"Women hold up half the sky"
Menopause brings changes. To help women stay balanced during this time and remain calm and focused in their daily lives and at work, bestselling author and medical doctor Sheila de Liz debunks myths in her book *Woman on Fire*. We had the opportunity to speak with her.

m&k: Dr. Sheila de Liz, your bestselling book *Women on Fire* has sparked a tsunami. Women feel heard and understood. When did you realize that this book was needed?
Sheila de Liz: It all started years ago when I realized that women were suffering greatly from the effects of menopause, which were caused by a lack of hormones.
But there have always been gynecologists—both male and female—who should be medically trained to do this.
Both the medical community and society at large have long overlooked the issue of hormone deficiency during menopause. To me, this was comparable to dentistry in the 19th century. I felt a growing need to shed light on the broad field of menopause in all its facets.
«The business and political worlds must recognize that when women leave the workforce during menopause, a great deal of quality is lost as well.»
What has your experience been like with the people around you since you wrote the book?
Every woman approaches me about it, opens up right away, and messages me privately. There’s an enormous need among women, and few places for them to turn. My colleagues have had mixed reactions to the topic: Many are grateful that someone has taken this «educational work» off their hands. And this is also true for the now empowered and informed patients who come on their own and tell us what symptoms they’re experiencing and what they want to do to relieve them. Of course, there are also colleagues who aren’t thrilled.

What arguments do these colleagues use when they approach you?
They would feel that their work was being interfered with because they have their own approach to dealing with women going through menopause.
Menopause has long been a taboo subject. Why has this topic been neglected for so long?
Out of misplaced shame and outdated notions about women and their worth once their childbearing years are over. Terms like «old iron» and «empty nest syndrome» are common prejudices in this context.
These are societal prejudices, but why has the medical community avoided the topic of women's health during menopause for so long?
The field wasn't very interesting, since with this kind of «assembly-line medicine,» very few doctors even have the time to address the issue.
«In principle, hormone deficiency in women affects all organs—from the hair follicles all the way down to the soles of the feet.»
What are the most common misconceptions about hormone therapy?
Many people still believe that hormone therapy causes cancer, leads to blood clots, high blood pressure, or strokes. Many also believe that hormones cause weight gain.
What arguments do you use to dispel these prejudices?
We simply replace the missing hormones and bring hormone levels to a level that is healthy for the body and its organs.
Why is taking hormones so controversial?
The problem is that the media have managed to convince women that they should be afraid of substances their bodies produce naturally. That was—and still is—a mistake. Modern hormone therapy uses only molecularly identical substances, so the body cannot tell whether the hormone comes from its own ovaries or from the pharmacy. Given the overwhelming benefits women experience when undergoing hormone replacement therapy, one must now ask whether it isn’t actually more dangerous to take nothing at all, since all organs suffer as a result in the medium and long term.
You run an online practice. Could you explain how it works?
Patients first schedule a detailed 50-minute introductory consultation via Zoom and then receive a personalized plan. If necessary, this may include prescriptions for HRT. A follow-up appointment is scheduled after 6–8 weeks, and additional appointments can be arranged as needed.
Almost every woman goes for a gynecological exam on a regular basis, doesn't she? Shouldn't that be a topic of discussion there?
The challenge often lies in time constraints. It takes patience and a lot of time to adjust HRT for patients. Every woman is different.

Based on your book, is public awareness of menopause now where you want it to be, or is there still room for improvement?
There is clearly much more room for improvement. Menopause affects all medical specialties. Therefore, gynecologists cannot shoulder this burden alone. In principle, all medical specialties should be familiar with menopause because it affects all organs. For example, orthopedists, dentists, ophthalmologists, neurologists, psychiatrists, and cardiologists should also be very familiar with the symptoms of menopause, because many patients of this typical age come to their offices. They present with specific symptoms linked to hormonal deficiency. And it doesn’t stop with these specialties: in principle, hormonal deficiency in women affects every organ, from the hair roots all the way down to the soles of the feet. There are so many menopausal symptoms. It’s believed there are around 136 different ones. These can include quite unusual things, such as difficulty swallowing and digestive problems. Skin rashes and pain in the soles of the feet. So it’s by no means just hot flashes and sleep disturbances. That’s why treating women going through menopause is a collaborative effort.
In your opinion, what does it take for this issue to make it onto the business agenda?
The business and political worlds must recognize that when women drop out of the workforce due to sleep deprivation, depression, lack of energy, and chronic muscle and bone pain, a great deal of highly qualified expertise is lost. As the saying goes, «Women hold up half the sky,» and that’s true: we women in midlife take care of the children, our jobs, the household, and our own parents. If these women aren’t at their best because of ailments that don’t have to be there, we have a problem. But if we support these women, everyone benefits.
Sheila de Liz, M.D., born in New Jersey in 1969, moved to Germany at the age of 15 and studied medicine in Mainz. She has been working at her own gynecology practice in Wiesbaden since 2006. She is a sought-after expert on all topics related to women’s health.

This article first appeared in the m&k print edition 11-12/2024.




























