“突破时刻”: 洛林凯利如何帮助改变更年期辩论

F五年前, Lorraine Kelly 想在她的日间电视节目中采访一位著名女性关于更年期的经历. 她接近的每个人都拒绝, so she decided to turn the tables and have a doctor interview her about her personal story.

Kelly shared with viewers about how she had felt “flat and joyless” despite leading a life she was happy with. It had taken a revelatory consultation with her interviewer, the TV medic Hilary Jones, to learn that she did not have depression but was experiencing menopausal symptoms.

“我想, nobody else will talk about it so I’ll do it. It was a breakthrough moment, and that’s what I think daytime telly does very well – we’re not afraid to tackle anything. I had someone talking about how to do a poo test for bowel cancer on the show this morning,“ 她说.

Since Kelly’s interview, attitudes towards the menopause have shifted dramatically. Celebrities including Gwyneth Paltrow, Oprah Winfrey and Gillian Anderson have spoken out, while a gamechanging documentary produced by Davina McCall 在 2020 resulted in what some doctors have called a “Davina effect” among patients whose midlife struggles suddenly made sense.

[object Window], women have extolled the virtues of hormone replacement therapy (激素替代疗法) for managing symptoms ranging from hot flushes and night sweats to anxiety and depression.

This has led to huge growth in awareness of how debilitating menopausal symptoms can be, resulting in unprecedented demand for treatment that culminated in HRT shortages 本星期.

Kelly said she had been proud to break a longstanding taboo. “We knew from the response from viewers that there was a problem here, and I was able to use my own particular problems to help other people – that’s a huge privilege, and a responsibility.”

She has discussed the HRT shortage on the show this week. “This is a scandal. 明显地, it affects me personally because I’ll run out of patches soon … You can be damn sure if this was a problem affecting men it wouldn’t be happening.”

Doctors have been glad to see awareness of menopausal symptoms raised by celebrities and on social media, but some worry that the emphasis on personal experience is resulting in a perception that HRT is the best remedy.

Paula Briggs, the chair of the British Menopause Society, said the scale of the celebrity involvement in the menopause was “the most bizarre thing I’ve ever seen” in medicine.

While she said much was helpful, there was also “evangelistic” misinformation shared on social media based on “a selective interpretation of clinical research papers”. This includes recommending higher doses of HRT, saying it’s safe for women with a history of breast cancer in their family, or claiming it protects against dementia. “Unless you’ve done medical training and you understand, it’s very easy to take a superficial approach.”

Some women feel pressured into taking HRT when it’s not right for them, with lifestyle changes such as a healthier diet or more exercise sometimes a better starting point, or paying for private clinics, 她补充说.

Olivia Hum, a menopause specialist, said in the medical community there was “a real worry that the debate has swung too far in the opposite direction”, with people feeling “very scared about menopause and the symptoms”.

然而, she added that McCall’s documentary “has done the most immense amount of good for women”.

“I’m not particularly pro-celebrity endorsement of medical stuff, but the information she gave was very scientific … my inbox filled up during the documentary with emails from women who went, ‘Oh my god, I never realised this was the menopause. I lost my job, my relationship … I just realised I don’t have to put up with this crap any more’,“ 她说.

The journalist Mariella Frostrup, who wrote Cracking the Menopause, said women had been forced to share personal experiences publicly because, like many women’s health issues, menopause “hasn’t been taken nearly seriously enough”.

“The idea that this is something celebrities are demanding, but that it’s an unnecessary thing, adds to the ridiculousness of the situation and the injustice. I think women have been incredibly poorly served by a system that’s patronised them and ignored the very real suffering,“ 她说.

Heather Currie, former BMS chair and an NHS gynaecologist, said the high-profile public discourse had helped extinguish misconceptions around HRT that arose from publicity exaggerating its risks in the late 1990s.

But she added that some dangerous messages had gained traction, for example recommending HRT for the rest of your life, while certain symptoms that are more embarrassing to talk about, such as bladder problems, are sidelined.

Individual experiences are also sometimes unhelpfully extrapolated into universal advice. “Women are affected completely differently. There is a huge range in symptoms, their severity and the impact they can have,“ 她说.

Currie said the goal should be for women to feel they can trust their doctors, which hasn’t always been the case due to a previous lack of training. “The key thing is accurate information for women that they can easily access, and consistent advice when they go to a healthcare professional.”

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