continued. “Women ages 50 and older are the fastest-growing demographic group, making essential contributions to society, families, communities, and the paid and unpaid workforces. This is a moment of tremendous opportunity.”

The Menopause Society builds on its 35-year, science-based track record with the creation of Making Menopause Work. The program—which includes a free Employer Guide, an assessment, planning tools, and other resources, with an employer designation program to come—incorporates recommendations based on new scientific consensus recommendations from a multidisciplinary panel of leading medical, legal, and human resource experts.

“Employers need to take menopause symptoms seriously and also know that they’re manageable and temporary,” said Jill K. Bigler, labor attorney at Epstein Becker Green and a member of the advisory panel for the Consensus Recommendations. “Making Menopause Work is a smart, strategic move for employers. It safeguards workers’ opportunities for leadership and financial security. It retains workers and productivity. And it builds a multigenerational workplace where midlife employees hold institutional knowledge, bring calm under stress, and make wise decisions.”

Understanding menopause and creating menopause-responsive workplaces

Menopause, the end of menstrual periods, usually occurs between ages 45 and 55; although perimenopause can start as early as age 35. Symptoms are different for each person. For some, periods become irregular and then stop. Others may experience hot flashes, difficulty sleeping, memory problems, mood disturbances, vaginal dryness, or weight gain.

The Society’s Consensus Recommendations cite a survey by the Society for Women’s Health Research showing that two out of five people had considered looking for or had found a new job because of menopause symptoms. Not only do employers risk losing talent and revenues when they ignore menopause, they also face greater costs for healthcare as well as the cost of replacing and training workers.

Creating a supportive workplace culture is the first step in turning these numbers around. The Employer Guide supports employers, managers, and supervisors to do this, including opening conversations for those who want it, understanding how to hear and support people’s needs, and recognizing menopause as a normal part of life for half the population.

From there, the Employer Guide helps employers update policies, benefits, and environments, including offering the following:

Health insurance plans that include adequate and affordable coverage for menopause-related care
Access to adequate bathrooms and flexible breaks to use them—vital for people with heavy or unpredictable bleeding
Improved ventilation and updated uniforms with breathable, flexible fabrics—a game changer for people experiencing hot flashes
Quiet work environments and flexible deadlines, which improve focus for people experiencing insomnia, anxiety, or brain fog
Peer support networks, employee resource groups and employee assistance programs, which can help people know they’re not going through menopause alone

Employers or employees interested in learning more about this important initiative should visit menopause.org/workplace.

The Menopause Society (formerly The North American Menopause Society) is the leading nonprofit organization dedicated to empowering health care professionals to improve the health of women during the menopause transition and beyond. Employers who support Making Menopause Work become part of a movement that includes more than 2,000 health care professionals who have earned The Menopause Society’s Certified Practitioner (MSCP) credential, along with tens of thousands of people who rely on The Menopause Guidebook, the most complete consumer menopause resource available.

Not in the mood for sex after menopause?

A new study suggests that cognitive behavioral therapy could be key in improving sexual function in postmenopausal women

The Menopause Society

CLEVELAND, Ohio (Sept 10, 2024)—Many women report a decline in sexual function, including desire, when transitioning through menopause. Such problems can contribute to poor self-image and negatively affect physical and emotional well-being. A new study suggests that cognitive behavioral therapy may be a safe and effective treatment for mitigating sexual concerns during this period. Results of the study will be presented at the 2024 Annual Meeting of The Menopause Society in Chicago September 10-14.

Partially due to declining estrogen levels, 68% to 87% of peri- and postmenopausal women express sexual concerns. Despite such high prevalence and negative impacts, treatment options–particularly nonpharmacological ones–are quite limited. In response, researchers initiated a small study to evaluate the efficacy of a four-session individual cognitive behavioral therapy protocol for improving sexual functioning (eg, desire, arousal, pain, satisfaction). Secondary objectives included assessing body image, relationship satisfaction, menopause symptoms (such as hot flashes), depression, and anxiety during peri- and postmenopause.

The researchers found that participants in this study experienced a significant improvement in multiple areas of sexual functioning, body image and couple satisfaction, as well as a significant decrease in menopause symptoms, depression, and anxiety, and self-reported overall health. In addition, 100% of participants indicated they were very satisfied with the treatment and that it helped them cope with their symptoms more effectively.

