Getting women to talk about menopause has not been easy. “Shameful”, “embarrassing”, “important topic, but I don’t want to face menopause”. These are some of the answers news has received after asking several women in their 40s and 50s if they would like to be interviewed about menopause. But two ladies do not think this is either embarrassing or shameful. The undersigned’s own cousins, the sisters Lise Opgård Tonning (59) and Ingeborg Opgård Hågensen (49). – I feel great, laughs Ingeborg. But it has not always been this way. Ingeborg Opgård Hågensen got her energy back with estrogen treatment. She takes local estrogen via hormonal patch. Photo: Hanne Larsen / news 38 years old and in menopause Both she and her older sister have experienced what it means to reach early menopause and not understand the burden. Menopause normally occurs somewhere between the ages of 40 and 60. Lise got the first symptoms already when she was 38 years old. – At first I didn’t understand anything. My mood was unstable, I was cranky and could start crying for nothing. In addition, I sweated profusely and lost sleep at night, she says. The 59-year-old is originally from Alta, but has lived all his adult life in Sandnes in Rogaland. She has a husband and four adult children. While the children were still in their teenage years, she had the first problems. – I thought of my colleagues who had talked about menopause, but at the same time I was so young. I didn’t realize it could be, she says. Lise Opgård Tonning thought she was ill before she realized that it was menopause that was bothering her. Photo: Hanne Larsen / news When women enter menopause, the production of the female hormone estrogen plummets. This leads to the cessation of menstruation, and one can experience symptoms such as hot flashes, insomnia, reduced sex drive, dry skin, dry mucous membranes, abdominal pain, stiff joints and emotional changes. For Lise, the years leading up to the age of 40 were an emotional and physical nightmare. She did not recognize herself and made countless trips to the doctor. She couldn’t google either, as this was before internet use exploded. Finally, blood samples were taken to check whether it could actually be menopause that had occurred. And that was that. – The doctor was very clear that then it was just a matter of continuing with hormone treatment, i.e. estrogen tablets, says Lise. Lise Opgård Tonning entered menopause already in her late 30s. Today, the 59-year-old lives a good and vigorous life. Photo: Privat She found that to be a lucky pill. – For me, getting my sleep back was the most important thing. For several years I had walked around like a zombie because I slept so little. Now I got my life back. It was like night and day, she says. – Without oestrogen, I would have become a grumpy old woman that no one could like, little sister Ingeborg chimes in. Estrogen treatment Estrogens are a general term for substances that act like female sex hormones. The purpose of hormone therapy is to replace the falling estrogen level in the body. The most common treatment is a combination of estrogen and progesterone. Hormone treatment has a good effect on complaints during menopause, such as hot flashes, sleep difficulties and abdominal complaints. Estrogen treatment also reduces the risk of osteoporosis. Due to the risk of serious side effects, this medicine is not prescribed for long-term use. Source: Health Norway and Store norske lexikon. The 49-year-old also entered menopause relatively early. At the start of her forties, she noticed that her body was in a bad state: hot flushes, pain in muscles and joints, as well as insomnia. Today she takes a hormone patch, which should produce fewer side effects than estrogen tablets. Ingeborg has scoured the web in search of information. In meetings with various doctors, she has been well prepared. – I often feel that I know more about the topic than many doctors. When I say that such and such is the case, it has happened that they have to go out with the doctor’s book and check whether it is correct, says Ingeborg. She believes that a woman should not leave it up to the doctor to decide whether or not to give estrogen. – I think that you decide over your own body. I have told many people that they must not give up if they are denied estrogen. Because I know that many will be, she says. Horror reports about estrogen Gynecologist Jorun Thørring has together with copywriter Marit Rein written a book about the menopause. She confirms that many doctors are reluctant to prescribe estrogen. Gynecologist Jorun Thørring and copywriter Marit Rein use humor and their own experiences to talk about a difficult topic. Photo: André Bendixen / news She refers to research in the early 2000s from the USA, which also hit Norway like a bomb. – I remember well Dagbladet’s front page that day. There were three lines that ran across the entire front page: “Breast cancer”, “blood clot” and “stroke”. The Women’s Health Initiative was a large American study initiated by the National Institute of Health in 1991, in which 27,000 women participated. The study showed that the use of estrogen could lead to serious diseases. As a result, sales of estrogen plummeted. – It stuck like a nail. In a few days, sales plummeted, and they are still there – 20 years later. Figures from the Norwegian Institute of Public Health show that the sale of medicines for hormone therapy in Norway fell by 67 per cent from 2001 to 2021. In 2001, 3.9 per cent of the population used such preparations, compared to 1.3 per cent in 2021. Thørring has in his work had hundreds of women visit the office who know little about the problems that can occur during menopause. Many therefore become anxious and unsure of what is wrong with them. Many of them have been to their GP, and they have searched online for answers. – They have not been guided in the topic. They have been misled, claims Thørring. She in no way wants to talk down the doctors in Norway, who she believes are mostly fantastic. But when it comes to knowledge about menopause, she believes that not everyone is as up-to-date. – It completely depends on who you meet. I was called by a woman who had been to the doctor and asked for estrogen. She was told that she could not. It could lead to both cancer and blood clots, says Thørring. “Your mother had to put up with it” Ole-Erik Iversen is a professor at the Department of Clinical Medicine at the University of Bergen. He has been researching women’s health for 35 years. He believes that far too many doctors are unnecessarily restrictive in prescribing estrogen. – The figure