The new draft guidelines from NICE on the management of menopause have been a hot topic and prompted a lot of controversy.
Here’s what I shared with them in more detail:
QUOTED: Having read the guidance in full, the big concern comes from the fact that by recommending psychological therapy, people may see this as a signal to women and society that symptoms are ‘all their heads’, which is what women have been experiencing for decades. Its no wonder the reaction has been negative.
QUOTED: 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.
ADDITIONAL INFO: There are women who are looking for non-hormonal options or who can’t have HRT for reasons of previous cancer, hormone blocking therapy or mixed causes for their symptoms. It’s hard to argue that making CBT an option alongside HRT is all bad.
But, we must be clear with women about the following:
- CBT aims to teach coping strategies to minimise distress which can worsen symptoms. It thereby has the potential to make them more manageable but is unlikely to eliminate them entirely.
- It isn’t currently available. It’s even harder to get hold of than your favourite brand of HRT! So the reality is, it isn’t an option at present. It’s also usually symptom-specific so if you have anxiety, hot flushes AND night sweats, you now have 3 lots of homework to do, just to get by.
- The guidance is VERY light on the benefits of HRT, which remains the single most effective treatment for all menopausal symptoms and brings additional benefits such as maintenance of bone strength and may reduce cardiovascular risk long-term which themselves are real threats to women’s health as they age.
If you would like to explore your options for managing your menopause and are looking for clear, evidence-based advice, please book now to speak to Dr Wilson.