“To our knowledge, this is the first study that has examined the efficacy of a cognitive behavioral therapy protocol specifically aimed to improve sexual concerns experienced during peri- and postmenopause,” says Dr. Sheryl Green, lead study author from McMaster University in Ontario, Canada. “Results suggest that this type of therapy leads to significant improvements across several important sexual concern domains, and we hope this study will provide the basis for larger randomized clinical trials in the future.”

More detailed results will be discussed at the 2024 Annual Meeting of The Menopause Society as part of the Top Scoring Abstract Session presentation titled “Cognitive behavioral therapy for sexual concerns during peri- and postmenopause, a clinical trial.”

“This study is important to women experiencing sexual health related issues and provides their healthcare professionals with another nonpharmacologic treatment option to discuss with their patients,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

Both Drs. Green and Faubion are available for interviews prior to the Annual Meeting.

For more information about menopause and healthy aging, visit the newly redesigned www.menopause.org.

The Menopause Society (formerly The North American Menopause Society) is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.

Wednesday, August 09, 2023

New survey confirms need for more menopause education in residency programs

Lack of standardized menopause curriculum and access to menopause-specific educational materials leaves many healthcare professionals ill-equipped to manage needs of record numbers of menopausal women

Peer-Reviewed Publication

THE MENOPAUSE SOCIETY

CLEVELAND, Ohio (August 9, 2023)—Despite the fact that nearly 90 million women in the United States are projected to be postmenopausal by 2060, menopause remains low on the priority list of many residency programs. A new survey reveals the lack of a standardized menopause curriculum and limited access to menopause educational resources for residents. Results of the survey are published online today in Menopause, the journal of The Menopause Society.

Because women today are living longer, it is not surprising that there are a record number of postmenopausal women. And, that number is only expected to grow, with women spending roughly onethird of their lifetimes in menopause. Despite the increased demand for menopause care and education, many obstetrics and gynecology trainees graduate from their residency programs with gaps in their education regarding the management of menopause symptoms and related conditions.

When the last needs assessment was published for menopause education in 2013, it confirmed that most residents felt that they had limited knowledge and needed to learn more about the various areas of menopause medicine, including hormone therapy and bone health and related conditions such as cardiovascular disease and metabolic syndrome. At the time, only 20.8% of residents stated that their program had a formal menopause curriculum. Based on the results of this newest survey, it appears that the situation has not improved much, with only 31.3% of the obstetrics and gynecology residency program directors who responded reporting they had any type of menopause curriculum as part of their residents’ training. Nearly 20% claimed they had a curriculum confined to a rotation block.

Of the programs with a menopause curriculum, 96.8% used lectures and 77.4% used assigned readings. All programs with a menopause curriculum included five or fewer menopause lectures per year for trainees, with 71.0% reporting two or fewer lectures per year. Of the respondents, 83.8% agreed or strongly agreed that their program needs more menopause educational resources.

Based on the results, researchers concluded that, nationally, most obstetrics and gynecology training programs lack the curriculum necessary to effectively prepare residents to manage menopausal women. Moreover, there is a lack of consistency in the menopause curriculums that do exist such that there is no true level of standardized care.

Survey results are published in the article “Needs assessment of menopause education in United States obstetrics and gynecology residency training programs.”

“This study highlights the ongoing problem of the lack of education of medical trainees in menopause management. An easily accessible, standardized menopause curriculum would benefit trainees across multiple residency training programs, including obstetrics and gynecology, internal medicine, and family medicine, with the ultimate goal of ensuring that all women have access to competent menopause care,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

For more information about menopause and healthy aging, visit www.menopause.org.

JOURNAL

Menopause

DOI

10.1097/GME.0000000000002234

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Needs assessment of menopause education in United States obstetrics and gynecology residency training programs

ARTICLE PUBLICATION DATE

9-Aug-2023

Wednesday, April 28, 2021

The doctor behind 'The Vagina Bible' wrote a new book on menopause, and she says she's skeptical of the startups targeting middle-aged women

pyeo@businessinsider.com (Patricia Kelly Yeo) 15 hrs ago

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© Peacock Alley Entertainment Dr. Jen Gunter in 2019.

