"The secret sign of ageing" – international disease-mongering

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Just five days ago we wrote about an American journalist’s observations of medicalization of one problem sometimes observed after menopause – vaginal atrophy.

Today, we see that this disease-mongering trend has popped up in Australia as well. This should be no surprise. Such campaigns are usually led by multinational pharmaceutical companies and their advertising and public relations agencies.

What caught our eye was an article on a women’s health foundation website – a foundation that posts a pretty thin excuse for why it won’t tell you its source of funding.

Its article on vaginal atrophy uses classic disease-mongering language:

“Ask a woman over the age of 50 about the ‘signs of ageing’ and she’ll most likely lament about grey hairs, wrinkles and certain body parts having lost their youthful perkiness. What she probably won’t mention is that is that things are ageing “downstairs” too; up to 40% of postmenopausal women show signs of vaginal atrophy.”

The silent epidemic that no one talks about.

The huge prevalence estimate – where does that 40% figure come from?

Oh, and it can lead to greater problems:

“There is a greater risk of infection due to the increased chance of tears or bleeding with intercourse. Untreated vaginal atrophy can lead to long-term urogenital problems, such as incontinence.”

How much greater risk of infection and how often long-term problems occur – we’re not told. Women may infer that it happens to everyone with vaginal atrophy.

The article concludes with more classic marketing language:

• It’s still a taboo topic.
• There’s no need to suffer in silence.
• Women are encouraged to see their health care professional.

And, of course, there’s a prescription drug waiting at the end of the rainbow.

If that rainbow hasn’t touched down in your country yet, it will.

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Comments (12)

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Eve Glicksman

October 25, 2010 at 9:36 am

Love reading your blog and I agree with you almost always. This time, though…
I wrote a piece on this topic myself (below) – using reliable sources as listed at the end – and determined that vaginal dryness is indeed a common problem that many women don’t realize can be addressed. I read the offending piece you cited and didn’t pick up any particular pitch for drugs or see such an ad on the page. And what’s wrong with encouraging a woman to ask her doctor if she experiences painful intercourse? Ok, there is no attribution for the 40 percent or details about the infection risk, but the info doesn’t sound far off to me. I have seen stats about STD risks increasing because of thinner vaginal tissue after menopause.

Liz Scherer

October 25, 2010 at 10:07 am

Clearly, the author of the piece picked up on the International Medical Society’s ‘End the Silent Suffering’ Campaign, which was launched on National Menopause Day. See: http://www.imsociety.org/world_menopause_month.php?SESSID=3tl1h0eciroj8gf029ira3gpt7
The 40% statistic is intriguing. In the published IMS recommendations (early online edition of Climacteric), the lead authors say that vaginal atrophy affects anywhere from 20% to 50%. On the other hand, the 25% seeking treatment figure cited in the Australian article is a direct lift from the published recommendations (but differs from the PR fact sheet).
Notably, the IMS recommendations, the summary of the PR 10-minute phone survey (which is used to justify the “silent suffering of women global epidemic” and the Australian site miss one critical point: no distinction is made between mild versus severe vaginal atrophy, both in terms of incidence and treatment strategy. Rather, all appear to support first-line use of estrogen therapy.
Vaginal atrophy is a real (and sometimes severe) problem…for some menopausal women. For others, it’s an annoyance that can be effectively managed with over-the-counter lubricants and moisturizers.
This campaign is fear-mongering and disease-mongering at it’s finest. Unfortunately, I suspect that we’ve not seen the end of it…yet.

Liz Scherer

October 25, 2010 at 10:22 am

Eve – I commend you on your piece, which is a general, well-balanced, consumer overview of vaginal atrophy. However, your comment demonstrates that you are missing the larger point, which is that like the North American Menopause Society (and its pro-HRT stance – see its recent comments on the latest WHI study reports), the International Menopause Society continues to act irresponsibly in promoting the medicalization of menopause. The ‘End the Silent Suffering’ Campaign was sponsored by Novo Nordisk, the manufacturer of Activella,a local estrogen agent for treatment of vaginal atrophy. If you read the IMS recommendations, you will discover that the step-wise treatment of vaginal atrophy is just about entirely ignored, lubricants and moisturizers are deemed ineffective and unsafe (i.e. irritating), local estrogen is touted as safe, and other important environmental and psychosocial factors that affect sexual desire are ignored.

Eve Glicksman

October 25, 2010 at 10:52 am

Agreed: “End the Silent Suffering” campaign is way over the top. And any first-line advocacy of drugs to treat this condition is foul. But the article that was flagged here and the subject in general needs to be aired – if only to educate women that there are other solutions and that medication usually isn’t necessary.
I think it’s a positive trend that women’s sexual enjoyment is a public concern at all after so many decades of it being a non-issue or laden with stigma.
The issue here is about discussing the subject responsibly. Slam the campaign itself, but the article here – while not praiseworthy -doesn’t warrant that kind of villification.

Eve Glicksman

October 25, 2010 at 2:35 pm

We’re on the same page regarding the sleaziness of the International Menopause Society. But the author here doesn’t hide the fact that this is a PR piece – interview request at the end. Nor does the author refer to the problem as an epidemic or push meds. Plus, the source of the recommendation – dubious as it is – is included for anyone.
My point is really to save the darts for the real scoundrels. This article didn’t strike me as disease-mongering on its own, much less did it pretend to be more than a press release/reader beware. Nonprofits are as guilty of having an agenda as any corporation. But please continue to nail the IMS – the true culprit – all you want! Thanks to you and Gary for keeping us on our toes.

Gary Schwitzer

October 25, 2010 at 2:55 pm

I appreciate the healthy exchange of perspectives.
I will always write about what I see as even subtle unquestioning disease-mongering, which is why I chose to write about this Australian website.
We can disagree about the extent of the potential harm, but it’s a slippery slope.
Thanks for your comments.