Ms. Magazine responds to The Lancet

Ms. Magazine Article: Out of Touch on Menopause: Experts Respond to The Lancet’s ‘Over-Medicalization’ Claims, by Dr. Mary Claire Haver

This article in Ms. Magazine by Dr. Mary Claire Haver is encouraging in that it advocates in a strong and compelling manner for better menopause care — but it is discouraging in what it suggests about a recent series by The Lancet which claims to promote an “empowerment model for managing menopause.” Full disclosure: I haven’t read the series in The Lancet, but given the rebuttals outlined in the Ms. article, it does indeed sound as though there are significant discrepancies between what The Lancet says and what Dr. Haver describes as “the lived experience of women in this stage of life or our clinical experience in treating them.” For example, Dr. Haver quotes The Lancet as saying:

During the menopausal transition, women should “challenge self-critical beliefs, which can … make [hot] flushes worse.”

…or “it’s all in your head,” as many of us have heard or had suggested about our medical complaints. Then there is this:

“On the basis of scarce data, we found no compelling evidence that risk of anxiety, bipolar disorder, or psychosis is universally elevated over the menopause transition.”

…which is false, as Dr. Haver then details:

“Research has shown a four-fold increase in risk of depressive symptoms, and a two-and-a-half-fold increase the diagnosis of major depressive disorder—risks greatest in women with vasomotor symptoms. Also, the rate of antidepressant use for women has been shown to double after age 40.”

She goes on to beautifully summarize how Alice-in-Wonderland it is to define “the over-medicalization of menopause” as the over-prescription of hormone replacement therapy, rather than the over-prescription of myriad other pharmaceutical treatments for conditions HRT has been shown effective in treating or preventing.

An excellent read, and one I would recommend to any women going through the menopause transition and their treatment providers and advocates. It is a concise, pithy read that does an excellent job of stating where we are now, and where progress is sorely needed.