Menopause—a neglected cause area?
Women are roughly half of the workforce and besides personal suffering, there’s also a huge impact on the work life of women. In addition, more research on consequences of menopause for the occurence of illnesses is needed to prevent deaths of women. E.g. due to menopause, there’s a suspicion that Alzheimer’s disease is supported (currently studdies are ongoing) and it leads to fractured bones that can cause death and many other diseases and potentially is a huge cost factor on healthcare systems that maybe could be reduced to early, proper treatment. Given the amount of people affected, we might have to rethink this cause area. Treatments are partially unevolved or untested for longterm consequences. Education of women all over the world is lacking. Medical stuff is not up to date to the newest findings and menopause treatment is lacking in medical curriculums.
Severity of symptomes is very individual, but I think society deeply underestimates how heavily stronger symptones effect the women and for which time span, since symptomes start in perimenopause and often last for more than 10 years, starting around age 40.
While well-known symptomes like heat waves where women don’t only face the shame factor, but also can be so overwhelmed by the body reactions that they can’t think one clear thought, I want to point out effects on the brain: Brain fog (severity level: you don’t find your words anymore, miss the name of your boss), motivation loss (severity level: you find it challenging to answer a whatsapp message and ask for the scence of existence), depression (severity level: crying half a day without even knowing why), anger (severity level: you explode about random small things like a public barbecue and cause a scene including calling the cops), heavy mood changes: (you turn from an overwhelming, funny mood into complete catastrophizing and vice versa), panic attacks, disturbed sleep (can be several hours per night)… Trying to navigate such heavy symptomes in a professional work environment is not easy at all and just to appear “normal” takes a lot of energy. Our societies are in no way prepared for that. As a result, we loose a lot of women’s workforce and brainpower.
Some examples:
One third of women in Switzerland either reduced their working hours, paused their job completely or quit their job in menopause according to Menosupport-Suisse-Studie.
Accorcing to an Oxford study, 65% of participants stated their work performance was negatively impacted.
According to a survey by Carrot Fertility among British and American Women, 80% of the 2000 interviewed women andressed difficulties managing menopausal symptomes while on the job. One third of participants feared negative aspects of their symptomes on their career progression.
The vast majority of women don’t get proper treatment for their symptomes and somehow try to navigate through them.
Divorce rates are highest inbetween age 40 to 60 to women (60%), therefore also impacting the productivity and well-being of men and ressources available for doing good.
If we just do the math only for the EA environment, this is already a huge impact of a loss of highly qualified individuals which results in an overall loss for doing good.
Besides all the personal suffering from women, wouldn’t it be a very beneficial thing to improve the situation for EA-women alone from the point of view of preserving more of their potential for the greater cause instead of leaving them busy with their symptomes?
I estimate that menopause in higher-income countries still isn’t sufficiently neglected to be worth allocating EA funds to. (it could well be worth the time of an EA community member using non-EA government health funding, though: I feel this way about a lot of higher-income countries health system improvement work). In lower-income countries I’d have to defer to GiveWell. Why don’t you look through GiveWell’s evaluations and see if there’s anything on it there?
In an EA community context, the average age of an EA is 28 so most community members haven’t hit the age range to experience menopause in themselves, a friend, or a partner. EAs also disproportionately look after themselves and are likely to seek menopause treatment if available. There is definitely something to be said for covering/raising awareness of menopause treatment for your workers if you are an EA org (again, I feel strongly that EA orgs need to do their bit to promote a healthy workplace environment, in a variety of areas). However, EA orgs are often very small, and I’d worry about individual people feeling singled out by any such initiatives.
I wouldn’t have written the post if the expected outcome of a woman going to her doctor with (peri)menopause syndroms is to get treatment.
The experience of many women also in higher-income countries is more like this:
Due to a lack of education, the woman doesn’t link her individual symptomes to menopause. Therefore she goes to her standard doctor.
Due to a lack of education, the standard doctor doesn’t link the symptomes to menopause and sends the woman to a specialist.
The specialist treats the symptome, but not the cause, or understands the link and there isn’t necessarily a good therapy existing due to a lack of studies and medical development.
The findings of a greek study point out the worldwide huge lacks in the healthcare system:
”Overall, training on menopause management is profoundly inadequate even nowadays. Menopause management requires theoretical education and clinical experience for the optimal management of menopause-related issues. Although menopause education is included in some medical and specialty training curricula, physicians are not adequately trained to provide the standard of care to women transitioning to menopause.” Link
Besides, only because EA women are younger nowadays doesn’t mean they will stay young forever.
Concerning Give Well—I didn’t find anything about that topic there. But on an earlier research, I already wondered what about period poverty, as many girls miss classes or completely stop to attend school because they don’t have any products to deal with their period and I couldn’t find a single reviewed program about that topic. So perhaps women’s health is a bit of a blind spot in general?
As I say, in higher-income countries it’s probably a great project for an EA community member to take on with non-EA government funding (which is far more freely available if you are sufficiently trained in public health).
For sanitary product handout in low-income countries, I note this study https://pubmed.ncbi.nlm.nih.gov/36185073/ which puts a number at $2300/DALY for menstrual cups. That’s great (it’s about 10x the cost-effectiveness bar the government of a higher-income country might use for its citizens), but it’s nowhere close to the EA funding bar which is about $80/DALY at the moment I think—about 50x as much.
EA money has a very high cost-effectiveness bar. Something not reaching it doesn’t mean that thing is not a good thing, it just means that we haven’t (yet) worked out how to get it cost-effective enough that we can save more lives by reallocting our grant pots towards it. If you can think of a way to deliver menopause education (or sanitary product handout) in a way that’s many times more cost-effective than the standard method, it might be worth doing some additional investigation?
NOVAH (domenstic violence prevention), Lafiyah Nigeria (contraceptive access), and FEM (contraceptive awareness) are the women-specific EA charities I know. There are also very good arguments that the Against Malaria Foundation has substantial benefit to women, as every child’s life saved is a mother who does not have to grieve.
For reference, @Kirsten also took a look into it several years ago—https://forum.effectivealtruism.org/posts/Kc4xQAu8R2qQnpzn8/khorton-s-shortform?commentId=epQcsE7PMNc4SENuT
As a heuristic, if a problem is suffered by wealthy people, then it’s not a good marginal use of resources.
Global poverty is an EA cause area because it’s cost-effective, because people in extreme poverty can’t buy the things they need even when they’re really important.
Factory-farmed animals are even less able to help themselves than people in extreme poverty.
I haven’t considered the issue for more than 60 seconds, but my gut impression is that there won’t be cost-effective menopause interventions because wealthy and powerful women also experience menopause, so if there are good ways to make menopause less harmful, then those ways will already be being pursued.
I take it you don’t support existential risk reduction then? After all, rich people will be killed along with everyone else.
Rich people are visibly not investing enough in existential risk reduction, so my heuristic fails in this case.
Another related heuristic is that people are more likely to invest in immediate problems that already affect them, and less likely to invest in future problems, especially speculative future problems. Menopause is the former and existential risk is the latter.