Review of Over 70 Years of Menopause Science Highlights Research Gaps and Calls for Individualized Treatment

Although about half of people go through menopause, less than 15% of them receive effective treatment for their symptoms. Treatment options for people experiencing irritating or severe menopause symptoms are often under researched, and some have questionable efficacy, or cause harmful side effects. 

“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,” write the authors. “Recognition that menopause, for most women, is a natural biological event, does not exempt the use of interventions to alleviate symptoms.”

For this review, the researchers looked at over 200 sources across 71 years to synthesize what’s currently known about menopause. 

Key takeaways from the review include the following:

• The timeline of when menopause phases occur isn’t well understood and varies from person to person, so the authors argue that current age restrictions on prescriptions and therapies are illogical and problematic. While symptoms often start during perimenopause, few menopause therapies are currently approved for perimenopausal patients.
• Menopause treatments range from hormone therapies to lasers to plant products, but the authors argue that few have been studied over long enough timespans. They highlight potential side effects and health concerns for each type of treatment and note that even the most effective and well-researched option available presently — hormone therapy targeting estrogen — is still far from a perfect solution for all.
• Symptoms vary widely between people and throughout the course of menopause. Some people get many severe symptoms while others get few to none; but even if someone has no noticeable symptoms, there can still be significant “silent health consequences,” including bone loss and a higher risk of diabetes, cardiovascular diseases, and certain types of cancers. Additionally, the authors highlight that some symptoms, like short-term memory loss, can be temporary, and note that other symptoms, like depression and anxiety, are sometimes pre-existing conditions that have been falsely attributed to menopause due to stigma surrounding it. They also recommend exercising regularly and maintaining a nutritious diet that includes plenty of protein as a way to reduce the likelihood of contracting symptomatic health complications.

Going forward, they call researchers to look deeper into when the menopause process starts and to focus on making menopause treatments more effective and safer overall. They underline the importance of researching the symptoms and other health impacts of menopause outside of high-income countries. Additionally, they suggest studying the impacts of menopause on work both from home and in an office, as well as the impacts on people with less traditional career paths such as caregivers and volunteers.

The team also argues that menopause treatments need to be holistic and tailored to the person being treated — addressing both the physical and mental health impacts of menopause, as well as the underlying health risks associated with menopause and any other relevant health concerns. “Women with bothersome menopausal symptoms should be counseled on treatment options and offered evidence-based therapies,” they write. “Therapy should be individualized depending on age and health risks, recognizing that health risks may increase with age.”

Sources: 

Susan R. Davis, JoAnn Pinkerton, Nanette Santoro, Tommaso Simoncini. Menopause—Biology, consequences, supportive care, and therapeutic options. Cell, 2023; DOI: 10.1016/j.cell.2023.08.016

Cell Press. “Review of over 70 years of menopause science highlights research gaps and calls for individualized treatment.” ScienceDaily. ScienceDaily, 6 September 2023. <www.sciencedaily.com/releases/2023/09/230906112354.htm>.

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