This article is from the magazine Les Dossiers de Sciences et Avenir n°220 dated January/March 2025.
Menopause, which is estimated to occur around the age of 51, is generally announced four years earlier by a series of symptoms, the most prominent of which are hot flashes and night sweats. Other, less well-known symptoms can appear and persist for around ten years: joint pain, mood and sleep disorders, decreased concentration and memory, genitourinary difficulties (cystitis, incontinence or vaginal dryness).
Approximately 85% of postmenopausal women experience at least one of these symptoms. The cause is a decrease in estradiol secretion (or hypoestrogenism), a sex hormone that interacts with all organs via specific receptors. This decrease is responsible for bone loss and a risk of fracture in 40% of women and increases the risk of cardiovascular disease (estrogens have a protective role in the arteries).
Hormonal treatments
"Every woman between 45 and 55 years old should benefit from a preventive consultation to assess her risk factors, says Brigitte Letombe, gynecologist. Menopause is certainly an event physiological, but we can support women." In the crosshairs are hormonal treatments, prescribed to only 6% of women in France. "The studies published in 2002 in the United States by the Women's Health Initiative, which we now know were poorly conducted, caused harm." , continues the doctor, who mentions the risks of breast cancer attributed to the American treatment.
Since then, studies carried out on the hormonal treatment used in France (estradiol and micronized progesterone) have only observed a slightly increased risk, after six years of treatment. "It is necessary to prescribe it more to improve the quality of life of the 25 % women who suffer from severe disorders" , adds Anne Gompel, gynecologist, professor emeritus at the University of Paris Cité.
For women for whom hormone therapy is not recommended (those who have had breast or endometrial cancer, for example), research is focusing on molecules that target neurons to lower body temperature. These drugs, which have been approved in the United States, could soon be approved in France.
By Riva Brinet-Spiesser
English 
French