Please find this letter about World Menopause Day from Manuel
Neves-e-Castro Lisbon, Portugal, an EMAS founder, past Vice-President and Honorary
Another “World Menopause Day” is coming soon! As a proponent of this event, I am
very glad to see that this has been ever since a successful celebration all over the
world! My intention was to update and activate Menopause Societies from congress
organizers into educational providers. This was successfully accomplished.
This celebration has been an excellent opportunity to deliver important messages to the
public and to many doctors, since many of them are still reluctant to accept that
hormonal treatments, when indicated, are very important tools to improve quality of life
and for the prevention of many diseases.
Our targets must be the physicians and the women themselves. You must help them
and show them the good results. We are not proposing hormonal treatments primarily
for preventive purposes, as it has been repeatedly stated by practice guidelines.
Keep in mind that the WHI results were obtained with steroids not used everywhere
(conjugated equine estrogens and MPA). For example, natural progesterone and
dydrogesterone are friendly to the breast, as opposed to MPA. Estradiol by the
parenteral route is to be preferable, avoiding a metabolizing first- pass effect by the liver
and delivering pure estradiol in circulation.
Please do not think about hormones as the only tools to help a climacteric woman. Our
duty is to prevent the diseases that are more common and to improve their quality of
life. Our first strategy must be the practice of the Medicine of the Quality of Life. This is
based on the tripod Mental Health + Mediterranean diet + Physical exercise.
Remember that to be helpful and successful you must be an empathic human being (to
listen and to support those women), a knowledgeable physician (to be able to interpret
ALL their symptoms and signs) and a competent specialist (to be up to date with the
As you all know, and have already felt, it is very rewarding for us to watch what we can
accomplish when we help a woman to regain a good quality of life.
One of the pioneers in this field, my good and late friend Prof. Robert B. Greenblat,
once said that “A woman in the autumn of her life deserves an Indian summer rather
than a winter of discontent”.