Most women going through menopause are not being given proper treatment, leaving millions to suffer in silence, a major review suggests.
Just 15 percent of women get effective drugs or therapies, and misinformation leads many to go down the route of unproven natural remedies, according to the review, which analyzed over 200 studies going back 70 years.
While only around a third of middle-aged women suffer noticeable menopause, the review said that many more go through silent changes in the body, such as loss of bone density that leaves them vulnerable to chronic disease down the line.
The study, conducted by researchers in the US, Italy, and Australia, found popular treatments like acupuncture and herbal supplements either just slightly improved menopause symptoms or didn’t work at all.
Menopausal symptoms include hot flashes, night sweats, changes in mood, sleep disturbances and cognitive difficulties, which can significantly impact women’s lives
And antidepressants, which are commonly prescribed for hallmark symptoms like hot flashes, may alleviate symptoms but come with a host of side effects that may add to women’s misery, including nausea, sexual dysfunction, and high blood pressure.
‘The road to menopause is not difficult for all, but for some, symptoms may be severe or even disabling and disruptive to work and family,’ the study authors wrote.
‘Recognition that menopause, for most women, is a natural biological event, does not exempt the use of interventions to alleviate symptoms.
‘Despite decades of research pertaining to menopause, more work is needed.’
Without effective, evidence-based treatment, the researchers cautioned menopausal women are left vulnerable to long-term ‘silent’ health consequences like bone loss, diabetes, and heart disease.
The review looked at more than 200 sources spanning 71 years to collect data on current menopause knowledge.
They examined the effects of prescription drugs and homeopathic remedies, such as herbal treatments and acupuncture, on common side effects like hot flashes and night sweats.
They found ‘acupuncture appears no more effective than placebo,’ and herbal treatments only resulted in improvements in small, uncontrolled studies, so the evidence there is inconclusive.
However, cognitive-behavioral therapy did lead to some small improvements and boosted sleep and mood.
Additionally, the study, published Wednesday in the journal Cell, evaluated the effects of several selective serotonin reuptake inhibitors (SSRIs), which are typically used to treat depression, on reducing hot flashes and night sweats.
The researchers found SSRIs like citalopram, fluoxetine, and paroxetine reduced these symptoms by 25 to 70 percent.
However, patients who took these medications 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 amount of menopausal women in each age group who have vasomotor symptoms, better known as hot flashes or night sweats
‘Women with bothersome menopausal symptoms should be counseled on treatment options and offered evidence-based therapies,’ researchers wrote.
‘Therapy should be individualized depending on age and health risks, recognizing that health risks may increase with age.’
Menopause is a normal part of aging that occurs because the ovaries stop producing eggs. As a result, levels of the hormones that ovaries produce drop.
A hallmark sign of menopause is that affected women stop getting their period.
Nearly nine in 10 women experience symptoms of menopause, including hot flashes, night sweats, changes in mood, sleep disturbances and cognitive difficulties, such as anxiety and low self-esteem, as well as memory or concentration problems.
Other signs include sexual issues, bladder problems and dryness of the vagina.
Symptoms usually arise before menopause officially begins, during a period called perimenopause. During this time, women’s periods become irregular, hot flashes start, and fertility decreases.
For some, this only lasts a few months, but it can stretch as long as four to eight years.
The average age of onset for menopause in the US is 51. Those who undergo it between the ages of 40 and 45 have what doctors call ‘early menopause.’
After menopause, women enter post-menopause. This is when a woman hasn’t had a period in over a year, and symptoms like hot flashes, vaginal dryness, and changes in sex drive continue.
This lasts for the rest of a woman’s life.
The researchers noted doctors should focus on preventing and treating the ‘silent’ health consequences menopausal women are prone to, including osteoporosis, diabetes, and heart disease.
‘Comprehensive care of postmenopausal women involves lifestyle optimization,’ they wrote.
‘This includes optimizing nutrition, avoiding being sedentary and increasing physical activity, adding strength and resistance exercise or training, getting adequate sleep, reducing stress, decreasing alcohol consumption, and avoiding smoking.’
They also suggested menopause be characterized by ovarian function stopping rather than no longer having a menstrual cycle.
This is because many women who are not menopausal stop having a menstrual cycle due to certain birth control or procedures like a hysterectomy.
These approaches, the team argued, could help improve women’s long-term health.
Researchers added: ‘Optimizing health at menopause is the gateway to healthy aging for women.’