Menopause Resources for Women
Explore valuable resources and in-depth studies on menopause, its phases, and symptom management in the following section. Educating women about the menopausal journey is one of our top priorities, and we offer a diverse library of articles and resources for you to access whenever you need it most
Australian Menopause Society (AMS)
AMS is an organisation of doctors and other healthcare professionals dedicated to empowering women navigating the menopausal transition.
The organisation’s mission is to help promote and encourage open discussion around menopause for women, support scientific research and studies, and provide publicly available information to women for better understanding of the menopause phases.
You can visit the AMS site for more information, or directly download their library of fact sheets on menopause.
The Menopause Society (Formerly NAMS)
The Menopause Society, formerly known as NAMS or the North American Menopause Society, was founded in 1989 and is a nonprofit organisation designed to support healthcare professionals with tools and resources to better understand and care for women in the menopausal transition and beyond, which ultimately leads to improved menopausal care and a more enjoyable mid-life journey for women.
The Menopause Society provides both free and paid resources for professionals and patients, including The Menopause Guidebook and MenoNotes, which you can access below.
Findings from Menopause Research
Exploring the Menopause Journey: Insights into Symptoms and Current Interventions
The Normal Menopause Transition
This scientific paper, published in 1992, presented data from a cohort study involving 2,570 mid-aged women from Massachusetts, which was the largest and most comprehensive cohort study of its time.
Highlights:
What are the natural menopause transitions and when do they occur?
What factors affect these transitions?
What signs and/or symptoms accompany these transitions?
It concluded that despite having a cohort of over 1,100 premenopausal women and five years of observation, the sample size was only just sufficient to produce reliable estimates of the parameters of menopause transition and their associated factors.
Since the paper's publication, many new insights have emerged.
Managing Menopausal Symptoms After Breast Cancer
Managing the symptoms of menopause after a diagnosis of breast cancer offers some unique clinical challenges.
Highlights:
For those with a personal history of breast cancer HRT, even topical oestrogens are considered at least relatively contra-indicated and unsafe.
Over the past two decades, extensive research and numerous clinical trials have focused on developing effective non-estrogen therapies to support women experiencing menopause without measurable success.
Many women prefer natural products to manage their menopause symptoms.
Among the various herbal treatments available for menopausal hot flashes, the most popular are phytoestrogens, such as those derived from soy or red clover, and black cohosh.
A review of studies on non-hormonal treatments for hot flashes found that red clover extracts worked no better than a placebo in reducing symptoms.
Some studies suggest black cohosh may help reduce the frequency and severity of hot flashes, while others show little to no effect. It may not be suitable for people with liver issues.
Studies on herbal products often show mixed results. One challenge in reviewing this research is that the studies and herbal extracts themselves vary widely. Factors like where and how the herb is grown, and how it is processed, can all affect the final composition of the extract.
A New Era In Menopause Management
This scientific article highlights that menopause is increasingly being discussed on public platforms, as evidenced by a recent advertisement for a new medication for vasomotor symptoms featured during the 2024 Super Bowl. However, many women still leave their vasomotor symptoms (VMS) untreated due to various factors.
Highlights:
VMS are common and can have a long duration; more than 75% of US women report these symptoms across the menopause transition with a mean duration of 7 to 9 years and a duration of a decade or longer in one-third of women.
Despite guidelines supporting the use of hormone therapy for bothersome VMS, it has been difficult to shake the perception that hormone therapy is a risky option. That, coupled with the lack of education on menopause management in most medical schools and residency training programs, has led to the current state in which many individuals cope with untreated menopause symptoms.
The first NK3 receptor antagonist, fezolinetant, was approved by the FDA in May 2023. While this new drug has provided an effective, novel, nonhormonal therapeutic option for individuals with VMS and has eliminated the potential safety concerns associated with the use of hormone therapy, it is very costly with a monthly list price of about $550+ and so the uptake has been less than anticipated.
Cognitive Problems in Perimenopause: A Review of Recent Evidence
This scientific review delves into recent research on cognitive challenges encountered during perimenopause, analyzing menopause-related symptoms, individual factors, stress levels, and the neurobiological changes associated with these issues. It further evaluates treatments that have been shown to effectively enhance cognitive function during this transitional phase
Highlights:
The review highlights that cognitive issues are prevalent during perimenopause and significantly impact a substantial number of women
Research indicates that women often face challenges with verbal learning and memory during perimenopause, with these areas being the most notably affected
Recent studies also suggest that this phase can bring difficulties with processing speed, attention, and staying focused.
The North American Menopause Society does not recommend MHT for the treatment of cognitive complaints at any age during the menopause transition.
“While off-label medications and brain health-promoting activities are currently available treatments, there is a need for more targeted interventions to effectively address the cognitive concerns experienced by many individuals during perimenopause.”
Diagnosis and Management of Mood Disorders During the Menopausal Transition
This article reviews the current literature on the prevalence and risk factors associated with depression during the menopausal transition.
Highlights:
The peak period of risk for depression in women occurs between the ages of the first menstrual cycle and menopause (nicknamed the “second puberty”). The hormonal changes during the reproductive years for a woman may increase risk of mood disorders.
