Dear RHM- March 2016

By: Red Hot Mamas

Published: March 10, 2016

Dear Red Hot Mamas,

We’ve come so far, so far, but there still exists a remaining deficit in how we traverse through menopause with little difficulty. It’s certainly not crystal clear for women, or for their clinicians.

First let me qualify that, for a great many of us menopause is not always a picnic in the park. Menopause brings on real and significant physiological and psychological symptoms. In fact, about 75% of women experience menopausal symptoms like hot flashes and night sweats. Common symptoms of menopause symptoms include having erratic periods; hot flashes, night sweats; fuzzy thinking; memory lapses; sleep problems; round the clock PMS like feelings; irritability; vaginal and urinary changes; sex drives that are locked in neutral, and weight gain, just to name a few. The array of symptoms can vary in severity from being somewhat annoying to totally interfering with women’s ability to enjoy their lives.

For many of us, riding out the storm of the hormonal upheavals at menopause can be a bewildering experience. When there is a decline in our ovarian function and our estrogen levels begin to plummet during our perimenopausal years, we oftentimes wander blindly without knowing what to do to manage our symptoms. And these symptoms may last for many years.

Women today feel hormonally challenged. We lack of information about options that are available to us to treat those symptoms. As a result, our symptoms are left untreated. Is there light at the end of the tunnel, where do we go from here? We certainly are not being presented with a treasure chest of options resulting in our feeling confused.

I would like to bring to your attention an academic article which just appeared in The New England Journal of Menopause entitled “Menopause Management – Getting Clinical Care Back on Track” by JoAnn Manson, M.D., Dr. P.H., and Andrew M. Kaunitz, M.D., N Engl J Med 2016; 374:803-806/March 3, 2016/DOI:10.1056/NEJMp1514242. This article provides a perspective of the current condition of the challenges faced in menopause management. I’d like to hear your input after reading this article. Here is the link and quotes from this article:

“By 2020, more than 50 million women in the US will be older than 51 years of age, the mean age when menopause occurs. During the late stages of the perimenopausal transition, almost ¾ of women report symptoms such as hot flashes or night sweats, and women with moderate-to-severe symptoms often experience them for a decade or longer.”

“Despite the availability of effective hormonal and nonhormonal treatments for menopausal symptoms, few women with these symptoms are evaluated or treated. Leading medical societies agree that hormone therapy is the most effective treatment currently available for these symptoms and should be recommended for women with moderate to severe hot flashes, in the absence of contraindications”. “For women with contraindications to hormone therapy, or a preference for nonhormonal approaches, several effective options are available, including low-dose paroxetine”.

“The use of hormone therapy has decreased by 80% among US women since the initial findings of the Women’s Health Initiative (WHI) were published in 2002. Women’s decisions regarding such therapy are now surrounded by anxiety and confusion. The WHI trial was designed to address the risks and benefits of long term use of hormone therapy for the prevention of chronic disease in postmenopausal women who were on average 63 years of age at initiation of therapy. But its results are now being used inappropriately in making decisions about treatment for women in their 40s and 50s who have distressing vasomotor symptoms. Not only has hormone-therapy prescribing obstetrician-gynecologists and internists or family physicians decreased substantially, but the new generation of medical graduates and primary care providers often lacks training and core competencies in management of menopausal symptoms and prescribing hormonal (or nonhormonal) treatments”.

In closing, it’s important for you to find your way through the maze of menopause. This can be done through knowledge. Gather information you read or hear about and discuss this information with your clinician. And find a clinician who is aware of and comfortable to talk to you about all aspects of menopause and menopause treatments. An outstanding resource for you to know about is The North American Menopause Society, They have a list of credentialed menopause specialists on their website. These clinicians have been certified and deal specifically on the health concerns of menopausal women.

And, lastly, keep the pressure on the medical community. Our voices need to be heard. Medical schools must address the concerns of menopausal women in their curricula and all clinicians need to be well trained in the intricacies of menopause. Let’s keep the pressure on these folks.

Good health to you all,

Karen Giblin