Non-hormone treatments, beneficial lifestyle changes and the effects of perimenopause and menopause on sleep and cognition are some of the top research priorities established by the Menopause Priority Setting Partnership (MAPS), an initiative led by the University of Chicago Medicine and global partners that aims to establish shared priorities in menopause research.
The finalized ten priorities were determined at the 19th World Congress on Menopause in Australia and published in a Dec. 21 in The Lancet. An international steering committee of clinicians, researchers and menopause advocacy group representatives based the list on data from two international surveys administered by MAPS.
"A process like this is really gratifying because you get a better understanding of what is important globally, not just here in Chicago or the United States," said , director of UChicago Medicine’s menopause program and the Center for Women's Integrated Health.
Menopause is a natural stage of life caused by decreased estrogen production in the ovaries. It starts one year after the last period and for many is associated with hot flashes, sleep problems and cognitive impairment.
A first-of-kind effort, the MAPS global survey identified unanswered menopause research questions from those with lived experience of menopause and the clinicians who care for them. UChicago Medicine is the only institution in the U.S. participating in and funding the study, along with the in Australia and the in the U.K.
Participants in the MAPS surveys were prompted on their three top concerns or questions about menopause. They were asked to provide demographic information as well. The first survey launched in October 2023 yielded 1,698 responses from 593 people across 42 countries. A second survey, which included 64 questions carried over from the first survey, produced 2,125 responses from 42 countries and resulted in a shortlist of 26 questions.
Christmas said safe and effective non-hormone treatments (such as prescribed medicines, herbal remedies and complementary therapies) garnered the most interest from respondents, despite recent renewed interest in hormone therapy (HT).
HT was popular in the 1990s, until a long-term study published in 2002 linked menopausal women taking estrogen and progestin with a slight increase in stroke, heart attack and breast cancer. Since then, numerous studies have questioned those early findings, highlighting both the risks and rewards of the approach and the importance of considering factors like a patient's preexisting conditions, age and how the therapy is administered.
"What came out very clear and strong from this research was that people want a better understanding of what they can do to improve their overall health and quality of life through the menopause transition and beyond," said Christmas. "This is a pivotal time for midlife women’s health. MAPS highlights significant gaps in menopause management specifically when it comes to sleep, cognition and management of symptoms in those with medical complexity."
MAPS steering committee member Karen Nakawala, a cervical cancer survivor whose awareness campaign and Teal Sisters Facebook group has helped increase cervical cancer screenings in Zambia, hopes the initiative helps address the many needs surrounding menopause.
"We need to have resources available for women and health support to help manage symptoms and effects," said Nakawala. "We need to improve on education and awareness through public campaigns which will encourage women to freely speak up and share experiences, more friendly workplace policies which can include mental health support and advocacy to raise awareness about the importance of menopause care and reduce stigma."
MAPS researchers are now working on shaping the top ten priorities into research questions and are engaging with funding organizations to lead research to answer the questions.
Their work is supported by the , a non-profit organization based in the United Kingdom that helps research and prioritize health conditions based on the lived experiences of patients and their healthcare providers.
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