Practice Clinical updates

Non-hormonal treatments for menopausal symptoms

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5101 (Published 23 November 2017) Cite this as: BMJ 2017;359:j5101

Re: Non-hormonal treatments for menopausal symptoms

Whilst it is good to see an article on the menopause, I find the statistics very surprising- the statement that only 25% if women have problematic vasomotor symptoms that impair quality of life and might require treatment. As a menopausal woman myself, a large proportion of my friends are also menopausal and I can only think of one who does not have troublesome vasomotor symptoms; nearly all of them have decided to use the hrt option because their symptoms made it difficult to manage their commitments. I suspect, however, that they are a more articulate and informed group than the general population. If people think that there is no other option and that these symptoms should be accepted as something women have to put up with, then they will be more likely to report in questionnaires that whilst they do have symptoms, they are coping with them.

Menopause is still something which bears a taboo in society in general and is not openly discussed. I was reminded of a textbook I read when a medical student, which (over 25 years ago) said that dysmenorrhoea was primarily due to a fear of periods and could be treated by education. Hard to believe, isn't it?

With the different advice regarding hrt over the last 20-30 years, there is definitely a need for better education on the latest evidence. It would also be good to hear of research being done on the undoubted sleep disturbance which is commonly seen in the menopause unrelated to night sweats/hot flushes, and which often seems to be the symptom which drives women to the point at which they feel something has to be done. We need more and better information about what symptoms are occurring and how long they might last - at the moment, we are still in the dark ages - telling women that symptoms might last 4-10 years - or longer or shorter - doesn't give them much of a basis on which to make decisions about treatment.

Competing interests: No competing interests

06 December 2017
Jacq Hawkins
GP
Central Lakes Medical Practice, Rydal Road, Ambleside