for how many people receive estrogen is still unreasonably low. This means that thousands of women are walking around with problems that could easily have been solved, says Iversen. Together with other researchers, Iversen has written several articles in which they show that the picture is more nuanced. He admits that the risk of breast cancer increases somewhat after more than five years of use, but that this is balanced by the fact that the risk of colon cancer is reduced. – And it is a far more dangerous disease, he says. Iversen refers to several follow-up studies which support that estrogen in sum is not dangerous for the right group of women. For example, a Danish study from 2012. The same research institute that launched the big shock rapport in its time has also come up with follow-up research. – A new study with 18 years of follow-up of the Women’s Health Initiative study showed no increase in total mortality, says Iversen. – Why are sales of estrogen still so low, 20 years after the negative reports? – Providing information on more complex connections takes time. For those doctors who occasionally meet the women, it will be safest to report passports and not spend a lot of time explaining the advantages and disadvantages, he says. Ole-Erik Iversen is a professor at the University of Bergen. He believes it is time to dispel the myth of estrogen being dangerous. Photo: Haukeland University Hospital He refers to the statement women are met with: “It is safest that you refrain, your mother and grandmother had to.” “Women have always had to endure this.” – But they shouldn’t have to put up with this. I have met women who feel they have been robbed of large parts of their lives, because doctors have refused them oestrogen, he says. When it comes to the use of estrogen, Iversen says that there are many benefits that are little known. Like estrogen can prevent dementia and help with osteoporosis. – Marked by the headlines Marianne Natvik is a specialist in general medicine and a researcher on menopause at the University of Oslo. She also has the impression that doctors have been – and that some may still be – skeptical about prescribing hormone therapy for women in menopause. She also refers to the studies from the USA, which were hugely popular when they arrived over 20 years ago. – The headlines were big, and they influenced us. The women stopped the treatment, and the doctors became restrictive in writing prescriptions. It takes time to reverse such a trend, says Natvik. Marianne Natvik is a specialist in general medicine and researches menopause at the University of Oslo. Photo: Truls Alnes Antonsen / news Having said that, she believes that the doctors are updating themselves, getting better and want to help women with problems during menopause. She points out that the research after the major studies around the year 2000 gives a more nuanced picture. – When the right women are given an individual assessment, the risk is small. The benefit of the treatment will always be weighed against the risk. Today, there are various types of preparations that enable more women to get help, she says. No illness At the same time, she is clear that menopause should not be made sick. But: – Even if it is not a disease, women can have symptoms that make them feel sick. We must take this seriously, says Natvik. However, she does not agree that hormone treatment should be uncritically spread to everyone. – Not everyone should have it, and some people cannot get it for various reasons, says Natvik. She still believes it is important that women should be able to talk to their GP about what they experience during menopause. – There will then be a conversation about what is what: What is about hormonal changes during menopause, and what is connected to other parts of life. Hormone treatment helps many, but does not solve all health challenges, she says. Will live long afterwards Marit Rein believes it is important that women get to know as much as possible. – After all, we will live perhaps 30-40 years after menopause has occurred. Then it is important that those years are as good as possible, she says. – One should not accept that the ailments go beyond the quality of life, adds Jorun Thørring. The ladies want to defuse the topic of menopause and have therefore invited several transition parties, which have been held in pubs, bars, cafes, libraries and community centres. At the first transition party in Tromsø, the duo talk about the barracks. – And the questions after the lecture were so many. It says something about the interest in knowing more about menopause, says Rein. Marit Rein and Jorun Thørring have written a book about the menopause and travel around to inform women about the topic. Photo: André Bendixen / news In the book “Kvinnfolk” Rein talks about her encounter with menopause, which came when she turned 50. Just as with Lise Opgård Tonning, Rein also thought she was seriously ill. – I went through a number of investigations, says the 60-year-old. When the doctor concluded that it could be menopause that was bothering her, estrogen was suggested. Rein was not unaffected by the scare reports about estrogen that came in the early 2000s. – You get scared, she says. Rein chose to seek more knowledge about the topic and quickly found that the research was more nuanced than one first got the impression. She therefore took the chance and has not regretted it. Happy husband At home on Ingeborg Opgård Hågensen’s sofa, there are jokes about life in menopause. The sisters have just been out for a walk and fell on the ice on the side of the mountain. – Then we were happy that we are taking oestrogen. Otherwise we might have broken a leg, says Lise. – How do your men notice that you are on estrogen? – My husband was probably very relieved. He probably thought it was very tiring with my crying spells and mood swings, says Lise. Sisters Lise and Ingeborg openly share experiences with each other when they meet. Photo: Hanne Larsen / news – Some may not want to talk about the fact that they are in menopause, because they want to be young and pretty all their lives. But that’s why estrogen is so good. Then you become young and pretty, laughs Ingeborg. Although she praises the help the hormones have given her, she is clear that one must not have too high expectations. – There is no magic cure. I can still have hot flashes at night, but without estrogen I would probably have them around the clock, she says.
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Doctors are still reluctant to give estrogen to women in menopause – news Troms and Finnmark
