The Doctor’s Corner: An early start on treating menopause
This is the first of a two-part series updating women of all ages on the use of hormones.
It is a pleasure to be back putting pencil to paper with good news for women going through “the change.”
A Global Consensus Statement, hot off the press in the April issue of the journal Climacteric, concludes that the benefits of menopausal hormone therapy (MHT) outweigh the risks when started before the age of 60, or within 10 years of menopause.
An impressive array of experts from all over the world met in Paris last November, coauthoring the statement on behalf of the International Menopause Society (IMS). They hailed from such elite institutions as the Cleveland Clinic, Harvard Medical School, Columbia, Oxford and the Chinese University of Hong Kong.
Represented were seven international professional organizations, including the American Society for Reproductive Medicine, the North American Menopause Society and the International Osteoporosis Foundation. (To disclose, I have been a medical speaker for pharmaceutical companies manufacturing FDA-approved, bioidential hormones, ones you get from regular pharmacies.)
Why is this consensus important? I recently spoke to the eminent authority Philip Sarrel, emeritus professor of obstetrics and gynecology and psychiatry at Yale University School of Medicine, where he has studied MHT for 50 years. According to Sarrel, who was not an author on the global consensus statement, “The conclusion from the recent IMS meeting in Paris is that women under the age of 60, or within 10 years of menopause, should use estrogen therapy, that the benefits far outweigh the risks.”
So there you have it. This good news should empower women to ask for MHT, instead of putting up with misery in fear. Even women who do not experience menopausal symptoms, such as night sweats, sleeplessness, exhaustion, loss of sexual interest and depression, are advised to consider starting MHT during their menopausal transition to live longer.
Among the bullet points of the consensus statement, the panel concludes that there appears to be a lower risk of venous blood clotting and stroke with estrogen taken across the skin. This means that estrogen pills are not the preferred type of medication.
The experts do not recommend custom-compounded, bioidentical hormone therapy. Many choices of FDA-approved bioidentical MHT products are available. Hopefully, the Global Consensus Statement will engender broader insurance coverage of FDA-approved bioidentical MHT products.
Another bullet point from the consensus states, “The dose and duration of MHT should be consistent with treatment goals and safety issues and should be individualized.”
Women who suffer the exhaustion of menopausal symptoms can rest assured that experts from all over the world finally conclude that the healthiest choice is to take MHT to treat these symptoms. Even those who breeze through “the change” cool as cucumbers are advised to seriously consider MHT early in this transition to live longer and healthier lives.
Hopefully, this news will empower millions of women starting menopause to reconsider use of MHT. Medical providers should also be made aware that there is a strong indication for many women to initiate MHT within 10 years of their transition, or before the age of 60.
(This information is not intended as a substitute for consultation between women and their healthcare providers.)
Check https://www.menopause.org or https://www.acog.org for further information.
Review the Global Consensus Statement (it’s only one and one half pages) at informahealthcare.com/doi/full/10.3109/13697137.2013.771520.
DR. JANE K. BENING is a board certified gynecologist who has lived in Laguna Beach and has had a private gynecology practice in Newport Beach for 22 years. She can be reached at ask@drjanebening.com or at her office (949) 720-0206.