Most women going through menopause don’t get proper treatment, leaving millions to suffer in silence, a major study suggests.
Only 15 percent of women receive effective drugs or therapies, and misinformation leads many to go down the route of unproven natural remedies, according to the review, which analyzed more than 200 studies from 70 years ago.
While only about one-third of middle-aged women experience noticeable menopause, the research shows that many more women experience silent changes in the body, such as loss of bone density, that leave them vulnerable to chronic disease over time.
The study, conducted by researchers in the US, Italy and Australia, found that popular treatments such as acupuncture and herbal supplements only slightly improved menopausal symptoms or did not work at all.
Menopause symptoms include hot flashes, night sweats, mood swings, sleep disturbances and cognitive problems, which can have a significant impact on women’s lives
And antidepressants, commonly prescribed for hallmark symptoms like hot flashes, can ease symptoms, but come with a host of side effects that can add to women’s woes, including nausea, sexual dysfunction, and high blood pressure.
Without treatment, the researchers warn that menopausal women remain vulnerable to “silent” long-term health consequences such as bone loss, diabetes and heart disease.
“The road to menopause isn’t difficult for everyone, but for some, the symptoms can be severe or even disabling and disruptive to work and family,” the study authors wrote.
Recognizing that menopause is a natural biological event for most women does not preclude the use of interventions to alleviate symptoms.
“Despite decades of research on menopause, more work is needed.”
The researchers looked at more than 200 sources over a 71-year period to gather data on current knowledge about menopause.
They examined the effects of prescription drugs and homeopathic remedies, such as herbal treatments and acupuncture, on common side effects such as hot flashes and night sweats.
They found that “acupuncture appears no more effective than placebo,” and herbal treatments only resulted in improvements in small, uncontrolled trials.
However, Cognitive Behavioral Therapy did lead to some minor improvements and boosted sleep and mood.
In addition, the study published Wednesday evaluated in the journal Cell the effects of several selective serotonin reuptake inhibitors (SSRIs), typically used to treat depression, on reducing hot flashes and night sweats.
The researchers found that SSRIs such as citalopram, fluoxetine and paroxetine reduced these symptoms by 25 to 70 percent.
However, patients taking these drugs experienced a host of uncomfortable side effects, including nausea, insomnia, dry mouth, sexual dysfunction, headache, high blood pressure, constipation, and dizziness.
Based on their findings, the team called for more individualized treatment approaches rather than recommending the same treatments to every woman.
This graph from the study in Cell shows the number of menopausal women in each age group experiencing vasomotor symptoms, commonly known as hot flashes or night sweats.
“Women with bothersome menopausal symptoms should be counseled about treatment options and offered evidence-based therapies,” researchers wrote.
“Therapy should be individualized according to age and health risks, recognizing that health risks may increase with age.”
Menopause is a normal part of aging and occurs when the ovaries stop producing eggs. As a result, the levels of the hormones that the ovaries produce fall.
A characteristic sign of menopause is that affected women stop menstruating.
Nearly nine in ten women experience menopausal symptoms, including hot flashes, night sweats, mood swings, sleep disturbances, and cognitive problems, such as anxiety and low self-esteem, as well as memory or concentration problems.
Other symptoms include sexual problems, bladder problems, and a dry vagina.
Symptoms usually develop before menopause officially begins, during a period called perimenopause. During this time, women’s periods become irregular, hot flashes begin, and fertility declines.
For some, this only takes a few months, but it can take as long as four to eight years.
The average age of onset of menopause in the US is 51 years old. Those who undergo these between the ages of 40 and 45 have what doctors call “early menopause.”
After menopause, women enter postmenopause. This is when a woman has not had a period for more than a year and symptoms such as hot flashes, vaginal dryness, and changes in sex drive persist.
This lasts for the rest of a woman’s life.
The researchers noted that doctors should focus on preventing and treating the “silent” health consequences that menopausal women are prone to, including osteoporosis, diabetes and heart disease.
“The comprehensive care of postmenopausal women includes optimizing lifestyle,” they wrote.
“This includes optimizing nutrition, avoiding a sedentary lifestyle and increasing physical activity, adding strength and resistance exercise or training, getting enough sleep, reducing stress, reducing alcohol consumption and avoiding smoking.’
They also suggested that menopause is characterized by the cessation of ovarian function rather than no longer having a menstrual cycle.
This is because many women who are not in menopause no longer have a menstrual cycle because of certain birth control methods or procedures such as a hysterectomy.
These approaches, the team argued, could help improve women’s health in the long run.
Researchers added, “Optimizing health during menopause is the gateway to healthy aging for women.”