menopause

The menopause should be tackled not just by treating specific symptoms, but more broadly, argue a group of researchers in an article published in The Lancet, one of a series on the subject. A medicalised approach can disempower women and lead to overtreatment, the authors warn. "Instead of focusing on menopause as an endocrine deficiency, we propose an empowerment model", they say. This model would incorporate the influence of psychological, social, and contextual factors that can be modified, and would also value the patient as the expert on her own condition.

Heavy metals - including arsenic, cadmium and mercury - may adversely affect the ovaries of women approaching menopause, a study claims. Those with high levels of metals in their urine had lower levels of anti-Müllerian hormone, indicating diminished ovarian reserve - fewer oocytes in the ovaries compared to other women of that age. The authors, whose study is published in The Journal of Clinical Endocrinology & Metabolism, used urine data from more than 500 women in the US up to 10 years before their last menstrual period.

The vast majority of mammals remain fertile until the end of their lives. Humans and some species of whales deviate from that norm and do go through menopause. Now, research published in Science reveals that menopause exists in female chimpanzees, too, and that it lasts for a fifth of their adult lifespan. To reach these conclusions, the research team observed 185 female chimpanzees between 1995 and 2016 in Uganda's Kibale National Park and measured hormone levels in urine samples from specimens of various ages.

A review published in the journal Cell highlights the "urgent need" for more studies on the menopause - and at an international level, so that the results can be applied to all countries. The article, published by a research team in Australia, the US and Italy, summarises the available evidence on the biology of the menopause, its consequences for women and therapeutic options. It highlights the lack of studies in certain areas, for example on the efficacy of non-oral oestradiol, or on the efficacy and safety of hormone therapies during the perimenopause.