An Overview of Menopause

Menopause, according to the National Institute for Health and Care Excellence, is the ‘biological stage in a woman's life when menstruation stops permanently due to the loss of ovarian follicular activity’ [1]. This incurs a decrease in important gonadal hormones, namely oestrogen and progesterone [2].

The menopause and perimenopause (the time during which a woman may experience menopausal symptoms but still has irregular periods [1]) are associated with many uncomfortable symptoms. NICE lists 18 different symptoms [3] but some online resources list as many as 38 symptoms associated with menopause [4]. It is not difficult to see why menopausal women are a lucrative prospect for any marketing team. 

My Experience

After researching Hormone Replacement Therapy in the media these past 6 weeks, I have experienced an unexpected, yet retrospectively unsurprising, phenomenon. My own personal search engines and social media platforms have become saturated with advertisements for menopause clinics, supplements and examinations. 

As a 20 year old woman, the nature of my research project lies outside of my own personal experience. I undoubtedly will experience the menopause, but with an average age of 51 in the UK [1], it will be some time before I can truly relate to these women that I have been studying. However, as I collected data from platforms such as Google, Instagram, Facebook and Tiktok, I have created a new digital profile for myself. The cookies piled up, and now, in the eyes of an algorithm, I am a perimenopausal woman.

Menopause Supplements

While my project focuses on HRT, it was the brazen advertisement of unproven alternatives that really shocked me. There is very little scientific evidence or data that indicates the efficacy of “natural” or herbal remedies for menopausal symptoms [5]. I recognise that this may be due to a lack of research, and of course acknowledge the possibility that they may actually provide some relief. However, the language used and claims made by these supplement companies feel misleading and overly confident. I have seen countless paid advertisements claiming immediate visual results, such as reduced bloating or weight loss. These claims are presented as facts, yet they can rarely be found accompanied by any actual scientific evidence. A common botanical found in these supplements is Ginseng, but multiple studies have found little evidence to suggest it has any effect on physical menopausal symptoms like hot flushes [6][7]. I am therefore concerned that women are being mis-sold. [8] Perimenopausal and menopausal women are particularly vulnerable to these advertisements. With nearly three quarters of menopausal women experiencing “loss of confidence” [9], they are the perfect target for products offering immediate aesthetic improvements. 

Beyond the convincing language used to promote these products, the visual marketing is just as persuasive. Neutral colour schemes, images of serene women, motifs of flowers and foliage. Admittedly, I often found myself drawn in by the packaging and gorgeous websites. I found myself wondering if I should be taking a supplement… Would my skin be clearer? Would I have more energy? If a healthy young woman with absolutely no need for menopause supplements can be tempted, what chance do those actually suffering with the symptoms stand? 

EMB

My experience with this targeted medical marketing has deepened my conviction that Evidence Based Medicine (EBM) is the safest approach. EBM involves the utilisation of the best available data to steer clinical practice [10]. If, as consumers of health related products, we kept this practice in mind, we could avoid being swayed by convincing advertising or glowing reviews. The menopause can be a confusing and turbulent period in a woman’s life, and it is only natural to find solace with those who are sharing the experience. However, anecdotal evidence (such as that found in product reviews or Facebook opinion pieces) does not hold the same value as that collected from actual clinical trials and investigations. I would encourage peri/menopausal women to remain vigilant in their interaction with media and marketing surrounding menopause, as I have seen first hand how convincing, and how absurdly expensive, these products can be.  

I would like to thank my supervisor, Dr Margaret McCartney, as well as Frank Sullivan and Dr Deirdre Murphy for their guidance in my research. I would also like to thank Lord Laidlaw and the Laidlaw foundation for this opportunity, and my Laidlaw cohort for their continued support through the process.

REFERENCES:

[1] https://cks.nice.org.uk/topics/menopause/background-information/definition/ 

[2] https://www.sciencedirect.com/science/article/pii/B9780123742711000411#

[3] https://cks.nice.org.uk/topics/menopause/diagnosis/diagnosis-of-menopause-perimenopause/

[4] https://www.mymenopausecentre.com/symptom-checker/)

[5] Geller SE, Studee L. Botanical and dietary supplements for menopausal symptoms: what works, what does not. J Womens Health (Larchmt). 2005 Sep;14(7):634-49. doi: 10.1089/jwh.2005.14.634. PMID: 16181020; PMCID: PMC1764641. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764641/ 

[6] Wiklund IK, Mattsson LA, Lindgren R, Limoni C. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group. International Journal of Clinical Pharmacology Research. 1999 ;19(3):89-99. PMID: 10761538. https://europepmc.org/article/med/10761538 

[7] Kim MS, Lim HJ, Yang HJ, Lee MS, Shin BC, Ernst E. Ginseng for managing menopause symptoms: a systematic review of randomized clinical trials. J Ginseng Res. 2013 Mar;37(1):30-6. doi: 10.5142/jgr.2013.37.30. PMID: 23717154; PMCID: PMC3659624. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659624/ 

[8] Dr Margaret McCartney

[9] https://www.southampton.ac.uk/news/2023/05/government-urged-to-improve-menopause-care-to-keep-women-in-the-workplace.page 

[10] https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-ebm/