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Controversy in Menopause Care - What are our goals?


Menopause, a natural phase in a woman's life, has long been a subject of medical debate and controversy. Recently, the Lancet journal published an editorial article on menopause care that has stirred significant discussion within the medical community. (Link to Lancet editorial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01570-2/fulltext)

HRT menopause care study


While the Lancet is a respected medical journal, this particular editorial has raised eyebrows due to its departure from cutting-edge research results and blatant dismissal of accepted best practices in menopause care (see below for patient resources).


At the heart of the controversy lies the article's boldly worded discussion around hormone replacement therapy (HRT) as an unnecessary treatment for menopausal symptoms. The authors argue that HRT as a mode of symptom control is not justified thereby minimizing the short and long term impacts that the menopause transition has on women's health. Insultingly, the article does not explain the well established long term benefits of hormone replacement therapy on women's health; including, protecting of cardiovascular health, preservation of bone density, long term protection of cognitive function, and an improvement in mental/emotional health.


Contrary to the Lancet article's claims, current research suggests that when used prescribed appropriately by a hormone trained provider, HRT is a safe and effective treatment that can manage symptoms as well as protect future health. HRT alleviates symptoms such as hot flashes, night sweats, and vaginal dryness, improving women's quality of life during this transition. Furthermore, HRT has been shown to decrease cancer risks (including breast cancer), protect bone health, support long term cognitive function, and decrease all cause mortality.


The Lancet article fails to acknowledge the individualized nature of menopause care. Every woman experiences menopause differently, with unique symptoms and medical histories. Blanket statements suggesting that all women should avoid HRT overlook the nuanced approach required in managing menopausal symptoms and the significant health risks that are associated with this life transition. Instead of dismissing current research, The Lancet should be educating healthcare providers on the the latest research and treatment options available to our patients.


While the Lancet journal is renowned for its contributions to the academic medical community, its recent article on menopause care has sparked controversy for its divergence from current evidence and recommended practices. Perhaps even more concerning - the article voices opinions that dismiss the protective role HRT has been proven to play in the current and future health of women receiving it.


As our understanding of menopause evolves, it is crucial for healthcare providers and researchers to stay abreast of the latest professional practice guidelines to ensure the best possible care for women experiencing this natural transition. By embracing a personalized and holistic approach to menopause care, we can empower women to navigate this phase of life with confidence and protect their future health for years to come.


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