Experts, MPs, and advocates have cautioned that the latest official recommendations for managing menopause could have negative effects on women’s well-being.
In the previous month, the National Institute for Health and Care Excellence (Nice) released new recommendations for GPs regarding the treatment of menopause symptoms in women. These guidelines suggest that women who are dealing with hot flushes, night sweats, depression, and sleep issues may benefit from receiving cognitive behavioural therapy (CBT) in addition to or instead of hormone replacement therapy (HRT).
However, the guidance has faced criticism for using misogynistic language that undermines symptoms and may ultimately harm women’s health by not highlighting the positive effects of HRT on bone and cardiovascular health compared to CBT.
Mumsnet expressed their thoughts on Nice’s recommendations in a response, stating that the language used was condescending and harmful to women’s health. This information was shared with the Guardian exclusively.
Justine Roberts, the founder and chief executive of Mumsnet, said: “Women already struggle to access the HRT they are entitled to. We hear daily from women in perimenopause and menopause who are battling against a toxic combination of entrenched misogyny, misinformation and lack of knowledge among GPs.
Frequently, they are dismissed or advised to accept severe physical and mental symptoms, which can have a significant impact on their lives.
This guidance will exacerbate the struggle by focusing on the negatives instead of the positives and neglecting to mention the safest types of HRT. Additionally, by equating CBT with hormone replacement therapy, it may cause doctors to be hesitant in prescribing HRT and women to feel more hesitant in requesting or receiving it.
Kate Muir, a prominent figure in menopause education and activism and the writer of the book “Everything You Need to Know About the Menopause (But Were Too Afraid to Ask),” has criticized Nice for causing unnecessary alarm. According to her, the preliminary guidance from Nice distorts scientific evidence to stoke fear and discourage women from considering safer options of HRT.
According to Dr. Nina Wilson, a general practitioner in Sussex and the creator of One Woman Health clinic for women, promoting CBT could potentially worsen the negative perception of menopause. She explained, “Suggesting psychological treatment may give the impression that symptoms are simply in a woman’s mind, which can perpetuate societal stigma.”
CBT may be beneficial for a man dealing with erectile dysfunction caused by stress and anxiety related to performance concerns. However, it does not address the root issue – constricted blood vessels – in the same way that Viagra does. This comparison can also be made with HRT, where CBT can help reduce stress but does not address the underlying cause of decreased estrogen levels.
According to the speaker, the guidelines from Nice did not adequately emphasize the advantages of hormone replacement therapy (HRT). They claimed that HRT is the most powerful method for managing menopausal symptoms and can also promote bone health and potentially decrease the risk of heart disease in the long run. These are significant concerns for women as they get older.
Carolyn Harris, representative of Swansea East and leader of the cross-party parliamentary organization on menopause, stated that the updated recommendations were “outdated,” “unsophisticated,” and “poorly planned.”
She stated that while talking may provide emotional relief, it cannot alleviate physical discomfort in the joints or alter one’s lifestyle. It is important for women to have access to the support they feel is necessary during menopause, but currently, HRT and CBT may not be readily accessible.
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The author suggests that “Nice” should reconsider and develop new standards for defining menopause.
According to Caroline Nokes, who chairs the Commons’ committee on women and equalities, there is no one solution that works for everyone when it comes to managing the menopause. She believes that it is important to not only focus on the potential risks of hormone replacement therapy, but also recognize its significant benefits.
The speaker stated that the most severe effects of menopause can be reduced by replacing the depleted estrogen, which is achieved through Hormone Replacement Therapy (HRT). For individuals who are unable to undergo HRT, Cognitive Behavioral Therapy (CBT) may offer significant relief. However, it is important for medical professionals to not let their concerns about HRT hinder the potential benefits of CBT. Additionally, there continues to be difficulties with the availability of certain types of HRT, such as Estradot.
A representative from Nice stated: “The guidance emphasizes the importance of healthcare professionals personalizing their discussions about treatment options based on individual circumstances. The effects of menopause symptoms on quality of life can greatly differ.”
Recent findings indicate that cognitive behavioral therapy can effectively decrease menopause symptoms such as hot flashes, night sweats, depression, and sleep issues.
The proposed guidelines state that CBT could be used in addition to or instead of HRT, and outlines the advantages and disadvantages of various treatment choices so individuals can collaborate with their healthcare provider to determine the most suitable option for their specific needs.
Source: theguardian.com
