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Facing the taboo of menopause, a unique dedicated center
Faced with the taboo that still surrounds menopause today, a physiological phenomenon that affects all women, a unique center in Toulouse is fighting against the recurring lack of information. “Joint pain is a very classic symptom of the start of menopause. However, less than one in two women will spontaneously link this symptom to menopause.” The example given by Professor Florence Trémollières is striking and illustrates one of the main missions of the institution that this gynecologist and endocrinologist has directed since 2011: to provide information in order to help. “I have patients who come from Strasbourg, Lille, Brest, because they can’t find a doctor who is able to answer their questions,” sighs the director of the menopause center at Toulouse University Hospital, the only one of its kind entirely dedicated to the issue in France. In May, Emmanuel Macron had thought of her to lead a future parliamentary mission on menopause, a subject, he said in Elle magazine, about which “we realized that we knew very, very little.” The parliamentary mission project is now “at a standstill” due to political turbulence, according to a source close to the case, but patients continue to need help. – Battery of questions – Around the age of 50, women stop having their periods: their ovaries no longer produce hormones (estrogen and progesterone) and no longer release eggs at regular intervals. This is menopause, and coping with it can be an ordeal. The changing body, the impression of tipping into old age, all still surrounded by a certain taboo. Under tired neon lights, there are two of them waiting, this morning at 7:45, to be received by Christelle Moreau, the center’s nurse. Armed with a battery of questions, the latter first seeks to identify the patients to whom menopause poses an increased health risk. Because if it is a normal evolution of the female body, the phenomenon nonetheless brings its share of problems, the most well-known of which are hot flashes. More seriously, menopause increases the risk of pathologies such as cardiovascular diseases or osteoporosis, a reduction in bone density that increases their fragility. Hence the nurse’s insistence regarding possible fractures suffered by her patients. In front of her, Julie Bonjour is a textbook case: she has broken her ankles three times in barely five years. “Do you smoke?”, continues Mrs. Moreau. “Yes,” replies the patient, 46, director of studies at a high school in the suburbs of Toulouse, who confesses to “about fifteen cigarettes a day.” – Hormonal treatment – “It would be good to stop, because it has an impact on the bones,” continues the nurse. Since menopause is not an illness, there is no cure. But menopausal women can take hormone therapy to take over from the ovaries, especially when they stop working prematurely. This is the case for Kelly Garcia, now 43, but who was only 30 when chemotherapy caused “premature ovarian failure.” “Women are programmed to receive hormones until they are 50, so if you are menopausal before 40, it becomes an illness, and like any illness, it must be treated,” explains Ms. Trémollières, recalling that premature menopause can also increase the risk of heart attack and Alzheimer’s. The advantage of the menopause center is that after a blood test by the nurse, patients only have to cross the corridor in a well-oiled ballet to reach the bone densitometry room, the barbaric name for the examination aimed at determining bone density. A regular at the place, Kelly Garcia slips in and lies on her back while a robotic arm scans her lumbar spine (the lower part of the spine) and her femoral neck, which are very vulnerable to fractures. “Other cities are not so lucky” to have a menopause center. And, she worries, “some patients are left completely helpless when it comes to the symptoms they may have.”vgr/elr/as
