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Differing views of menopause

        DIFFERING VIEWS OF MENOPAUSE
Modern medicine tends to equate the menopause with a formidable array of symptoms, and longer-term deterioration of body tissues that it blames on oestrogen deficiency. The implication is that menopausal women need hormone therapy to minimise or avoid symptoms and to maintain good health into old age. This view of menopause is increasingly under attack as oversimplified. Critics say that the absence of serious menopausal problems in many women who undoubtedly experience an overall drop in oestrogen (and other sex hormone) levels has not been adequately explained.
Some critics of the medical view also argue that the increased incidence of many diseases attributed to menopause may largely reflect ageing processes that would occur even if there were no such life stage as menopause. Others say that the focus on hormonal factors leads to the neglect of other possible biological contributors to symptom development and later health problems. These include lack of exercise, smoking, and poor nutrition involving inadequate vitamin and mineral intake. There is also criticism of the tendency to neglect psychological and social influences on mood states like irritability, depression and anxiety, which may be glossed over as 'menopause-related' without further investigation. The emergence of these symptoms at menopause may have less to do with hormones than with the reappraisal of personal relationships, or changes in self-confidence or self-esteem.
Although the medical view is widely criticised, women themselves are often the first to vouch for the effectiveness of oestrogen in relieving distressing symptoms like flushes and sweats. There is also good evidence that oestrogen has a beneficial effect on bone structure and blood vessel function, in some women at least. The challenge facing thoughtful doctors and those who run menopause clinics is to try to work out, in conjunction with their patients, the pluses and minuses of hormone use. And it is imperative that women learn all they can, so that they are equipped to make informed decisions in favour of HRT or against it.
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