Menopause is being seen everywhere, or so it seems. Podcasts, celebrities, media coverage, and some workplace initiatives. You would think that with all this information available women would be more empowered and better informed and being so, would then be able to get better care. But greater awareness hasn’t necessarily removed the barriers once women enter the healthcare system.
A recent survey by Gallup found that 24% of women who had sought help for perimenopause/menopause symptoms had to push to be taken seriously or to receive treatment. 23% saw multiple providers; 20% couldn’t get the care they needed despite trying.
The advice women sometimes receive from friends or online sources when this happens is to see another provider, as 23% of women in this survey had done. But there are costs associated with that, time off from work, time and mental labor to fill in all the new paperwork and there might be a financial cost as well. Do that more than twice and it can be easy to see why a woman might become discouraged.
What are the consequences when the uncertainty isn’t removed by seeking medical help?
This issue is broader than just the menopause transition, it extends to women’s healthcare as a whole. The Gallup survey found that 51% of women reported at least one problem accessing healthcare, compared with 39% of men. One in three women said a provider had minimised or dismissed their symptoms, while similar proportions reported being misdiagnosed or unable to get a diagnosis.
An article in the Guardian reported on research by University of St Andrews published in PLOS One. The research was a scoping review that sifted 1,112 published studies, of which 38 studies analysing patient records met the relevant criteria. Thirty-three of those reported significant treatment differences between men and women. The overall review found women less likely to receive active management across a range of conditions.
Dr Miriam Veenhuizen said the surprising element was the consistency of the pattern across areas including cardiology, surgery, transplantation and emergency medicine, adding that the differences remained after statistical adjustment in most studies. She suggested women’s historical underrepresentation in clinical trials could be one contributor, because clinical guidance has consequently been disproportionately based on male data.
The question all this information raises is when women enter the healthcare system, especially with hard-to-diagnose symptoms, are they treated in a way that actually answers their questions or provided with answers that help them?
Symptoms fluctuate, they can overlap with other conditions. I’ve written about that here -
It’s certainly true that clinicians should be cautious about attributing every symptom and change in a woman’s health to the menopause transition, but existing menopause research supports women’s reports of being told they are too young, having symptoms discounted because they still menstruate, receiving conflicting information and seeing multiple providers.
The Gallup survey also reported that 40% of women who had experienced peri/menopause reported associated physical or mental health challenges negatively affecting at least one area of their life or work.
In the MATE survey 63% of men said that their partner’s menopausal symptoms had affected them personally and 34% reported it having a negative effect on their relationship.
These symptoms can lead to exhaustion, difficulty concentrating and general lack of motivation. All of these can be viewed through a lens of personalization by the male partner. Is their partner losing interest in them, in the relationship, are they doing or saying something wrong?
Women can find themselves not only advocating for themselves in the doctor’s office but in the home. With no clear language to explain what is happening, they are reliant on their partner to believe what they are hearing, regardless of what other reasons they might be ascribing to the changes.
And that belief is the first and most significant step a man can take. He doesn’t have to fix it, advocate on her behalf, diagnose it or suggest treatments. He simply has to believe what his partner is experiencing is real.
Healthcare studies are useful, they show us where the level of care women need isn’t being met. Equally relationship surveys can show us how relationships change during this transitional phase. What I believe is missing is the study that meets them both. We don’t know the impact on relationships of prolonged uncertainty. There is anecdotal evidence, I’ve written and spoken about my own experiences several times. But I haven’t been able to find a focus on that.
A woman leaving the consulting room doesn’t carry that experience into a vacuum. She brings it home and to the workplace. If she comes home with uncertainty, does that show up in the relationships she has? The menopause transition is experienced individually. Increasingly we need to know how it is lived collectively.
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