Earlier this year, The Journal of North American Menopause Society (an adjunct publication to its namesake organization), published a paper on “menopause preparedness” to inform on the latest perspectives and approaches to menopause for both providers and patients. The Society for Women’s Health Research brought together 13 experts, including policy leaders, researchers, gynecologists, psychiatrists, and epidemiologists, to discuss recommendations for improving menopause care and “developing a more standardized approach” within the medical community.
Menopause is a transitional phase characterized by a decline in estrogen and progesterone, and the cessation of the menstrual cycle after a 12-month period. Although it is a natural biological process, it is accompanied by sleep disruption, irregular periods, vaginal dryness, and hot flashes, to name a few symptoms. Being able to identify the onset of menopause may help women prepare for and manage symptoms, along with being informed of options for hormone therapy and other treatments to improve quality of life and identify health risks that may accompany menopause.
In the roundtable discussion, participants acknowledged that “gaps persist in elucidating the genetic, biological, and environmental factors that influence the onset of menopause, symptom presentation and comorbidities” and how menopause may be neglected in comparison to other health conditions women face.
The panelists first looked at hormone therapy (HT), emphasizing that, while there are contraindications against HT use for certain groups of women (based on a 2002 study by the Women’s Health Initiative and an initiative in 2017 by the U.S. Preventive Services Task Force, which resulted in a significant decline in provider prescription), HT needs to be evaluated as an effective treatment for women younger than 60 suffering from genitourinary syndrome of menopause (GSM). GSM consists of vaginal dryness, burning, painful sex, irritation, and urinary incontinence, which widely impacts menopausal women.
The authors state that education for both women and healthcare providers about HT as an effective and safe option could lead to more progressive GSM treatment for women under 60 and those with premature or surgically induced menopause.
Also discussed and agreed upon by the group members was the need for more research and approaches to alternative, non-pharmacological interventions such as vaginal lubricants and moisturizers, herbal remedies, and other lifestyle interventions, such as yoga and mindfulness, to improve symptoms. Emphasis was placed on the fact that menopause training is not a routine part of medical school curricula, and healthcare providers who learn more about addressing menopause symptoms are a better advantage to prevent and treat underlying conditions and risk factors associated with menopause.
The members point out the importance of the patient-provider relationship and encourage healthcare providers to learn how to treat diverse populations in order to develop individualized treatment care plans.
Lastly, the group discussed how changing the conversation about menopause can help challenge the stigma associated with aging and the natural stage of menopause.
- First, they acknowledge that empowering patients and strengthening the healthcare system starts with a holistic patient care model.
- Second, more robust education for healthcare providers would enable them to treat patients according to their stage of menopause, address symptoms and potential underlying conditions, and assist with determining the best lifestyle interventions.
While there is still much more research, training, and education involved to address a stage of life that affects all women, the authors conclude that “effective menopause preparedness programming would promote pre-menopause wellness, and, thus, improved health outcomes as individuals transition into postmenopausal life,” and a “global increase in awareness” can improve potential outcomes among this demographic at large.
Menopause Preparedness: Perspectives for Patient, Provider, and Policymaker Consideration
Aninye, Irene O. PhD; Laitner, Melissa H. PhD, MPH; Chinnappan, Shivani BA; the Society for Women's Health Research Menopause Working Group
Menopause: The Journal of North American Menopause Society, October 2021