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Largest Canadian survey on menopause reveals treatment gaps

Largest Canadian survey on menopause reveals treatment gaps
June 21, 2007

An unprecedented 2.7 million Canadian women – or one in six – will reach menopause over the next decade. Today, more women than ever face the many disruptive symptoms that can accompany the transition towards this major life event.

However, a new national survey on menopause – the largest of its kind – reveals that challenges in patient-physician dialogue, knowledge gaps and dissatisfaction with treatment options may be preventing this extraordinary demographic wave from truly understanding and managing this important stage of life.

‘The survey reinforces that menopause can have a serious impact on quality of life and what’s most concerning is women appear to be largely unprepared for it,’ said Dr. Janet Dollin, president-elect of the Federation of Medical Women of Canada and community family physician.

‘We have a real opportunity to help women prepare by recognizing and managing symptoms so that menopause can become a more positive and empowering experience.’

The survey, conducted by Leger Marketing and sponsored by Wyeth Canada in partnership with the Federation of Medical Women of Canada, shows menopause ranks among the most major milestones in a woman’s life in terms of impact on daily life.

For nearly one in three women, the survey reveals menopause has the same or greater impact on daily lives as bearing and raising children.

‘Women of this generation are in the peak of their personal and professional lives and are used to taking charge. We must ensure they are prepared for menopause in the same way they have been for other significant life stages,’ Dollin added.

The survey, which polled 2,049 Canadian women over 40 and 125 general practitioners with at least 50 percent female patients, reveals significant gaps in knowledge and a lack of treatment options.

While 72 percent of women feel knowledgeable about menopause, less than 30 percent consider this knowledge to be very good.
That number drops to less than two in 10 for women experiencing symptoms in the early stages of menopause.

Only half of physicians consider their menopause patients to be knowledgeable; less than one in 10 consider them very knowledgeable. Regarding treatments for managing menopausal symptoms, nearly four in 10 physicians are dissatisfied with current options and only half of women are satisfied.

Embracing a new attitude toward menopause

A large proportion of female baby boomers, 58 percent (those between the ages of 41 and 61), are still under the average age of menopause (51), according to Statistics Canada.

The first baby boomers turned 60 in 2006 and by the end of the year, almost 1,100 were celebrating this birthday each day.

These female boomers are often characterized as the healthiest, wealthiest, most active, educated and influential generation of women in history. The survey clearly reflects this generation’s positive attitude towards aging with a majority agreeing with the statements: ‘As I get older, I feel more self confident’ (84 percent); ‘50 is the new 40’ (74 percent); and, ‘I see menopause as the beginning of an exciting phase of life’ (53 percent).

‘There’s no doubt that today’s women entering menopause are intent on enjoying the second half of life,’ said Dollin.
‘Through improved education, dialogue and treatment options we can help this and future generations of women welcome the transition to this new chapter in their lives.’

A wide range of symptoms were reported by 84 percent of women in the survey who were at some stage of menopause. Difficulty with sleep, hot flashes, mood swings and fatigue were the most common symptoms and these symptoms can occur long before a woman’s menstrual period has stopped for twelve months.

While the average age of menopause is 51, half of the youngest women surveyed (ages 41 to 45) reported symptoms, and for many, these symptoms occurred frequently.

The following were either experienced often or always by this youngest group:

• Difficulty sleeping (51 percent)
• Hot flashes (39 percent)
• Fatigue (57.3 percent)
• Insomnia (40 percent)
• Night sweats (38.5 percent)

Regular mood swings were also experienced by 44 percent of this youngest age group, which was larger than that experienced in older age groups.

Impact of symptoms on relationships, workplace

Nearly three in 10 women (27 percent) reported menopause negatively affected the relationship with their spouse. Of those women who cited sleepless nights as a menopausal symptom, nearly half said they experienced the same or more sleepless nights as when raising a newborn.

For working professional women, hot flashes interfered with work for more than half and caused anxiety in the workplace for a quarter of respondents.

While nearly all physicians say they proactively discuss menopause with patients over the age of 40, only half of women say this conversation took place. Of those women whose physicians did initiate discussions, 62 percent indicated this discussion happened at age 46 or later, after disruptive symptoms may have already occurred.

‘Encouraging earlier dialogue about menopause between women and health care professionals is very important. Women may unnecessarily be living regularly with disruptive symptoms such as difficulty sleeping without even realizing they are related to menopause,’ said Dollin.

Treatment dissatisfaction underscored need for non-hormonal options

Physicians cited hormone-replacement therapy (HRT) as the most recommended treatment for managing the symptoms of menopausal women, but virtually all believe there is a need for more proven non-hormonal therapies.

Seven in 10 women agreed. While reasons vary, female physicians cite reluctance among women to take HRT as the number one reason that more non-hormonal therapies backed by evidence are required. Seven in 10 doctors are apprehensive about naturopathic therapies largely because of the lack of quality research and evidence supporting their safety and efficacy.

Three in 10 physicians admit they have not been provided with enough counsel and treatment options related to menopause to adequately provide alternatives to their patients.

‘Given how the menopause landscape has changed in recent years, there’s clearly a demand for evidence-based research and treatment options that both women and health care professionals can have confidence in,’ said Dollin.

Source: The Federation of Medical Women of Canada (FMWC)

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