Gynecologist Jen Gunter's new book debunks myths about menopause.
Gunter said most startups that are trying to tackle menopause aren't selling anything new.

Her expert advice for those approaching or in menopause: quit smoking, exercise, and eat healthy.

Menopause - medically defined as the stage after a biological female's final menstrual period - is as universal an experience as first starting your period in puberty.

Accompanied by declining levels in sex hormones and eventual loss of fertility, the experience of going through menopause isn't exactly well-depicted in media or commonly spoken about - so Dr. Jen Gunter wrote her second book about it.

"Menopause is puberty in reverse," she writes in "The Menopause Manifesto," set to be published May 25. Unlike pregnancy, menopause will happen in all biological females who live past a certain age, yet few honest, accessible, and women-centered discussions on the reproductive transition exist, Gunter said.

Beyond the loss of period and measured hormonal declines, menopause symptoms can vary widely. Common ones include changes in body temperature, mood, sleep, weight, and sex drive.

Intended to be an inclusive, educational and historical guide to the fertility transition, "The Menopause Manifesto" is Gunter's follow-up to The New York Times-bestselling "The Vagina Bible" published in 2019.

Gunter, a practicing gynecologist in the Bay Area, also dispenses science-backed health advice for women across the board.

Having first spoken out against Goop's controversial jade eggs in 2017, Gunter is a vocal online critic of health misinformation and the many forms misogyny can take within it.

Speaking to Insider, Gunter said she was inspired to write "The Menopause Manifesto" largely due to the negative stereotypes women approaching menopause face around their sexual value and social worth, as well as the lack of easily understandable, de-stigmatized information on the biological transition.

Similar to her first book, it cuts through the misogyny embedded in conventional Western medicine to talk about women's health to debunk myths and provide historical and social context. Her 25 years of clinical experience and her personal experiences with premenopause, the long and varied phase leading up to it, guided its writing as well.

Gunter's focus on aging women is happening at a time when there's been a"menopause product boom," and calls for increased venture funding. Though she said that women over the age of 45 have been "treated like a silent demographic," Gunter expressed skepticism about the increased attention to the estimated $600 billion market.

"If you need calcium, you can take a calcium supplement," she said. "Why do you need one branded for menopause? Is that like a pink tax, plus a menopause tax on top of it?"

Instead, Gunter offered three general health recommendations for those either already in or approaching menopause: quit smoking, exercise, and eat a healthy diet - with plenty of fiber.
Venture-backed menopause startups aren't doing anything new

"The Menopause Manifesto" draws upon dozens of scientific studies evaluating the evidence for different approaches to managing menopause symptoms, most of which are caused by declining levels of the sex hormone estrogen.

One of the first mainstream medical treatments for menopause that might come to mind is hormone replacement therapy. In her book, Gunter rejects the term for its value-laden connotations, preferring to use the term menopausal hormone therapy, or MHT.

"While MHT can be helpful for many people, it really needs to be looked at as one part of the puzzle," Gunter said. "Often the focus seems to be on estrogen, as opposed to the whole experience."

Other approaches beyond MHT and lifestyle recommendations, Gunter found, have little evidence for wellness and alternative health products in treating the symptoms of menopause. In "The Menopause Manifesto," she devotes seven chapters to both medical treatments and unregulated products, including dietary supplements, bioidentical hormones, birth control, and MHT.

Although Gunter said she would need to consider each product on an individual basis, she's wary of slickly marketed products, particularly supplements and other combination products that market themselves as blanket solutions.

"Things claim to be 'ovary support' or 'menopause support,' but that's a medically meaningless term," she said. "Most people don't need to take a supplement."

With the exception of omega-3 fatty acids and vitamin B12, the data on efficacy for most menopause-targeted supplements, including popular multivitamins, remains spotty and scarce, according to "The Menopause Manifesto." Despite the billions of dollars consumers pour into the supplement industry, food remains the best way to get micronutrients.

In the last year, she said a handful of startups have pitched her menopause-related ventures, none of which seemed to be different for existing free resources for menopause patients.

"Someone pitched me some app that women would sign up for and pay for with all the guidelines [for menopause]," Gunter said.

