The Lancet has published a four-paper series on the menopause. Papers two, three and four – Optimising health after early menopause; Promoting good mental health over the menopause transition; and Managing menopause after cancer – are largely in keeping with current international and national guidelines, including NICE guidance. Menopause care should be individualised, and women should be supported to access accurate and balanced information relating to symptom management and long-term health.

Paper one, entitled An empowerment model for managing menopause, advocates that most women should navigate the menopause without the need for treatment and that ‘over medicalisation’ can lead to disempowerment and over treatment.  The paper recognises that symptoms of menopause vary and can affect women to varying degrees. Potential symptoms include vasomotor symptoms (hot flushes and night sweats), sleep disturbance, mood related symptoms, muscle and joint pains, and genitourinary symptoms. In women most severely affected, menopausal symptoms can impact on their personal, working and social lives.

The opinion paper, paper one, proposes an empowerment model that recognises factors modifying the experience, in which the patient is an expert in their own condition. However, it is important that women experiencing severe symptoms, potentially eligible for HRT or other non-hormonal treatments which could relieve symptoms, are provided with appropriate care.

Historically, there has been a lack of information about the menopause and some women have found it hard to get the treatment they need. This is changing for the better, and there is concern that the use of the word ‘over medicalisation’ could in fact lead to the disempowerment of women. A balanced approach is important, to ensure that the women who need treatment get it.