Menopause is an experience every woman is biologically programmed to go through after a certain age. It’s as inevitable as puberty, except instead of marking the beginning of reproductive years, it marks the end of menstrual cycles.
Even though menopause is a universally relevant topic, there’s a lack of appropriate and evidence-based care from the average healthcare practitioner. It’s a culturally complex topic that touches not just on medical care, but also on socioeconomic status, ageism, sexism, race, gender identity, and more.
Despite how complex the topic is, we’re all doing women a disservice by avoiding it, and this further perpetuates a system that often neglects women’s needs, especially women of color.
Instead, we need to bring this topic to the forefront of conversations about women’s health to drive evidence-based care and end out-of-date and even discriminatory medical care. All women deserve to understand their bodies, their options, and to have their voices heard.
Health Risks That Come With Menopause
Although menopause is a natural experience, this doesn’t mean it comes without health risks. Menopause causes a dramatic drop in estrogen levels, and this increases the risk of heart disease, stroke, and osteoporosis.
Menopausal women also frequently experience worsened mental health, hot flashes and night sweats, sleeping issues, urinary incontinence, reduced libido and sexual function, and even difficulty concentrating.
Altogether, menopause can bring about major health risks and symptoms that decrease one’s day-to-day quality of life. This is more than grounds for specialized care, yet many women are subject to the message that “it’s natural” or “normal” to experience all of these debilitating effects.
The truth is, menopause being a natural process has nothing to do with whether or not women deserve care to improve their health and wellbeing. Pregnancy is also a natural process, but you’d be hard-pressed to find anyone who disagrees that women deserve proper care and attention to mitigate risks during this time of their lives.
We hope to see more healthcare practitioners taking women’s concerns about menopause seriously and finding appropriate ways to help manage their symptoms.
Current Treatments Available for Symptom Management
Current Treatments Available for Symptom Management
On top of menopause not being taken as seriously as it should be by most of the medical industry, when treatment does occur, it’s sometimes ineffective and not reflective of what women actually need and want.
Many women are simply told their symptoms will pass and to suffer through, while others are given SSRIs, statins, pain medications, osteoporosis drugs, or neurokinin receptor agonists. While these may be appropriate in some cases, none of these options addresses the root cause of menopause symptoms in the way hormone replacement therapy can. This can lead women to needing several medications which can become expensive and may even cause unwanted side effects.
Hormone therapy instead replaces estrogen production that the body has stopped making. It can come in the form of pills, skin patches, rings, gels, creams, or sprays at a dose catered to each specific case. It generally contains estrogen along with progesterone, although this will be modified for trans-care cases.
Hormone therapy is administered with a “lowest effective dose” model needed to manage symptoms. This reduces any potential risks while ensuring women still get the results they desire. Hormone therapy is most effective in conjunction with a healthy lifestyle that includes physical activity, nutrient-rich foods, low stress, and limited alcohol consumption.
Upcoming Changes in Menopause Care
The current tools for menopause care are relatively limited, but there have been exciting advances on this front in the past few years.
One promising treatment is a surgery called ovarian cryopreservation which can delay menopause and lengthen a woman’s window of fertility. Yale scientists originally developed this technique for women undergoing cancer treatments as a way to preserve fertility. They saw a menopause onset delay of approximately 10 years in these patients and are now working to test the safety of applications for broader use.
How it works is a portion of the ovaries are removed and frozen during fertile years to later be thawed and reimplanted. This seems to work best on women before the age of 40. It allows women to naturally produce greater amounts of their own estrogen at a time when it would otherwise wane, likely resulting in the many health benefits women who start menopause later in life tend to see.
Another novel treatment is injections of a drug called rapamycin. This drug was originally used to prevent organ transplant rejection, but it also appears to slow down the release of eggs with each menstrual cycle and preserve fertility. While this research is new, it’s a promising hope for women looking to delay menopause and women hoping to have children later in life.
Lifestyle Factors
No examination of menopause-related health concerns would be complete without addressing lifestyle. However, it’s important to remember that not all lifestyle factors can be adjusted, and predetermined factors such as socioeconomic status may make it more difficult to adhere to recommendations.
The effectiveness of lifestyle factors can also be overstated by certain health professionals and used as a reason to avoid treatment. Lifestyle factors are simply not enough for some women to manage their menopause symptoms, but they’re helpful for every woman to keep in mind.
One of the most influential factors is avoiding smoking and excessive alcohol consumption. Alcohol impacts the brain, liver, and GI tract in such a way that it can make unpleasant menopause symptoms worse.
A healthy diet and regular physical activity can also support overall health, improve mood, reduce the risk of several diseases, and improve sleep. A diet rich in fruits and vegetables, lean proteins, healthy fats, and fiber is commonly recommended across the field of nutrition experts.
Last but not least, a frequent aggregator of menopause symptoms is stress. All women should prioritize mental health, but this becomes increasingly true in later years when the body is less physically resilient to high levels of stress.
Final Thoughts
Every woman’s experience of menopause is unique, and there’s no one-size-fits-all approach to care. Seeking out a trusted healthcare practitioner who’s willing to hear your concerns and work with you is a great first step, as well as honoring your body and personal needs throughout the entire journey of menopause.