"And I'm like, 'The North American Menopause Society has one and it's free! How is your app different from that?' Then there's just a big silence."
Her doctor's advice for managing menopause symptoms is science-backed and likely unsurprising

Menopause symptoms can include hot flashes and brain fog. Gunter pointed to some ways to improve health and well-being during that time.

Gunter's recommendations for people in menopause are simple: quit smoking, strive for the American Heart Association's recommended 150 minutes of weekly aerobic exercise, and learn how to eat healthier - including hitting the broadly recommended daily 25 grams of fiber.

"The science of nutritional studies is really challenging for a lot of reasons, but the takeaway really is that people need to eat more vegetables," she said.

In addition to getting enough fiber, Gunter added we'd likely all be a little bit better off with trying to eat more plant-based protein and minimizing processed food. More accessible, high fiber, healthy food would improve public health overall, and reduce people's risk of other conditions like hemorrhoids and colorectal cancer.

"I guess what people can benefit from isn't sexy," she added. "Nobody wants to buy a book about the hundred joys of fiber."

Gunter also highlighted adding weight-bearing exercise, since strength training can help mitigate the effects of bone loss and accelerated loss of muscle mass that occurs during menopause.

What works for one person may not work for another, but Gunter is firm in her belief we all probably need to move our bodies more - a message that's often lost in Instagram-friendly advertising for women's health products.

"If health and wellness is something that appeals to you - exercising and learning how to eat better and prepare meals is good, but there isn't a specific pillow or bed sheet or supplement that's going to help with menopause," she said.

Wednesday, October 18, 2023

Menopause costs the Canadian economy billions every year. Here’s why

Story by Katie Dangerfield • Global News

Deepti Neto, 63, was trying to run her Toronto-based real estate business running on three to four hours of sleep every night.

She had always been a great sleeper, but in 2013 she started experiencing insomnia and her cognitive and communication abilities were declining as a result.

Global News
Women needlessly suffering with menopause symptoms
Duration 5:01 View on Watch

Menopause symptoms costing economy billions
Duration 2:17 View on Watch

Neto tried to buy a new mattress to help, but it wasn't until she noticed her period became more sporadic that she realized she may be experiencing perimenopausal symptoms.

"So I did what everyone does: I drank herbal teas, went to acupuncture, I did everything I could do, but nothing was helping. My sleep was getting worse," she said, adding that it was affecting her business.

"I am a real estate agent so my communication and cognitive skills are my best skills, it's my job. I was getting worried."

She then went to her doctor, who informed her that he could not provide treatment until she had gone a full year without a period, as that is "when they consider you to be in menopause," she said. Instead, she was given antidepressants.

But Neto was still having sporadic periods. She was experiencing insomnia, hot flashes and anxiety, all of which are characteristic of perimenopause, the stage leading up to menopause. And she said the antidepressants were causing her more fatigue.

She stopped taking the antidepressants and switched doctors. She was then prescribed menopause hormone therapy and "immediately started feeling better."

"The sleep symptoms were eradicated within a week or two," she said, adding that if she hadn't advocated for her health, she may have never found the solution.

Menopause, exacerbated by stigma, lack of workplace support and the burden of debilitating symptoms, carries a substantial cost for the Canadian economy, amounting to an estimated $3.5 billion per year, according to a new report.

The Menopause Foundation of Canada released the report Monday, finding that unmanaged symptoms of menopause cost employers an estimated $237 million annually in lost productivity. And women experience a substantial financial burden, with $3.3 billion in lost income because of reduced hours, diminished pay, or leaving the workforce altogether.

The report also found that 540,000 lost days of work can be attributed to menopause symptom management per year.

"Many women are blindsided by menopause, which is really just being unprepared for this stage of life," explained Janet Ko, president and co-founder, of the Menopause Foundation of Canada.

"What that leads to is some women stepping back from the workforce, leaving altogether, taking a lesser job, reducing their hours, going part-time or not taking that promotion. We believe menopause is the missing link to explain why more women are breaking through the glass ceiling," she added.

Menopause impacts women’s careers according to a recent report

In Canada, there are more than two million working women aged 45-55, which is the average age at which most women experience menopause, according to the report.

