In this episode, my panel of menopause expert physicians and nurse practitioners discuss the recent four-part article series on menopause published in The Lancet (link below).

We address the agenda behind these articles and the implications for menopause care. The panel strongly disagrees with the claim that menopause is being over-medicalized and emphasizes the importance of hormone therapy in managing menopausal symptoms and preventing long-term health issues.

We also criticize the suggestion that cognitive behavioral therapy should be the first-line treatment for menopause symptoms, highlighting the barriers to access and the lack of evidence supporting its effectiveness.

The panel advocates for a comprehensive and individualized approach to menopause care. The conversation methodically identifies the principal themes discussed in the Lancet article on menopause.

We cover topics such as biased review articles, the citation of the author's own studies, the lack of balance in the article, possible reasons for publication, surprising reactions from colleagues, the lack of education and training, the dismissal of women's experiences, ageism in medicine, the importance of treating perimenopause, ignoring the suffering of perimenopause, setting the stage for future health issues, empowerment through hormone therapy, misconceptions about hormone therapy and breast cancer, estrogen's protective effects on breast cancer, lifestyle factors and breast cancer risk, advocating for access to menopause specialists, and the importance of seeing a menopause specialist.

Takeaways

• The panel strongly disagrees with the claim that menopause is being over-medicalized and emphasizes the importance of hormone therapy in managing menopausal symptoms and preventing long-term health issues.
• The suggestion that cognitive behavioral therapy should be the first-line treatment for menopause symptoms is criticized due to barriers to access and lack of evidence supporting its effectiveness.
• The panel highlights the need for a comprehensive and individualized approach to menopause care, taking into account the diverse needs and experiences of menopausal individuals.
• The Lancet articles were criticized for misrepresenting the benefits of hormone therapy and failing to acknowledge the impact of menopause on mental health and overall well-being. Review articles should present a balanced view by citing studies that prove and disprove a point, rather than cherry-picking data.
• The Lancet article on menopause fell short of presenting a balanced view and may have been rushed for publication.
• Many healthcare providers lack education and training on menopause, leading to dismissive attitudes towards women's experiences.
• Hormone therapy is an important tool for treating perimenopause and menopause symptoms and can have protective effects on breast cancer.
• Advocacy is needed to improve access to menopause specialists and expand telehealth services.

https://www.thelancet.com/series/menopause-2024

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