The menopausal transition, also known as perimenopause, is a natural shift in every woman’s life. It refers to the changes preceding menopause (the final menstrual period) to one year after and is characterised by hormonal fluctuation, anovulatory cycles and onset of cycle irregularity and symptoms.
Every woman’s experience with this transition is highly personalised and symptoms can vary from mild interruptions to more severe impacts in their day-to-day life. It is worth noting, however, that only 20 per cent of women report no menopausal symptoms whatsoever.1
A 2021 multinational study found that less than half of women reported feeling “very well supported” during the menopause transition and that women who do not feel supported report more symptoms and a greater negative impact on their experience.2
Pharmacists can play an important role in helping the significant majority of women that do face symptoms to navigate through perimenopause and ensure they can confidently make informed health choices to stay in control of their symptoms.
More than hot flushes
Vasomotor symptoms (hot flushes and sweats) are the hallmarks of menopause, occurring in approximately 75 per cent of postmenopausal women, with 25 per cent of these being severely affected.1
While notable, hot flushes are not the sole issue that menopausal women must contend with. According to global, natural healthcare company SFI Health – Home of Flordis, menopausal women have a lot to think about, including changes to the vaginal microbiome, UTIs, insomnia, brain fog and memory loss, and elevated depressive symptoms.
“There are a multitude of potential symptoms,” said Simone Barrance, Science & Education Manager at SFI Health – Home of Flordis, “and while some women will not experience symptoms, many will. The pharmacist is in a unique position to help menopausal women understand their symptoms and the different treatment options available to help relieve them.”
Changing perceptions
While every woman’s experience with menopause is different, there has been a notable shift in perceptions and expectations of the experience. The next generation of women approaching menopausal transition is more likely to reject stigma and have higher expectations around healthcare and support than previous generations.
“In previous generations, women were expected to deal with it quietly, but today’s women expect information and treatment options,” said Dr Karen Magraith, President of the Australasian Menopause Society.
“Many of them are busy working and raising adolescent kids and caring for ageing parents and are expected to function at a very high level, despite debilitating symptoms.”
In the UK, research by the Menopause Experts Group found that employment tribunals involving menopause have increased by 44 per cent year on year3, highlighting women are expecting accommodations in the workplace.
Women are also seeking products that are high quality, sustainable and ‘stylish’ – just like themselves.
“Menopausal women are no longer treating their own health and natural processes as something to hide or be ashamed of,” Ms Barrance said.
“Ultimately, this next generation expects more and better service from health care professionals. However, we still need to do more to continue to change the conversation around menopause and help women understand the different treatment options that are available to them.”
Integrative support for menopausal women
A key role that pharmacists can play in supporting women through the menopausal transition is education around treatment options.
Actaea racemosa, also known as black cohosh, has been used for the relief of menopause symptoms for many years, providing an evidence-based option derived from nature for women going through this natural life stage.
Given the variance of quality and efficacy of black cohosh products available, it is important for pharmacists to seek standardised, clinically proven extracts produced with a careful focus on quality.
Ze 450 is a specific extract of black cohosh first authorised in Germany in 1998. It is also one of only three black cohosh extract types approved by the European Medicines Agency for review by the Committee on Herbal Medicine Products (HMPC).
Ze 450’s proposed mechanism of action is the modulation of serotonin, dopamine, GABA & Q-opioid brain receptor activity and signalling pathways in the brain. It’s also proposed to counteract inflammation and oxidation caused by oestrogen fluctuations.
SFI Health – Home of Flordis utilises the well-researched extract in two products to provide relief from multiple menopausal symptoms: Femular (Actaea racemosa [Ze 450] extract dry concentrate 6.5 mg equivalent to dry root and rhizome 42.25 mg) and Femular Forte (Actaea racemosa [Ze 450] extract dry concentrate 13 mg equivalent to dry root and rhizome 84.5 mg).
Being available in two doses means support for varying degrees of menopausal symptoms, from perimenopause through to post-menopause and both have undergone dose-dependent studies showing statistically significant improvements in menopausal symptoms.
Research has demonstrated that Femular can provide relief of multiple menopausal symptoms within weeks, and ongoing benefits increasing with use, especially at the three and nine-month marks.5
Role of pharmacists
Community pharmacies are increasingly becoming the first port of call for a myriad of health care needs and those that provide satisfactory support are likely to see customers return.
With most women experiencing menopause symptoms for five to 10 years6, pharmacists that ensure they can provide quality menopause education, support and suitable treatment options will be in a much stronger position to support them.
References
1 menopause.org.au/hp/information-sheets/what-is-menopause
3 menopauseexperts.com/tribunals-triple-in-less-than-2-years
4 nccih.nih.gov/health/black-cohosh
5 Drewe J, et al. The effect of a Cimicifuga racemosa extract Ze 450 in the treatment of climacteric complaints – an observational study. Phytomedicine. 2013;15 (20):659– 666.
6 menopause.org.au/images/factsheets/Menopause_What_are_the_symptoms.pdf
This article was originally published in the September issue of Retail Pharmacy magazine.
