More than 70 years of research on menopause have been reviewed by a group of scientists, who draw attention to the knowledge gaps that still exist, noting that more than 85% of women in high-income countries do not receive effective treatment for your symptoms.
The study published in the journal Cell, signed by Australian, American and Italian authors, adds that treatment options for those who suffer from the most severe symptoms are often poorly researched, and some have questionable efficacy or cause harmful side effects.
The experts, led by Susan Davis of Monash University in Australia, call for more research into the timing and treatment of menopause, as well as holistic, individualized treatment that addresses both the symptoms and other systemic changes that occur in the body.
Not all women need treatment for symptoms associated with menopause, but the study highlights that “more than 85% of women in high-income countries do not receive effective, regulatory-approved treatment for their symptoms.” In addition, “the proportion of symptomatic women who do not receive treatment in low- and middle-income countries has not been systematically documented.”
The physiology of menopause is “complex and incomplete” write the authors, who recall that for some women the symptoms can be severe, or even disabling, disrupting work and family. Recognizing that menopause, for most women, is a natural biological event, does not exempt the use of interventions to alleviate symptoms.
The team analyzed more than 200 sources over 71 years to synthesize what is currently known about menopause and propose a new definition as “definitive cessation of ovarian function,” an update of the traditional definition, which focused on menstruation.
There are many aspects of menopause that are still not well understood, such as when its phases occur, since it varies from one person to another, which is why the authors maintain that the current age restrictions on prescriptions and therapies are “illogical.” and problematic.” Although symptoms usually begin during perimenopause, there are currently few approved therapies for patients at this stage.
Menopause treatments range from hormone therapies to lasers and plant products, but few have been studied for long enough periods of time. Additionally, all of them have possible side effects and health problems.
The most effective treatment for menopausal symptoms is estrogen-targeted menopausal hormone therapy (MHT), which reduces bone loss and may have cardiometabolic benefits, but even this option “is far from a perfect solution” for all people.
The authors caution that even if there are no noticeable symptoms, there may be important “silent health consequences,” such as bone loss and increased risk of diabetes, cardiovascular disease, and certain cancers. Additionally, some symptoms such as depression and anxiety are sometimes pre-existing conditions that have been falsely attributed to menopause due to the stigma surrounding it.
The authors highlight that socioeconomic factors, such as a lower quality of life and the possible negative impact of menopausal symptoms on women’s work performance, are often not taken into account. “Therapy should be individualized based on age and health risks, recognizing that health risks may increase with age.”
In conclusion, “despite decades of research on menopause, there is still much to be done,” the researchers write, and looking ahead they urge to delve deeper into when the menopause process begins and focus on getting treatments are more effective and safe in general.
Additionally, they suggest studying the impacts of menopause on working both from home and in the office, as well as the effects on people with less traditional career paths, such as caregivers and volunteers.
The team highlights that “optimizing health in menopause is the gateway to healthy aging for women.”
