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Menopause Doesn't Have to Mean Suffering
Suddenly - and finally! - menopause is getting a lot of needed attention
Just when you think that women are left without options, it happens…
People start noticing that menopause is here to stay.
Yes, that’s right, people! As long as women get older, there will be that thing called menopause!
More than one million women in the U.S. pass through menopause each year. One million. And because of longer lifespans, we spend up to one-third of our lives in this phase.
But must a normal, natural phenomenon be a reason to suffer silently and needlessly?
What I mean is this: An attitude that makes us think we have to grin and bear it. Let it pass. Deal with it. Stop bitching and moaning. Start ignoring it. Just get on with it and live our collective life.
And yet. Those hot flashes, mood swings, joint pain, vaginal dryness, insomnia, heart palpitations - and 30-something other symptoms - are real. Not in our heads, not in our wild imaginations…but actually taking place in our (changing) menopausal bodies.
Lately (thank goodness) there’s been a lot of progress toward helping women deal with symptoms of menopause - real progress.
For instance, more and more experts are now in favor of hormone replacement therapy (HRT). What, you heard this was dangerous? There’s a reason why HRT went from being the go-to to being the steer-clear treatment for menopause symptoms.
To make a very long story short, hormone therapy was a very popular treatment for menopause until the Women’s Health Initiative (WHI) in the 1990s, a study that ultimately showed hormones to be more detrimental than helpful.
Once the study results were publicized, women and their prescribing doctors panicked and hormone use plummeted. Many women would not go near hormones, and many practitioners wouldn’t prescribe them.
As more and more women abandoned hormones - and continued to suffer - the study was more closely scrutinized. And it was eventually determined that the study was severely flawed, in many ways. (For instance, the 15-year study was done on post-menopausal women between 50-79.)
Here’s what the North American Menopause Society (NAMS) says about the benefits of hormone therapy, whose primary indications are for hot flashes, night sweats, vaginal dryness, and prevention of osteoporosis:
Literally hundreds of clinical studies have provided evidence that systemic HT (estrogen with or without progestogen) effectively helps such conditions as hot flashes, vaginal dryness, night sweats, and bone loss. These benefits can lead to improved sleep, sexual relations, and quality of life.
I reached out to Stephanie Faubion, M.D., MBA, the medical director of NAMS, to get clarification on the most up-to-date guidelines, which have recently changed. (I know, all the changes can give you whiplash…) Here’s what she said:
“While we always give the lowest dose needed to manage symptoms, we no longer emphasize taking the lowest dose for the shortest amount of time. Instead, we focus on using the appropriate dose and duration of therapy to adequately manage symptoms or to meet treatment goals.”
So, how long can women remain on HRT? Dr. Faubion explains:
“The duration of therapy depends on an individualized assessment of risks and benefits. Typically, benefits outweigh risks for symptomatic women without contraindications who are under age 60 and within 10 years of menopause onset. We typically try to wean women off by the age of 60 at least once. If they have bothersome recurrent symptoms or just feel better on hormone therapy, it can be continued longer-term after a discussion of potential risks/benefits. We also try to use the transdermal route of administration and wean down to the lowest dose (if possible) if therapy is continued longer-term.
If you don’t already have a healthcare provider who is in touch with the real symptoms of menopause, please find one who will listen and offer you solutions.
Because you matter, and so do your symptoms.
And - news flash! (#pun) - for those of you who cannot - or choose not to - take hormone therapy, there’s some good news to treat hot flashes: A new non-hormonal drug, Veozah, is coming soon to a pharmacy near you. Here’s some info about the drug and here’s a comprehensive article in The New York Times that will tell you more.
In the did-you-know-but-would-rather-not-know department, a small-but-not-insignificant fact: Hot flashes can stay with some women for up to 10 years after your last menstrual period. (Sorry.)
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For a Pause:
What would men do if they got hot flashes? (Warning: Make sure your bladder isn’t full when you watch; you might laugh a lot!)
A French physician coined the term “menopause” in 1821.
Because menopause was looked upon as a “deficiency disease,” various therapies to replace lost estrogen were advocated, including testicular juice, and crushed ovaries of animals. (I’m not making this up!)
Here’s a past article in this newsletter about soy and hot flashes. Can it - does it - help?
One More Thing…
She makes it all sound so good…
UPDATED 5/23/23: THIS POST HAS BEEN UPDATED TO REFLECT THE LATEST NAMS GUIDELINES BASED ON MY CONVERSATION WITH STEPHANIE FAUBION, M.D., MBA.