There is also a period before menopause, called perimenopause, which can last two to 20 years, Ko said. And then there's post-menopause, which can last for the rest of a woman's life.

"So women will actually spend up to half of their lives in a stage of menopause," she said.

While menopause is a universal life stage for most women, a survey in the report found that 46 per per cent of respondents said they are not prepared for this transition.

Menopause costs the Canadian economy billions every year. Here’s why© Provided by Global News

Ko referred to this as the "menopause knowledge gap," signifying a lack of understanding among women regarding the changes in their bodies and the symptoms triggered by hormonal fluctuations.

As a result, many women do not get the help they need.

"That not only impacts their health, their quality of life, but it also impacts their ability to work as productively as they would like," she said, adding that menopause usually happens during the peak of women's careers.

The survey also found that more than one-third of working women said menopause symptoms negatively impacted their work performance. And around one-quarter said they his their symptoms at work.

Sixty-seven per cent said they would not feel comfortable talking to their supervisor about their symptoms, and almost half said they would be too embarrassed to ask for help at work.

And an estimated one in 10 women will leave the workforce due to unmanaged symptoms of menopause.

During menopause, the ovaries stop the process of ovulation and estrogen production, and as a consequence, women stop menstruating, explained Teresa Isabel Dias, a pharmacist and a certified menopause practitioner based in Toronto.

Perimenopause is the transition period, lasting six to eight years, leading up to menopause when a woman’s menstrual cycles could become irregular as the hormone levels fluctuate.

"Women may start experiencing things like this at the age of 35. And nobody is aware of that such big change can take place so early in life. So a lot of women struggle for many years when they have early perimenopause because our health care is not trained on this," she said.

In Canada, the average age of menopause is 51.5 years. But most women are in perimenopause between the ages of 40 and 50, according to the Menopause Foundation of Canada.

And women can continue experiencing symptoms into their 60s and 70s.

There are also over 30 symptoms of menopause, including hot flashes, insomnia, brain fog, anxiety and joint pains.

Surprising facts about menopause

Not every woman goes through a rough time, Dias said, adding that "20 per cent do not experience any bothersome symptoms."

But one of the biggest risks of menopause that she hopes women will be aware of is the loss of estrogen.

"Estrogen is protective for the bones. It helps to not lose bone density as fast. It also helps with the heart," she said.

"Estrogen is a girl's best friend. And when we don't have it, we have to do other things to reduce our risk for disease," she said.

The number one piece of advice Dias gave for women is to lead a healthy lifestyle, such as eating healthy nutritious foods, drinking enough water, getting regular exercise and sleeping at least eight hours every night.

"We have to have compassion towards ourselves, have a lot of patience to go through this and believe that we'll get to the other side," she said.

Treatments for menopause, like hormone replacement therapy and pelvic floor physiotherapy, are available options. However, Ko pointed out that due to the significant stigma surrounding this topic, many women do not know where to seek help and often are hesitant to talk about it.

The report found that 87 per cent of working women felt their employer does not provide, or do not know if they provide, support related to menopause. The most common supports identified as desirable are medical coverage, flexible workplace policies and environmental adjustments, along with general awareness and education, the report found.

"It's a really important topic that doesn't get a lot of attention," Ko said. "Menopause is overwhelmingly viewed as negative in our society.

"The image of the menopausal woman is very unflattering, which is why I think many women don't want to be associated with that negative portrayal of a woman. So menopause comes wrapped up in secrecy and mystery."

Video: World Menopause Day: facts and misconceptions

But the workplace could be a great place to start breaking down the stigma, she said.

This could entail holding information sessions with employees, putting information up on the company website, creating an employee resource group and improving benefit plans (to cover hormone therapy), Ko said.

"We believe that most employers have just never considered this and that when they understand the number of women in the workforce that are going through this they'll start to look at it," she said.

"We have the skills, experience and leadership that employers need, and they can't afford to lose."

