Article Impact Level: HIGH Data Quality: STRONG Summary of The Lancet, 404(10471), 2535–2536. https://doi.org/10.1016/S0140-6736(24)02602-3 Dr. Zachary Nash et al.
Points
- The top priority identified was the need for safe and effective non-hormonal treatments for perimenopause and menopause, especially for those who cannot or do not wish to take hormone therapy.
- Research priorities included understanding menopause-related cognitive decline and sleep disturbances, including their causes, detection, prevention, and management.
- The study emphasized the role of diet, exercise, and stress reduction in managing menopausal symptoms and the need for better support in implementing these changes.
- Key questions addressed how to manage menopause in women with breast cancer and heart disease, as well as the risks of hormone therapy related to dementia and long-term health effects.
- The initiative highlighted variations in menopausal experiences across different countries, cultures, and ethnicities, emphasizing the need for inclusive research and tailored healthcare approaches.
Summary
The Menopause Priority Setting Partnership (MAPS) aims to identify shared research priorities regarding menopause, focusing on the concerns of those with lived experience of menopause and healthcare providers. A global survey launched in October 2023 gathered 1,698 responses from 593 participants across 42 countries. A second survey, incorporating 64 questions, received 2,125 responses, resulting in a shortlist of 26 priority questions. These questions were further refined by a panel of 21 individuals, including people with lived experience of menopause and healthcare providers. The list of top ten priorities was published in The Lancet in December 2023.
- What are the safest and most effective non-hormone treatments (including prescribed medicines, herbal remedies, and complementary therapies) for perimenopause and menopause in people who cannot or do not wish to take hormone therapy?
- What lifestyle changes (eg, diet, exercise, and reducing stress) benefit people at different stages of menopause? How can people be supported to make these changes?
- Does perimenopause and menopause lead to cognitive problems (eg, brain fog and memory loss)? If yes, why, and how does this happen? How are these problems best detected and managed? Can they be prevented or reversed?
- Why and how is sleep affected during perimenopause, menopause, and post-menopause? What are the best ways to manage these sleep problems?
- How long should people take hormone therapy? What is the best way to stop hormone therapy?
- What are the best ways to help people prepare for perimenopause and menopause and recognise when it is happening? What helps them know when to seek professional help and make informed decisions about treatment?
- How do menopausal experiences vary across different countries, cultures, and ethnic backgrounds worldwide?
- What are the best ways to manage perimenopause and menopause in people who are living with or have survived breast cancer?
- Does hormone therapy change the risk of dementia?
- How long can people with a personal risk of heart disease or cancer safely take hormone therapy? If they can, which type and what dose of hormone therapy is best?
Among the priorities identified, the need for safe and effective non-hormonal treatments for perimenopause and menopause was most prominent, highlighting the desire for alternatives to hormone therapy (HT). Additional priorities included understanding the effects of menopause on cognition and sleep, with questions about the role of perimenopause in cognitive decline and sleep disturbances. The research also emphasized the importance of lifestyle changes, such as diet, exercise, and stress reduction, in managing menopausal symptoms. Other key questions focused on preparing individuals for menopause, managing symptoms in women with medical complexities, and understanding global variations in menopause experiences across cultures and ethnic groups.
The MAPS initiative underscores significant gaps in menopause management, particularly in areas related to sleep, cognition, and symptom management for women with complex health conditions. MAPS researchers collaborate with funding organizations as the research progresses to shape the top ten priorities into actionable research questions. This work aims to address the unmet needs surrounding menopause care and inform the development of evidence-based strategies to improve health and quality of life for women undergoing the menopause transition.
Link to the article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02602-3/fulltext
References Nash, Z., Christmas, M., Gronlund, T., Hickey, M., Burgin, J., Carpenter, J., Nakawala, K., Daniels, J., Dixon, S., El Khoudary, S., Fisher, A., Garlick, D., Giblin, K., Hardy, C., Hillman, S., Joffe, H., Kingsberg, S., Kuypers, N., Mishra, G., … Rother, V. (2024). Top ten menopause research priorities. The Lancet, 404(10471), 2535–2536. https://doi.org/10.1016/S0140-6736(24)02602-3
