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Review
. 2024 Mar 9;403(10430):947-957.
doi: 10.1016/S0140-6736(23)02799-X. Epub 2024 Mar 5.

An empowerment model for managing menopause

Affiliations
Review

An empowerment model for managing menopause

Martha Hickey et al. Lancet. .

Abstract

Menopause eventually happens to all people with typically functioning ovaries, and almost one billion women worldwide are postmenopausal. Although the biology of typical menopause is ubiquitous, the experience varies substantially. Factors contributing to the experience include not only individual factors, such as the nature and severity of symptoms, but also psychological, social, and contextual considerations, many of which are modifiable. In this first paper in the Lancet Series on menopause, we argue for a new approach that goes beyond the treatment of specific symptoms, to encompass a broad model to support women transitioning this life stage, using the model of empowerment. WHO defines empowerment as an active process of gaining knowledge, confidence, and self-determination to self-manage health and make informed decisions about care. Rather than focusing on menopause as an endocrine deficiency, we propose an empowerment model that recognises factors modifying the experience, in which the patient is an expert in their own condition and the health-care worker supports the patient to become an equal and active partner in managing their own care.

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Conflict of interest statement

Declaration of interests MH declares salary funding from the Australian National Health and Medical Research Council, support for meeting attendance from the UK National Institute for Health and Care Excellence, and the following roles: principal investigator for a clinical trial of salpingectomy vs salpingo-oophorectomy for prevention of ovarian cancer (TUBA-WISP II); board member for Breastscreen Victoria; editor for the Cochrane Collaboration; recipient of a fellowship from the Lundbeck Foundation (2022-23); site investigator for a clinical trial of a non-hormonal agent (Q-122) for vasomotor symptoms in patients with breast cancer (QUE Oncology, 2020-22); and site investigator for a clinical trial of a medical device for treating vaginal dryness (Madorra). AZL has grant funding for research on menopause from the National Institute on Aging of the National Institutes of Health in the USA. MSH has worked in collaboration with Rightsteps UK to develop CBT solutions for menopausal symptoms 2020–25 and is author of two books on CBT for menopausal symptoms with Melanie Smith. All other authors declare no conflicts of interest.

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