Raging over hormones

The fierce debate on whether menopause is being over-medicalised and overtreated is not set to die down any time soon.

It is a debate that has been going on for years and right now is raging. Is menopause a female hormone deficiency with accompanying health risks? Or is it a natural process we are at risk of over-medicalising? Recently, an editorial in the British Medical Journal provoked a strong reaction. Penned by Martha Hickey, a professor of obstetrics and gynaecology at the University of Melbourne, and her colleagues, it argued that the medicalisation of menopause emphasises its negative aspects, increasing women’s anxiety about this life stage. The paper suggested we should change the narrative and normalise menopause by emphasising its positive or more neutral aspects. The position the authors took was that menopause is experienced in different ways and while women with severe symptoms, such as hot flushes, will often benefit from hormone replacement therapy (HRT), most will manage the process without medical intervention.

The backlash was immediate. In a response, also published in the BMJ, the high-profile British menopause specialist Louise Newson called the article “medical gaslighting”, saying she was appalled and saddened to read it.

“There has been a very strong kickback from the UK,” confirms Hickey. “People who are pushing for more HRT to be used are annoyed at what we’ve done and see it as being retrograde. It evoked a lot of vitriol that we said there could be some good things associated with menopause.”