Position StatementsPosition Statements
In the interest of reducing confusion and improving midlife women’s quality of life, as well as access, if desired or needed, to appropriate health care, and promoting the use of clearer terminology, we recommend specific and precise use of the terms of perimenopause and menopause.
Medical research on sex hormones must be seen in terms of women’s health, rather than disease. Menopause is not a disease of estrogen deficiency but a normal phase of an adult woman’s life, nor is menstruation a disease requiring medication or other treatment.
In Spring, 2007, the Board of Directors of the Society for Menstrual Cycle Research decided to update the Society’s 2003 position statement, “Women’s Health Initiative & HRT.” The basic conclusions of the Society’s 2003 position statement remain: WHI provided strong evidence that hormone therapies are not safe and effective for prevention of chronic illness, and that menopause is not an estrogen deficiency disease. However, this updated statement adds a critique of an increasingly heard criticism, the “timing hypothesis,” which asserts that the WHI research results are limited to older postmenopausal women and that younger women would derive positive benefits from hormone use. This hypothesis has little experimental confirmation and should not be the basis for professional decision-making.
At the 2007 meetings of the Society for Menstrual Cycle Research, members discussed current consumer and medical interest in extended hormonal contraceptives to reduce or eliminate menstruation (cycle-stopping contraception). A number of research papers on this topic were presented. It is the position of the Society that menstruation is not a disease, and that further research on the potential health risks and long-term safety of cycle-stopping contraception is still needed.
Based on research presented at the 2003 meeting, the Society issued a statement recognizing that menstrual suppression may be a useful option for women with severe menstrual cycle problems such as endometriosis, but recommending that continuous oral contraceptive use should NOT be prescribed to all menstruating women out of a rejection of a normal, healthy menstrual cycle. The statement recommended more research is needed before women can make informed decisions.
SMCR issued an official position statment affirming that the WHI Estrogen plus Progestin trial has produced Level 1 evidence that was previously unavailable. These data strongly support SMCR’s position that menopause is a normal phase of all women’s lives and not an estrogen deficiency state that requires hormone “replacement” to prevent serious chronic diseases. Furthermore, integration of previous epidemiological data on menopausal women’s risks for cardiovascular disease with the new WHI data suggests that 59-79% of women’s risks for heart attack and stroke can be eliminated by positive lifestyles and socioeconomic biases in the observational studies. The Society also stated that more research is needed prospectively documenting women’s health and experiences through the menopause transition (perimenopause) in multicultural populations and more research is also needed into the etiology and management of hot flashes/night sweats and other changes that are distressing for some women during the menopause transition and following menopause.