-- with files from Global News' Saba Aziz

Saturday, October 28, 2023

New guide details menopause’s effects on the workplace, other surprising impacts

Peer-Reviewed Publication

UNIVERSITY OF VIRGINIA HEALTH SYSTEM

New guide details menopause’s effects on the workplace, other surprising impacts — IMAGE:
MENOPAUSE EXPERT JOANN V. PINKERTON, MD, IS UVA HEALTH'S DIRECTOR OF MIDLIFE HEALTH AND AN AUTHOR OF A NEW GUIDE TO THE SWEEPING EFFECTS MENOPAUSE CAN HAVE.
view more
CREDIT: UVA HEALTH

A sweeping new guide to menopause by a UVA Health expert and collaborators highlights the profound and sometimes surprising effects the “change of life” can have on women’s lives, health, workplaces and even finances.

The paper represents a holistic review of what we know about menopause and what we still need to learn. While it is directed primarily at doctors and scientists, it offers fascinating insights into how menopause affects American women and women worldwide.

According to article co-author JoAnn V. Pinkerton, MD, UVA Health's director of midlife health, such insights represent vital information for women, their physicians, policymakers and society at large.

“Hormonal changes occurring during the menopause transition may be associated with physical and psychological symptoms including irregular menstrual cycles, hot flashes and night sweats, vaginal dryness, mood changes, sleep disruptions and brain fog. Although all women go through menopause, less than 15% of them receive effective, individualized, evidence-based treatment for their symptoms,” said Pinkerton, professor of obstetrics and gynecology at the University of Virginia School of Medicine and executive director emeritus of the North American Menopause Society. “Working with menopause specialists from different countries, our paper summarizes what we know about menopause and calls for more research into the timeline and treatment of menopause. Menopause affects not only those going through it but also those who love them, live with them and work with them.”

Navigating Menopause

The researchers cite studies that found that moderate to severe menopause symptoms are associated with a decreased ability to perform work tasks and that this decrease is often associated with worse workplace outcomes for the women suffering them – especially for Black and Hispanic women.

This reduction particularly affects certain subgroups of women, including those who do not have a partner, those who smoke, those who are overweight or obese, those who serve as a caregiver for others and those who lack secure housing.

One survey of women in the United Kingdom found that those who reported struggling with menopause symptoms were more likely to suffer financial problems, depression and self-reported health issues, the researchers note.

“The United Kingdom is way ahead of the United States in addressing and minimizing the effects of menopause in women in the workplace,” Pinkerton said. “We need to improve our care of menopausal women both with individualized treatment options and address their needs in the workplace.”

Menopause Treatment

Thankfully, effective treatment options are available, and the new scientific paper offers a review of those options and which may be best suited for particular groups of patients. It also calls out one category of treatments that should be viewed with a skeptical eye: “Complementary and alternate medicines (CAMs) for menopausal symptoms have been frequently touted, are widely advertised, and have an overall dismal track record of efficacy when subjected to rigorous scientific study,” the experts note.

For example, popular phyto (plant) estrogen supplements have been studied extensively in numerous trials, but the researchers say no benefits have been found. Black cohosh, another dietary supplement sometimes used to treat menopause symptoms, has so far been found to be safe but of limited effectiveness.

Pinkerton hopes that the new paper will help women and their physicians sort fact from fiction when it comes to menopause and that it will serve as an important roadmap to good health in later life. For women, “optimizing health at menopause is the gateway to healthy aging,” Pinkerton and her co-authors note.

“We now have effective hormonal and nonhormonal treatment options for women suffering from menopause or at increased health risks as their estrogen levels decline,” Pinkerton said. “For menopausal women, don't suffer in silence – ask for help! At UVA, we have menopause specialists available to help those navigating the menopause transition and beyond.”

Review Published

The menopause review has been published in the scientific journal Cell. The article is open access, meaning it is free to read. It was written by Susan R. Davis, Pinkerton, Nanette Santoro and Tommaso Simoncini.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog at http://makingofmedicine.virginia.edu.

DOI

10.1016/j.cell.2023.08.016

Thursday, September 07, 2023

WOMYN'S HEALTH

Review of over 70 years of menopause science highlights research gaps and calls for individualized treatment

Peer-Reviewed Publication

CELL PRESS

Menopause symptoms and long-term consequences — IMAGE: CARDINAL SYMPTOMS AND CONSEQUENCES OF MENOPAUSE view more
CREDIT: CELL, DAVIS ET AL.

