Finding The Right Menopause Treatments For Your Symptoms
THE EFFECTIVE TREATMENT OF MENOPAUSE
Women present to my clinic daily with stories of being discounted by their OB-GYNs or primary care practitioners. Many women’s primary providers (OB GYNs and family medicine) are failing women suffering through menopause - telling them “This is normal and it will pass” or offering them inadequate treatments like antidepressants. And so many women feel like they are losing control over their bodies and well-being.
As you may have read in Part 2 of this series on menopause, a Yale University study shows that only a minority of menopausal women are receiving the medical care they deserve. Because this lack of assistance is so commonplace - and the fact that menopausal symptoms can have such a significant impact on women’s lives - I feel women must understand the best ways to find effective treatment and advocate for themselves.
HORMONE REPLACEMENT THERAPY - A PROVEN TREATMENT TO ADDRESS MENOPAUSE & DISEASE PREVENTION
In his book, “How to Achieve Healthy Aging,” Neal Rouzier, MD references countless medical studies that confirm the critical role HRT plays in treating menopausal symptoms and preventing disease. Specifically, “We must not forget the dangers of menopause and the deleterious consequences of estrogen deficiency. Estrogen protects bone, heart, brain, blood vessels, urogenital tissue, teeth, and eyes. Observational data from around the world show estrogen has beneficial effects on mortality from all causes.” (Consultant 2001July; Vol. 71:1085-1086) Here are just a few pull-out quotes from studies discussing the impact of hormone replacement on chronic disease and aging:
”Estrogen reduces the incidence of Alzheimer’s disease by 50%.” (JAMA 2002; 288:2123-2129.)
“Long-term estrogen replacement therapy use is associated with lower mortality and confers this apparent protection primarily through a reduction in cardiovascular disease.” (Obstetrics & Gynecology: January 1996 - Volume 87 - Issue 1 - p 6-12)
“Estrogen decreases colorectal cancer. Estrogen decreases cataracts and macular degeneration. Estrogen prevents tooth loss and gingivitis. Estrogen prevents urogenital atrophy, painful intercourse, and stress incontinence.” (Biomedica Jan. 2000; Vol. 3(1):6-9)
“Bone density is rapidly lost when HRT is stopped. HRT should be continued indefinitely.” (JAMA 2002 August; Vol. 288 No.7:880-887)
“In the final analysis of the estrogen-only arm of the WHI, there was no increased risk of breast cancer or heart disease.” (J Gen Internal Medicine 2004; 19(7): 791-804)
FIND A PHYSICIAN WELL-VERSED IN TREATING MENOPAUSE
As we outlined in our previous post, many physicians are unfamiliar with the intricacies of how a woman’s body reacts to hormonal changes - many don’t have a clear understanding of safe and effective treatments for menopause symptoms. Find a doctor who is willing to listen and take your menopausal symptoms seriously, and who regularly considers HRT as a tool for appropriate patients.
UNDERSTANDING WHICH TREATMENT IS RIGHT FOR YOU
As outlined in our Women’s Health & Aging page, your personal goals, symptoms, obstacles, past medical history and family history all play a role in how your specific menopausal symptoms should be addressed.
Bioidentical Hormone Replacement Therapy For Menopausal Women - In our clinic, we prefer to use bioidentical estradiol and progesterone. I believe that DHEA and testosterone can also play a vital role in treating menopausal women and addressing age-related diseases. Depending on a woman’s symptoms and priorities, they may require supplementation with some or all of the following hormones: estradiol, progesterone, testosterone, and DHEA. A woman’s lifestyle, risk factors, and preferences can determine which delivery option is best for them: transdermal creams, oral hormones, patches, pellets, or vaginal rings. I have found BHRT to be highly effective at reducing my patients’ symptoms of menopause - and am especially thrilled to hear many women report feeling more vital and energized and having better sexual function than they have had in decades.
Testosterone Therapy - Androgen production steeply declines with age. Relative androgen deficiency can contribute to clinical manifestations such as vasomotor symptoms (hot flashes and night sweats), sexual function changes (vaginal dryness and low libido), a diminished sense of well-being, anxiety, depression, fatigue, bone or muscle loss, insomnia, and more. While similar to many symptoms women experience in menopause, in early or pre-menopause they may not be related to a loss of estradiol and instead may be, in part, a result of loss of testosterone. Testosterone is a highly overlooked tool for menopause and is not commonly considered for women, despite supporting medical evidence (for more information, refer to “Beneficial effects of testosterone therapy in women” or “Testosterone therapy in women: Myths and misconceptions”).
Testosterone is not an FDA-approved treatment for women and is considered off-label for menopause and female sexual dysfunction. So it’s important to have a thorough conversation concerning risks and benefits with your prescribing doctor. Testosterone is one of the first tools I reach for when treating peri-menopausal women suffering from issues such as hot flashes and night sweats. I have found that of all the hormones that can be replaced during menopause, testosterone therapy is one of the most “feel good” therapies - providing rapid improvement in a woman’s sense of well-being and menopause symptom relief. You can read about this highly effective treatment - we well as myths and misconceptions - in our blog post, “Let’s Talk About Sex Part 2: Testosterone and Women’s Sexual Health.”
I’D BE HAPPY TO TELL YOU MORE ABOUT OUR APPROACH TO TREATING MENOPAUSE, AS WELL AS ANSWER ANY QUESTIONS YOU HAVE. JUST GIVE THE OFFICE A CALL AT 425-970-8568.
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