Earlier this week I came across an editorial in The Lancet medical journal that got me furious. It suggests that we're making too much of a fuss about menopause, treating it more like a disease that needs heavy-duty medical intervention rather than a natural life stage. While the journal is top-notch and the writers know their stuff, I can't help but feel this view misses the mark.

Menopause isn't just a "phase" you breeze through. It's a significant shift that can turn your body's usual operations on their head. Yes, it's natural, but so is the impact it has on your health, from your heart to your bones and even your brain. The drop in hormones like estrogen doesn't just signal the end of fertility; it can usher in a whole host of challenges, including a higher risk of some pretty serious health issues.

Now, about hormone replacement therapy (HRT). The article throws some shade at HRT, partly because of the old fears stirred up by the Women's Health Initiative (WHI) study a couple of decades ago. That study linked HRT to breast cancer, causing quite the stir. But here's the thing: the story has evolved since then. The risks that had everyone in a panic were mostly tied to progestin, a synthetic hormone, not the estrogen part of the therapy. Fast forward to today, and the consensus is that, when done right, HRT's benefits can outweigh its risks for many women.

The idea that talking about and treating menopause is somehow "medicalizing" it feels off to me. It's not about making a mountain out of a molehill; it's about acknowledging the reality of countless women and looking for ways to make this transition smoother and healthier. After all, with women living well into their 80s, a good chunk of life happens post-menopause. Why not make those years as healthy and enjoyable as possible?

The conversation around menopause and HRT needs a refresh. It's not about pushing every woman towards HRT but about having informed, open chats about what menopause brings and how we can manage it, whether that's with HRT, lifestyle changes, or other treatments. It's about giving women the info and support they need to make the best choices for their health and well-being.

So, let's keep the dialogue going. Menopause is a significant life stage, and it's high time we treat it as such, with all the care, understanding, and respect it deserves. Empowering women with solutions to prevent other disease progression rather then medicalize women with a battery of illness needing intervention often with side effect profiles much greater than those seen in bio-identical hormone replacement. 


Dr. Anat Sapan MD, specializing in peri/menopause care, advocates for a personalized approach combining Bioidentical Hormone Replacement Therapy with lifestyle strategies. Her telemedicine services in California, Florida and Illinois aim to help women overcome menopausal symptoms and enhance their quality of life.

Anat Sapan, MD

Anat Sapan, MD

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