Although about half of people go through menopause, less than 15% of them receive effective treatment for their symptoms. Treatment options for people experiencing irritating or severe menopause symptoms are often under researched, and some have questionable efficacy, or cause harmful side effects. In a comprehensive review publishing in the journal Cell on September 6, a team of world-renowned menopause experts summarizes what we know about menopause, calls for more research into the timeline and treatment of menopause, and encourages individualized, holistic treatment that addresses both menopausal symptoms and other systemic changes happening in the body.

“The road to menopause is not difficult for all, but for some, symptoms may be severe or even disabling and disruptive to work and family,” write the authors, who are based in Australia, Italy, and the United States. “Recognition that menopause, for most women, is a natural biological event, does not exempt the use of interventions to alleviate symptoms.”

For this review, the researchers looked at over 200 sources across 71 years to synthesize what’s currently known about menopause. The authors note the importance of recognizing that menopause impacts more than just cis women; they elect to use the term “women” in this review to reflect the language and focus of much of the research that currently exists in the field.

Key takeaways from the review include the following:

The authors propose a new definition for menopause as “final cessation of ovarian function,” an update to the traditional definition, which focused on menstruation. While the new definition doesn’t account for all variability, it seeks to encompass people of all genders, as well as people who have irregular periods, use certain types of contraception like IUDs, have had hysterectomies, and more.
The timeline of when menopause phases occur isn’t well understood and varies from person to person, so the authors argue that current age restrictions on prescriptions and therapies are illogical and problematic. While symptoms often start during perimenopause, few menopause therapies are currently approved for perimenopausal patients.
Menopause treatments range from hormone therapies to lasers to plant products, but the authors argue that few have been studied over long enough timespans. They highlight potential side effects and health concerns for each type of treatment and note that even the most effective and well-researched option available presently—hormone therapy targeting estrogen—is still far from a perfect solution for all.
Symptoms vary widely between people and throughout the course of menopause. Some people get many severe symptoms while others get few to none; but even if someone has no noticeable symptoms, there can still be significant “silent health consequences,” including bone loss and a higher risk of diabetes, cardiovascular diseases, and certain types of cancers. Additionally, the authors highlight that some symptoms, like short-term memory loss, can be temporary, and note that other symptoms, like depression and anxiety, are sometimes pre-existing conditions that have been falsely attributed to menopause due to stigma surrounding it. They also recommend exercising regularly and maintaining a nutritious diet that includes plenty of protein as a way to reduce the likelihood of contracting symptomatic health complications.
The authors highlight the fact that socio-economic factors such as lower quality of life and the potential negative impact of menopausal symptoms on a woman’s work performance aren't often acknowledged.

“Despite decades of research pertaining to menopause, more work is needed,” write the researchers. Going forward, they call researchers to look deeper into when the menopause process starts and to focus on making menopause treatments more effective and safer overall. They underline the importance of researching the symptoms and other health impacts of menopause outside of high-income countries. Additionally, they suggest studying the impacts of menopause on work both from home and in an office, as well as the impacts on people with less traditional career paths such as caregivers and volunteers.

The team also argues that menopause treatments need to be holistic and tailored to the person being treated—addressing both the physical and mental health impacts of menopause, as well as the underlying health risks associated with menopause and any other relevant health concerns. “Women with bothersome menopausal symptoms should be counseled on treatment options and offered evidence-based therapies,” they write. “Therapy should be individualized depending on age and health risks, recognizing that health risks may increase with age.”

“Optimizing health at menopause is the gateway to healthy aging for women,” write the authors.

###

Cell, Davis et al. “Menopause – Biology, Consequences, Supportive Care and Therapeutic Options.” https://www.cell.com/cell/fulltext/S0092-8674(23)00905-4 DOI: 10.1016/j.cell.2023.08.016

Cell (@CellCellPress), the flagship journal of Cell Press, is a bimonthly journal that publishes findings of unusual significance in any area of experimental biology, including but not limited to cell biology, molecular biology, neuroscience, immunology, virology and microbiology, cancer, human genetics, systems biology, signaling, and disease mechanisms and therapeutics. Visit: http://www.cell.com/cell. To receive Cell Press media alerts, contact press@cell.com.