After Liz Applegate underwent a hysterectomy about a year ago, she began to look into hormone therapy to relieve symptoms triggered by the surgery: mood fluctuations, a “foggy” feeling, sleep problems, low energy and low libido.
The first five doctors she consulted fell into two camps: those who pooh-poohed her symptoms or those who charged thousands for elaborate regimens that struck the 46-year-old as long on promises but short on solid science.
“It’s kind of scary to me, that that’s where this has been headed,” the Plano resident says.
Applegate’s experience isn’t unusual. It’s an unintended result of a landmark study that rocked the field of gynecology 10 years ago.
In 2002, results of the Women’s Health Initiative, the longest and largest trial of postmenopausal women using hormone therapy, linked estrogen and progesterone to increased risk for heart disease, breast cancer, stroke and blood clots. Since then, many doctors would “just say no” to hormone therapy. Others tried filling the gap with alternative — and sometimes unproven — treatments.
But evidence emerging since the study’s publication has shown that, when carefully prescribed, hormone therapy remains a good option for many women. Along with 14 other medical organizations, the North American Menopause Society issued a statement in July saying that hormone therapy is relatively safe for healthy, recently postmenopausal women (up to age 59 or within 10 years of menopause) who suffer from symptoms like hot flashes or vaginal dryness.
“We believe that too many women are missing out on the benefits of hormone therapy because of an overreaction to the results of the Women’s Health Initiative,” says Dr. Margery Gass, gynecologist and executive director of the menopause society.
No longer routine
The days of routinely prescribing long-term hormone therapy for women of a certain age are long over, says Dr. Julia Flowers, an OB-GYN at Baylor Regional Medical Center at Grapevine.
When it’s done correctly, she says, finding the right treatment for menopausal symptoms is akin to finding the right birth control. Expect to invest a little time and experimentation to tailor an approach that works best.
When a patient asks about menopause-related symptoms, Flowers starts by looking at her overall health. Other issues, such as low thyroid, can cause weight gain and fatigue, which women often chalk up to menopause.
In some cases, Flowers encourages patients to try an over-the-counter product, such as black cohosh, before she prescribes hormones. Exercise also can help relieve symptoms.
For those who do need hormone therapy, “I like to use the lowest dose for the shortest possible time,” she says. Women taking hormones should “know what medications you are on, why you are on it and how long you will be on it.” She likes to reassess every six to 12 months.
No miracle cure
Gass and Flowers agree: Hormones aren’t a miracle cure for the effects of aging.
“A lot of women feel that, if they don’t take estrogen, they’re going to age quickly,” Flowers says. “But a good diet and not smoking will have a much bigger effect on how you age in the long run.”
Both doctors encourage women considering hormone therapy to look for a physician who’s willing to listen and who is knowledgeable about menopause and hormone therapy.
Eventually, Applegate found a doctor who fit that bill, and she got some relief. But she’s still a bit frustrated.
“I’m from the generation that read What to Expect When You’re Expecting when I had my children,” she says. “But here we are now, and there’s no guidebook. There’s no What to Expect When You’re Going Through Menopause.”
Help is at hand
The North American Menopause Society is trying to fill that gap with a new guidebook for patients, available on its website, menopause.org. The site also offers an online summary of current thinking, “Hormone Therapy for Women in 2012,” as well as a “Find a Menopause Practitioner” link.
“We would like women to have information that’s based on science, and not wishful thinking,” Gass says.
Mary Jacobs is a Plano freelance writer.
Source: dallasnews.com
The first five doctors she consulted fell into two camps: those who pooh-poohed her symptoms or those who charged thousands for elaborate regimens that struck the 46-year-old as long on promises but short on solid science.
“It’s kind of scary to me, that that’s where this has been headed,” the Plano resident says.
Applegate’s experience isn’t unusual. It’s an unintended result of a landmark study that rocked the field of gynecology 10 years ago.
In 2002, results of the Women’s Health Initiative, the longest and largest trial of postmenopausal women using hormone therapy, linked estrogen and progesterone to increased risk for heart disease, breast cancer, stroke and blood clots. Since then, many doctors would “just say no” to hormone therapy. Others tried filling the gap with alternative — and sometimes unproven — treatments.
But evidence emerging since the study’s publication has shown that, when carefully prescribed, hormone therapy remains a good option for many women. Along with 14 other medical organizations, the North American Menopause Society issued a statement in July saying that hormone therapy is relatively safe for healthy, recently postmenopausal women (up to age 59 or within 10 years of menopause) who suffer from symptoms like hot flashes or vaginal dryness.
“We believe that too many women are missing out on the benefits of hormone therapy because of an overreaction to the results of the Women’s Health Initiative,” says Dr. Margery Gass, gynecologist and executive director of the menopause society.
No longer routine
The days of routinely prescribing long-term hormone therapy for women of a certain age are long over, says Dr. Julia Flowers, an OB-GYN at Baylor Regional Medical Center at Grapevine.
When it’s done correctly, she says, finding the right treatment for menopausal symptoms is akin to finding the right birth control. Expect to invest a little time and experimentation to tailor an approach that works best.
When a patient asks about menopause-related symptoms, Flowers starts by looking at her overall health. Other issues, such as low thyroid, can cause weight gain and fatigue, which women often chalk up to menopause.
In some cases, Flowers encourages patients to try an over-the-counter product, such as black cohosh, before she prescribes hormones. Exercise also can help relieve symptoms.
For those who do need hormone therapy, “I like to use the lowest dose for the shortest possible time,” she says. Women taking hormones should “know what medications you are on, why you are on it and how long you will be on it.” She likes to reassess every six to 12 months.
No miracle cure
Gass and Flowers agree: Hormones aren’t a miracle cure for the effects of aging.
“A lot of women feel that, if they don’t take estrogen, they’re going to age quickly,” Flowers says. “But a good diet and not smoking will have a much bigger effect on how you age in the long run.”
Both doctors encourage women considering hormone therapy to look for a physician who’s willing to listen and who is knowledgeable about menopause and hormone therapy.
Eventually, Applegate found a doctor who fit that bill, and she got some relief. But she’s still a bit frustrated.
“I’m from the generation that read What to Expect When You’re Expecting when I had my children,” she says. “But here we are now, and there’s no guidebook. There’s no What to Expect When You’re Going Through Menopause.”
Help is at hand
The North American Menopause Society is trying to fill that gap with a new guidebook for patients, available on its website, menopause.org. The site also offers an online summary of current thinking, “Hormone Therapy for Women in 2012,” as well as a “Find a Menopause Practitioner” link.
“We would like women to have information that’s based on science, and not wishful thinking,” Gass says.
Mary Jacobs is a Plano freelance writer.
Source: dallasnews.com
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