It’s time to end medical gaslighting for menopausal women


“We have WW in Lab 3. Good luck,” a colleague called out to me about the next patient. I picked up the chart, watched her complain, took her deep breaths and braced myself, and stepped into her exam room.

When I was in medical school and became a new doctor in the 1990s, “WW” was an acronym for patients who came in with a range of symptoms: weight gain, brain fog, irritability, joint pain, and low libido. , poor sleep, fatigue. These were “capricious women.”

Although we were well aware that these patients were likely to enter menopause, there was little valuable instruction and education regarding proper diagnosis, management, and treatment. We have been taught that we tend to complain of symptoms and become somatic due to dissatisfaction with our living environment and stress. The medical mantra of “everything is in her head” was very much alive and well. Provide her hormone replacement therapy (HRT) and send her off if she is found to be post-menopausal. If she’s transitioning into menopause, well, we didn’t offer anything.

In 2002, I was in my last year of training in Obstetrics and Gynecology. At this time, preliminary results were released for the publication of her study on HRT for the Women’s Health Initiative. This included false facts that scared a woman (and her doctor) into stopping all hormones. replacement therapy. This left an entire generation of women suffering and isolated from meaningful medical care. The lucky ones were offered antidepressants as a “panacea” for their symptoms.

Photo illustration by Erin O’Flynn/The Daily Beast/National Library of Medicine/Flickr and Public Domain

In the United States alone, one-third of the female population is perimenopausal or postmenopausal. More than 1 million women go through full menopause each year, and about 5% of women start menopause in their 40s. Perimenopausal symptoms may begin 7 to 10 years before her complete menopause. Given these numbers, you might think that women’s health care providers should discuss menopausal and peri-menopausal management routinely and openly. This essential aspect of management is still stigmatized and stigmatized.

Much of this stems from cultural guilt associated with growing up. When a woman loses her fertility, she should become emaciated, washed out, and worthless.

Sadly, the negative societal perception of menopause and the failure of the medical community to prioritize the health of this large group of individuals has created a knowledge gap among women entering this stage of life. and can have a substantial negative impact on overall quality. of life. If you don’t feel comfortable talking about your symptoms with friends, family, and most importantly, your doctor, you may find it difficult to understand (let alone control) exactly what’s going on in your body. I can’t.

With 20 years of clinical experience, countless hours of the latest research, and my own experience with menopause, I know that I have experienced all the same life-disrupting symptoms many of my patients have long complained about. found that the WHI study is seriously flawed. That finding has since been rebutted.

Hormone replacement therapy is safe for the majority of patients with no contraindications and carries minimal risk of breast cancer. HRT promotes overall quality of life, improves vulvovaginal health, reduces the risk of osteoporosis, and, if started early, may prevent cardiovascular disease and Alzheimer’s disease.

Fortunately, there is hope on the horizon.

The past decade has seen an explosion in the number of women telling their stories on social media, finding a more empathetic audience in the form of other women.

Unwilling to accept the status quo and suffer in silence, this generation of menopausal women share their journey, the names of helpful health care providers, and functional strategies for getting through this time in their lives. They’re arriving at medical appointments with research articles, lists, and resources to share with their healthcare providers so they can better advocate for the care they deserve.

Celebrities like Naomi Watts, Angelina Jolie, Michelle Obama and Salma Hayek have all openly discussed their menopause journeys, helping to clear away the secrets, shame and taboos surrounding this transitional period. .

Dr. Jen Gunter, Author, or menopause manifesto, Dr. Louise Newson, and Dr. Heather Hirsch lead important conversations on social media and their followers are loved by hundreds of thousands. When I turned to social media to discuss menopause, the conversation exploded with his 2 million TikTok followers enthusiastically participating, sharing stories and asking for advice.

Science is also changing. The North American Menopause Society advances breakthrough menopause treatment research, provides menopause care training and certification, and provides a helpful list of certified providers on its website.

Other medical societies, such as the American Heart Association, recognize the importance of the menopausal transition to disease conditions, particularly cardiovascular disease risk. And most recently, a team of researchers from the University of East Anglia and the University of Edinburgh provided evidence that hormone replacement therapy (HRT) is “potentially important” in reducing the risk of Alzheimer’s disease in women with the APOE4 gene. I found Increased genetic risk of disease.

There is also a growing understanding that when women have contraindications to hormone replacement therapy, there are numerous other pharmacological, over-the-counter, nutritional, and supplemental options to alleviate symptoms and promote health.

However, there is still much work to be done. With stories of frustration, misdiagnosis, gaslighting, and confusion erupting, many women’s health care providers have questions about how to provide basic care to menopausal women, and how to educate providers about care. , I noticed that there is a systematic problem with how to train. for these patients. They also seem to recognize that there is a problem with how our society views and treats menopausal women in general.

Photo Illustration by Erin O’Flynn/The Daily Beast/National Library of Medicine/Flickr

A simple PubMed search on “pregnancy” has so far found 1.1 million research articles, but a search on “menopause” returns only 94,500 articles. This 10:1 ratio has held true for the last decade as well.

It’s surprising that menopause receives so little research attention because more people go through menopause than have children, and it can affect overall health just as much as it does during pregnancy. is.

It’s no secret that our gender is at a tremendous disadvantage.

This stage of life is as important as the time of birth.

You are not a capricious woman and you are not crazy. No one, especially your healthcare provider, should make you feel like you’re capricious. You don’t have to take it anymore. There are treatment and care options. You deserve to be filled with beautiful and healthy menopause, strong muscles and bones, a clear mind, and a pain-free and disease-free body.

Mary Claire Haver, MD, is a board-certified OB/GYN and a Culinary Medicine Specialist. She chose to dedicate herself to caring for menopausal women. She is a national bestselling author of The Galveston Diet: A Doctor-Developed, Patient-Proven Plan to Burn Fat and Relieve Hormonal Symptoms.





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