Musings: Menopause ain’t nothing but a…

Posted by Liz on Dec 10, 2010 in menopause, musings | 2 comments

Number?

Sometimes it is just that. And sometimes it’s not.

I’m reposting this piece, which first ran in June 2009, because a reader recently challenged me on my consistent opinion that menopause is not a disease.

“Menopause is truly a disease. There are many so called true diseases that cause far less damage to a womens body.”

Actually, the conditions that wreak the most havoc on a woman’s body as she grows older appear to more closely associated with aging than with menopause. Theoretically, this would mean that our best strategy to address prevention or risk reduction, right?

Here are the facts:

Australian researchers suggest that many of the more common complaints of menopause may be possibly related to aging in general and not specifically the transition. In fact, in a study presented during last month’s 8th European Congress on Menopause, they reported that menopause is strongly associated with some but not other common complaints.

So what about the other symptoms? After reviewing data from 58,724 women (ages 45 to 50) participating in the Australian Longitudinal Study on Women’s Health, the strongest associations were seen between menopause and hot flashes/night sweats. These findings remained after adjusting for age during the study, age at menopause, smoking history, body mass index, sociodemographics (i.e. education, income, marital status and geographic location) and other factors that might influence outcomes. Other symptoms, including difficulty sleeping, stiff/painful joints and poor or fair self-reported health were also associated with menopause but to a much lesser extent. Headaches, migraines and incontinence appeared to be more strongly related to the aging process.

The researchers say that treatment (in this case, HRT) should be geared primarily towards alleviating vasomotor symptoms. Less clear, however, is how long therapy should be continued, since some symptoms can last for more than seven years. This study is scheduled to appear in Menopause.

Last September, I wrote a post about a survey being reported at the North American Menopause Society’s Annual meeting suggesting that women can actually discern the symptoms of menopause from those of aging.  Interestingly, many of the symptoms overlapped; in fact, 84%, 72%, and 77% of respondents associated vaginal dryness, urinary stress incontinence and weight gain, respectively, strictly with menopause, even though they can also be caused by aging as well.

So, what’s the primary point? It can be difficult to tease apart the effects of aging and the effects of menopause. Clearly, these new Australian data add a bit more to the confusion, and reinforce the point that more research and funding is needed in this particular area.

When I write that “menopause is not a disease and should not be treated like one,” what I am really saying is that disease, especially when it’s chronic can stigmatize, frighten and even create self-loathing. By offering up hormone replacement therapy as the only viable “solution” to preventing and ameliorating the symptoms of menopause and outrightly dismissing gentler alternative strategies, the medical community takes on the stance that Author Louise Foxcroft has written about:  “fear of the menopause is something we have learned, and it has grown out of a general, male and medical distaste for the idea of the menopause perceived as an end to viability, fertility, beauty, desirability and worth. Since the French physician de Gardanne coined the new term ‘ménépausie’ in the early nineteenth century, an onslaught of opinion, etiology, treatments, and not least and lest we forget, profit has followed. Women need to unlearn their dread and recognize that menopause is not, of itself, dread-full; that we are merely the victims of our biological process.”

So which comes first? Menopause and disease or aging and disease? Regardless, we can go out fighting or we can give in.

in all, a good thing, right?