Health experts, MPs, and campaigners have raised alarm over new guidance on menopause therapy, asserting that it could harm women’s health. The draft guidelines, issued by the National Institute for Health and Care Excellence (Nice) last month, suggest that women experiencing menopausal symptoms, such as hot flushes, night sweats, depression, and sleep problems, could be offered cognitive behavioral therapy (CBT) “alongside or as an alternative to” hormone replacement therapy (HRT).
Critics argue that the guidance, intended for GPs, downplays menopausal symptoms using what they consider misogynistic language. They contend that the failure to emphasize the benefits of HRT on bone and cardiovascular health, as opposed to CBT, could negatively impact women’s well-being.
Mumsnet, in its response to the guidance shared exclusively with The Guardian, criticized Nice’s recommendations, describing them as “patronizing” and “offensive,” expressing concern that they could be “detrimental” to women’s health.
Justine Roberts, founder and CEO of Mumsnet, highlighted the existing challenges women face in accessing HRT. She stated that the guidance, by emphasizing the negative aspects and equating CBT with hormone replacement therapy, could exacerbate these challenges, making doctors more reluctant to prescribe HRT and discouraging women from seeking it.
Menopause expert and campaigner Kate Muir accused Nice of scaremongering and distorting the science to deter women from choosing HRT. Dr. Nina Wilson, a GP and founder of the One Woman Health women’s clinic, expressed concern that advocating CBT might contribute to increasing the stigma around menopause, suggesting that it may be perceived as a signal that symptoms are psychological rather than physiological.
The guidance’s perceived lack of emphasis on the benefits of HRT, the most effective treatment for menopausal symptoms, raised further concerns. Critics argued that HRT not only addresses symptoms but also helps maintain bone strength and may reduce cardiovascular risk in the long term.
MP Carolyn Harris, chair of the all-party parliamentary group on menopause, deemed the guidance “antiquated,” “naive,” and “ill thought-out.” She emphasized the need for a more comprehensive approach to menopause treatment and called for a reassessment of Nice’s criteria.
Caroline Nokes, chair of the Commons’ women and equalities committee, cautioned against emphasizing the negatives of HRT over its positives. She stressed the importance of a personalized approach, acknowledging that different women may require different forms of support.
A Nice spokesperson defended the draft guidance, emphasizing the importance of a personalized approach and citing new evidence supporting the effectiveness of CBT in reducing menopause symptoms. The spokesperson asserted that the guidance presented the risks and benefits of different treatment options, allowing individuals to work with healthcare practitioners to determine the best approach for their needs.
