Making sense of the menopause: experience, evidence and you

Let’s talk about the menopause. We really need to! We have a series of guest blogs on the menopause, from women brave enough to share their experiences and doctors and researchers explaining some evidence on treatments. Read on to find out more.

Blog last updated: 03 August 2022.

It’s unthinkable that we wouldn’t tell girls about menstruation, yet this other stage in women’s lives is not freely discussed and women are arriving at it unprepared.

This isn’t so in all cultures and in those where aging conveys status, the menopause is often treated rather differently. Louise Foxcroft has noted, in her excellent book on the modern menopause, that modern Jewish Orthodox practice has begun to address the silence, with women themselves leading the change and creating new rituals. But for the average Luton Linda or Scarborough Susan, there’s a silence about the menopause – and it isn’t helpful.

Anne Cooper
“Why didn’t they tell me about the menopause?” asks senior nurse Anne Cooper

For one thing, it’s a taboo that’s preventing women from getting reliable information to help them manage the changes that come with the menopause and to make choices about treatments that might help with the symptoms that many experience. I’ve seen articles in women’s magazines that have been incredibly coy about the whole business. They’ve talked about mood swings but didn’t want to use the ‘M’ word and there was a distinct lack of information about what might actually help.

The blogs

Much more helpful is the wonderful menopause section of the website, where you can watch interviews with women talking about their experiences. The senior researcher on this project, Jenny Hislop, tells us more in the first of our guest blogs: Let’s talk about the menopause.

This project helped tackle a taboo that left senior nurse Anne Cooper, who had successfully managed type 1 diabetes for 35 years, unprepared for the impact the menopause would have on her blood glucose levels, along with memory problems that made her think she was losing her grip. “Why didn’t they tell me?” she asks, in her blog: Menopause and type 1 diabetes: why didn’t they tell me?

June Girvin knows a thing or two about reliable information, but struggled to find any to help her when she found herself dealing with menopausal symptoms which went beyond her understanding of what to expect. At the time of writing, June was a senior nurse and Professor at the Faculty of Health and Life Science at Oxford Brookes University. Like Anne, she laments that ‘No-One Told Me’ and is speaking out in a bid to change this for others. You can read June’s blog here: Everything I needed to know about the menopause… No One Told Me.

Martin Hirsch and Stuart Spencer also blogged for us about HRT: Hormone Therapy for the Menopause after Endometriosis Surgery – Friend or Foe? Martin and Stuart are doctors who do research in endometriosis alongside clinical practice. They explain what endometriosis is, what can be done about it, and what we know about HRT for women experiencing the menopause after surgery for endometriosis.

Finally, we look at sex and the menopause. Physiotherapist and comedian Elaine Miller tackled that double taboo and tells us that, while “what most people need is a good listening to”, there is help for menopausal changes which may threaten to ruin a satisfying sex life. Communication and reliable information are key. Read her blog: No sex please, we’re menopausal!

Evidence to help people make decisions about health

Providing people with the best available information to help them make decisions about health, whether that’s treatment, screening or lifestyle choices, is what we’re about at Cochrane. Cochrane Reviews gather the best evidence addressing a particular question, like ‘can exercise reduce menopausal hot flushes?’. There might be enough evidence to answer that; it might show that there are both risks and benefits that need to be weighed up. It might show that we still don’t know, that there are gaps in research, and this can help prompt future research studies. Like the Cochrane Review looking at exercise for hot flushes, which found only one small trial. Not enough evidence to say whether exercise has any effect.

We need to break down the menopause taboo

If women are going to get support and reliable information and if important gaps in our knowledge are to be addressed by new research, we need to break down the taboo. Talking is the first action in Menopause Support‘s campaign. Suffolk GP Hannah Short and a nurse, Natasha North, explain:

“Menopause Support is an advocacy network that works to improve health and care for women affected by menopause. We think that it doesn’t get talked about nearly enough, and often when it does it quickly becomes a controversial topic… Women and health professionals need clear, unbiased information so that they can make informed decisions together about how to manage the menopause.

Our #ChangeTheChange campaign was one of four grassroots campaigns being featured as part of the 2015 NHS Change Day, which is a call to action. We’re asking people to take three actions:

  • Get together (join a new online forum to connect and inspire people working to improve menopause health and care)
  • Get the facts (access new and up-to-date information about menopause)
  • Get menopause on the agenda (commit to discussing it at team, directorate or board meetings)”

It really is time to start talking and see what we can change.

Resources on menopause

The Editors have added these in April 2022. With thanks to @drhannahshort, GP Specialist in Menopause & Premenstrual Disorders, for her suggestions.

Please note, we cannot give specific medical advice and do not publish comments that link to individual pages requesting donations or to commercial sites, or appear to endorse commercial products. We welcome diverse views and encourage discussion but we ask that comments are respectful and reserve the right to not publish any we consider offensive. Cochrane UK does not fact check – or endorse – readers’ comments, including any treatments mentioned.

Making sense of the menopause: experience, evidence and you by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

1 Comments on this post

  1. I’ve just published a book on this very issue, written along with a GP. It’s called Making Friends with the Menopause and it was because my own GP failed to link my increased anxiety to perimenopause I became interested in the subject. I’d be very happy to talk/share more as it’s a subject I’m passionate about.

    Sarah Rayner / Reply

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