Several factors can elevate the risk of depression or lead to the emergence of depressive symptoms, such as health problems, social or environmental support, and daily stressors. Some have suggested that depression can be an “indirect consequence of sleep disruption that occurs in association with hot flashes.”
A history of PMS and a history of depression can increase the risk of depression during the menopausal transition.
“Several studies have examined the association between emotional well-being during the menopausal transition and different demographic characteristics, including socioeconomic status, ethnicity, marital satisfaction, and quality of family relationships.” The article touches upon “empty-nest syndrome,” which many women in the menopausal transition can experience, and this can increase the risk of depressive symptoms.
“A significant obstacle with a lack of solutions and research is having access to the most tolerable treatments to manage depression in an aging population who is also experiencing side effects (e.g., vasomotor symptoms) caused by the menopausal transition and other psychosocial factors that can increase the risk of mood disorders.”
Menopause: A Review of Botanical Dietary Supplements
This review examines the effectiveness and safety of botanical dietary supplements for menopausal women, driven by findings from the Women’s Health Initiative (WHI), which have spurred an increase in such products in the American marketplace. The article evaluates the evidence supporting the safety and benefits of botanical monopreparations marketed for menopause relief
“When the Women’s Health Initiative (WHI) was discontinued owing to unanticipated increases in risk for breast cancer, stroke, heart attack, and blood clots among women taking estrogen plus progestin, the search for alternative treatments that were perceived to offer beneficial effects with less risk intensified.” Some women have decided to search for more “natural” products, assuming that these products are more safe and effective compared to their pharmaceutical counterparts. “Whether these presumptions are correct remains to be seen.”
Highlights:
“Although botanical remedies have been used for centuries, many products in the American marketplace bear little resemblance to the simple preparations of the past. Potent, concentrated products extracted via a range of solvents may be consumed for prolonged periods, often in combination with over-the-counter and prescription drugs—unique circumstances when compared with use of the apothecary of yesteryear. Thus, a “long history” of use cannot be presupposed, and questions of safety and efficacy must continue to be entertained.”
This article goes into great detail about the various natural ingredients often used in menopausal symptom relief supplements and products. These ingredients include black cohosh, dong quai, red clover, ginseng, soy, and evening primrose seed oil.
The article concludes that future research on the safety of these botanical supplements should include long-term assessments, as women experiencing menopausal symptoms may use them for extended periods rather than short-term. It also recommends conducting dose-escalation studies prior to undertaking costly clinical trials on botanical extracts
Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations
This publication examines the heightened vulnerability to depressive symptoms in women during perimenopause, the phase leading up to menopause. The article notes that there is a lack of clinical recommendations for identifying, characterizing, and treating clinical depression. To address this gap, an expert panel, comprising members from the North American Menopause Society (now The Menopause Society) and the National Network of Depression Centers’ Women and Mood Disorders Task Group (NNDC), was convened to review the existing literature and develop guidelines for evaluating and managing depression during perimenopause
The areas addressed included: (1) epidemiology; (2) clinical presentation; (3) therapeutic effects of antidepressants; (4) effects of hormone therapy; and (5) efficacy of other therapies (e.g., psychotherapy, exercise, and natural health products).
Highlights:
Research generally indicates that the majority of women experiencing depression during menopause have encountered depressive episodes prior to this stage. The onset of menopausal symptoms can further complicate and exacerbate depression during this pivotal period of midlife
“Although estrogen therapy is not approved to treat perimenopausal depression, there is evidence that it has antidepressant effects in perimenopausal women, particularly those with concomitant vasomotor symptoms.” Therapeutic options for women such as psychotherapy and antidepressants are often recommended for the treatment of perimenopausal depression.
In 8 of the 12 studies included, the review found that elevated depressive symptoms were “significantly more prevalent in perimenopausal versus premenopausal women, and 6 of these were adjusted for covariates.” The studies show that 45% to 68% of perimenopausal women report elevated depressive symptoms compared to 28% to 31% of premenopausal women.
“Of the 11 longitudinal studies reviewed, 6 (54%) suggest an increased risk of depressive symptoms during the transition, with estimates of a 1.30 to 1.55 increased likelihood of depressive symptoms in the early transition and 1.71 to 2.89 increase in the late transition.”
In the study, the question “Is hysterectomy with and without oophorectomy a risk factor for depressive symptoms/disorders?” revealed that “a study of 5336 women from the Australian Longitudinal Study on Women's Health found that the risk of elevated depressive symptoms was 20% higher in women with a hysterectomy and ovarian conservation and 44% higher in women with a hysterectomy without ovarian conservation compared to women without a hysterectomy.”
Other important discussion points in the review include:
Symptoms that can coincide with depression (specifically for midlife women);
How depression is diagnosed during the menopausal transition;
The unique distinction of depression during the menopausal transition;
The risk factors of depressive disorders/symptoms during perimenopause;
The therapeutic effects and possible efficacy differences of antidepressants in perimenopausal and postmenopausal women;
The effects of hormone therapy, hormonal contraceptives, and other therapies for depressive disorders in perimenopausal women.
