The IMS President Rossella Nappi: “Stop Viewing Menopause As The End Of The World”

Menopause is a universal yet profoundly personal experience shaped by factors like family history, genetics, and lifestyle. In this exclusive in-depth interview, the newly appointed International Menopause Society‘s President, Rossella Nappi, Professor of Obstetrics and Gynecology at the University of Pavia, sheds light on many women’s physical and emotional challenges during this transformative phase of life. With the rise of innovative treatments like Fezolinetant, she explores how personalized medical solutions are changing the game, especially when it comes to managing symptoms like hot flashes.

But this conversation goes beyond medicine—it’s about reshaping the narrative around menopause. President Nappi speaks candidly about the need for societal acceptance, encouraging women to take control of their health, and emphasizes the crucial role of brain function in navigating menopausal changes.

With her focus on long-term well-being and the latest advances in personalized medicine, this feature highlights the importance of embracing this stage of life with confidence, knowledge, and the support of cutting-edge science.

Professor Nappi, you’ve described menopause as an “autobiographical event”. What do you mean by that?

Menopause is a deeply personal experience. It happens to each of us differently, influenced by our family history, genetics, and life experiences. It’s one thing to go through menopause at 40, another at 50 or 55. It differs if you’ve had children, undergone fertility treatments, or never had children at all. Whether you’re a career woman, a stay-at-home mom, or someone who commutes daily, it’s important to understand that menopause can be a positive phase of life. However, it may bring symptoms or health issues, which is why it’s crucial to discuss it with your doctor.

You mentioned the importance of personalized treatment, and today we have a new option that may help many women with symptoms like night sweats and hot flashes. Can you explain?

We don’t treat menopause itself; we treat its symptoms. Depending on what a woman experiences, we offer different therapies. The new treatment you mentioned, Fezolinetant, is a selective drug that targets the nervous system, though it’s not a psychotropic medication or hormone. It blocks the mechanism behind hot flashes. For a woman in her late 40s or early 50s entering menopause, taking a daily pill can significantly reduce the frequency and intensity of hot flashes within a week. This has a profound impact on quality of life, improving sleep, mood, and overall energy, allowing women to regain control of their lives.

You’ve talked about the delicate inner balance between control and acceptance. How can we change the narrative within ourselves, especially since society often shapes how we view menopause?

It’s absurd not to accept menopause—it’s a natural part of life. Menopause has a purpose. It protects us in the years to come because our bodies, at a certain point, should stop reproducing. This shift helps safeguard our health as we age. While some women today want children later in life, it’s essential to understand that maintaining a healthy lifestyle is crucial. We must avoid unhealthy habits and prevent age-related diseases for a long, healthy life. Menopause is a significant step in this journey, and I like to think of it as a portal to new dimensions we’ve yet to explore.

What should we expect from scientific research, as there are many developments underway?

Scientific research is making great strides in promoting healthy longevity. This involves not only personalized medicine but also substances that enhance cellular function, helping slow down the ageing process. We must prioritize lifestyle, nutrition, and a cutting-edge pharmacological approach. Fezolinetant, for instance, helps manage hot flashes, and we now have selective estrogen treatments for vaginal dryness and medications targeting osteoporosis, too. We must trust in research and keep moving forward—Italy is regaining a strong position in menopause research through rigorous clinical trials.

Dr Lisa Mosconi has highlighted how menopause affects the entire body, particularly the brain. Could you elaborate on this new understanding of menopause as a cerebral phenomenon, not just a hormonal imbalance?

Dr. Mosconi is an exceptional researcher, and she’s absolutely right. Menopause is a cerebral event. The brain’s central nervous system regulates instincts, emotions, and feelings, and the specific neuron responsible for hot flashes is located in the hypothalamus. The hypothalamus also governs many other functions, including sexual behaviour, hunger, and sleep. Menopause brings about a “Copernican revolution” in our being, and this transformation starts in the brain.

Professor Nappi, you’ve suggested it’s time to shift the narrative around menopause. How can we overcome the stigma around it?

As President Elect of the International Menopause Society, I believe this is the perfect moment for change. Menopause is a natural part of life, and it’s not about changing menopause itself. Rather, we need to focus on managing the symptoms and reducing the risk of chronic conditions that could affect our future well-being. It’s time to stop viewing menopause as the end of the world. It’s simply another phase in life—one that can be lived well, with happiness and longevity.

Prof. Rossella Nappi’s new book is out now: “Living well in menopause: Practical advice for facing changes with Serenity“