Hormones? Or Non-Hormones?
That is the question...but there are clear(ish) answers
Keeping up with menopause treatments can make you feel as if you’re sitting at a fast-paced tennis match between Serena and Naomi Osaka.
To make a long story short(er), estrogen replacement therapy was lauded “as the ultimate liberation of middle-aged women.” Until, that is, a long-term study frightened women - and their docs - away. Confusion, fear, and panic ensued as the media grabbed the story that hormones were dangerous. Overnight, pills were discarded by the majority of women who depended on them.
Many women were left to suffer the hot flashes and 30-something other documented symptoms of menopause and just wait them out.
But, as time passed, and researchers began to find fault with the study, they found many flaws in the way it was conducted.
And here we are today, back in the stands, but this time, enjoying a somewhat more evenly-matched game that is finally taking a sensible approach to our collective misery.
I’m happy for those who have the choice to get relief from their menopause symptoms like hot flashes and vaginal dryness with new recommendations that say they can take hormone therapy within 10 years of their last menstrual cycle for as long as they need to. It’s been written that Western women tend to view menopause negatively; perhaps now that people are paying attention, and we are getting the help we need, it won’t be viewed with the same pessimistic attitude as before.
What if you can’t take hormones?
There are some for whom hormone therapy is not recommended or those who may simply choose not to take it, like those who have had or have an estrogen-receptive tumor, or a high likelihood of blood clots. And there are also prominent medical groups who are still not on board with it (like the United States Preventative Task Force).
Remember this: It’s an individual decision, that has its benefits and risks for some.
Here’s what the North American Menopause Society has to say:
Consideration should be given to the woman's quality of life priorities as well as her personal risk factors such as age, time since menopause, and her risk of blood clots, heart disease, stroke, and breast cancer.
Other options do exist
If you fall into the I-choose-not-to-or-can’t-take hormones, it’s possible you’ve tried many approaches to manage your symptoms. (Personally, when I was waking multiple times a night soaked in sweat, I found bitching and moaning to be surprisingly effective…in getting my husband to sleep in the guest room.)
An advisory panel recently updated the North American Menopause Society’s 2015 position statement on non-hormone therapy for hot flashes, dividing the topics into five sections: lifestyle, mind-body techniques, prescription therapies, dietary supplements, and acupuncture, rating them for effectiveness and scientific evidence.
And…the winners were (I’ve included links to information on each):
Besides the treatments above, there are others, like yoga; weight loss; avoiding triggers like alcohol, caffeine and spicy or hot foods; and many more. Some women swear by any or all of these, yet the advisory panel was not as enthusiastic, using words and phrases like “limited evidence;” “mixed findings” and “unlikely to provide any benefit.”
I say: If sticking your head in the freezer (no one ever disproved THAT one…) helps relieve your hot flashes, more power to you. Same for putting an ice pack under your pillow, using paced respiration, or wearing this neck cooling tube or using a cooling towel.
For a Pause:
Did you know that reported menopause symptoms vary in different areas of the world? (Neither did I.) In Western societies, it’s hot flashes. In India, it’s low vision. In Japan, it’s shoulder pain.
Mary Jane Minkin, MD, has been my go-to source for the many, many menopause articles I’ve written over the years. She’s always helpful, informative and generous with her knowledge. And I love the name of her blog, Madame Ovary. Clever, no? Enjoy.
Is spotting normal during menopause? Here’s what I wrote for the women’s health & menopause website, Alloy.
And another one on the link between menopause-zzzz and insomnia.
Thanks for reading! If you have something, in particular you want to read about, please reach out by leaving a comment.
Until next time, stay well. Stay healthy. Stay safe.
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