Britain’s new official guidance on treating menopause will harm women’s health, experts and campaigners have warned, accusing the draft guidelines of being “patronising” and “scaremongering”.
Released last month, the guidelines to GPs from the National Institute for Health and Care Excellence (Nice) said that women experiencing hot flushes, night sweats, depression and sleep problems could be offered cognitive behavioural therapy (CBT) “alongside or as an alternative to” hormone replacement therapy (HRT) to help reduce their menopause symptoms.
But slamming the guidance, critics say it belittles symptoms through misogynistic language, and that women’s health would suffer as a result of failing to emphasise the benefits of HRT on bone and cardiovascular health as opposed to CBT.
Mumsnet said Nice’s recommendations used “patronising” and “offensive” language and would be “detrimental” to women’s health, reports The Guardian.
Justine Roberts, the founder and chief executive of Mumsnet, said: “Women already struggle to access the HRT to which they are entitled. We hear daily from women in perimenopause and menopause who are battling against a toxic combination of entrenched misogyny, misinformation and lack of knowledge among GPs.
“Too often they are fobbed off or told they simply need to put up with severe physical and mental symptoms – often with life-changing effects. “By emphasising the negative over the positive, failing to include information about the safest forms of HRT and placing CBT on a par with hormone replacement therapy, this guidance will worsen that struggle. It will make doctors more reluctant to prescribe HRT and women more fearful about asking for or accepting it.”
And menopause expert and campaigner Kate Muir, the author of Everything You Need to Know About the Menopause (But Were Too Afraid to Ask), accused Nice of scaremongering. “This draft Nice guidance skews the science to fan flames of fear and attempts to push women away from the choice of increasingly safe forms of HRT,” she said.
Dr Nina Wilson, a GP in Sussex and founder of the One Woman Health women’s clinic, said advocating CBT could increase the stigma around menopause. “By recommending psychological therapy, people may see this as a signal to women and society that symptoms are ‘all their heads’,” she said.
“If a man with erectile dysfunction experiences stress and anxiety due to performance worries, CBT could help with that, but it wouldn’t open up the blood vessels – the underlying issue – like Viagra would. It’s similar with HRT. The CBT can minimise the stress response but the underlying cause – the drop in oestrogen – is only addressed with HRT.”
Nice’s guidelines were also “very light” on the benefits of HRT, which was the “single most effective treatment for all menopausal symptoms”, she said, especially as it also helped maintain bone strength and may reduce cardiovascular risk long-term – “real threats to women’s health as they age”.
Carolyn Harris, the MP for Swansea East and the chair of the all-party parliamentary group on menopause, said the new guidance was “antiquated”, “naive” and “ill thought-out”.
“Nice needs to go back to the drawing board and come up with a whole new set of criteria around what the menopause is.”
draft guidelines
The Guardian article – New menopause therapy guidance will harm women’s health, say campaigners (Open access)
See more from MedicalBrief archives:
Hormone therapies best for menopause symptoms, new review finds
NHS removes words ‘woman’ and ‘women’ from menopause page
Experts warn against HRT for menopausal depression in new guidance