If you’ve been prescribed estrogen vaginal inserts for vaginal dryness or recurrent post-menopausal bladder infections and read the accompanying paperwork you might, as many women do, toss the box away, muttering, “not for me”. There’s a “black box warning” printed there, alerting you that using the product increases your risk of blood clots, breast cancer, and stroke. It’s simply not true, as reported in the Washington Post, and doctors want this warning lifted.
The warning is based on a long disproven study from 25 years ago called the Women’s Health Initiative. And, in fact, not only is there virtually no absorption of estrogen into your body from these inserts but leaving severe dryness especially when accompanied by recurrent bladder infections can actually be dangerous to your health.
Overall, The Menopause Society, an organization whose members specialize in the lengthy event of menopause, believe that unless there are specific medical reasons to the contrary (like history of breast cancer, blood clots, etc.) women are best served remaining on hormone replacement therapy (HRT) their entire lives. Interestingly, these lives will likely be longer because HRT reduces risks of heart disease, certain cancers, and dementia. Brett Eaton from our group is a Society member.
Women beyond the actual menopause transition can start HRT at any age, and the health benefits can be gained by lower doses than those needed by a younger woman who might have needed them for hot flashes and night sweats.
A large study from Sweden was reported in The Washington Post that menopause symptoms like hot flashes and night sweats are coming earlier, lasting longer and more severe. 24% of women born between 1918 and 1930 had symptoms compared with 35% born between 1954 and 1960.
Lots of data were collected and questions asked. Were the increased numbers because women were more willing to talk about their symptoms? Was it diet? Weight? Race? Smoking? Genetics? Stress? Use of birth control pills? Do hot flashes run in families?
Doctors are also beginning to realize that many women reporting a variety of “unexplained symptoms with negative tests” in their forties are actually in the foothills, so to speak, of early menopause. The blood levels of their hormones might be normal on the day of the test but because things are changing, these women often feel magically “better” when given a small dose of HRT.
And at the forefront of feeling “better” is feeling “mentally sharper”.
“I feel I’m getting my mind back,” as one patient happily reported.
THE MENOPAUSAL BRAIN
Now researchers are investigating just how the female brain, which had been susceptible to the shifting tides of hormones while menstruating, works during menopause. Think of your mood swings and brain fog of PMS and “baby brain”, if you were ever pregnant. Now your brain can finally settle down with a new resiliency.
In her new book, “The Menopause Brain,” neurologist Lisa Masconi, M.D. begins with the numerous symptoms of menopause (mood swings, depression, low libido, brain fog) and the effect of these symptoms on brain imaging studies. Then, after encouraging hormone replacement therapy, Dr. Masconi informs her postmenopausal readers of their new brain skills which include greater self-confidence, better emotional control and heightened empathy. The female brain is literally “rewired” for the better after the menopause transition.
One question Dr. Masconi admits is unanswered, but is definitely being researched. We know that untreated menopause symptoms increase heart disease and stroke symptoms and hormone replacement therapy (HRT) reduces these risks. We also know that women have a greater risk of developing Alzheimer’s dementia than men.
Can HRT reduce a woman’s risk for developing dementia? The answer is “probably” but not positively.
You can schedule a hormone evaluation with any of the WholeHealth Chicago practitioners for either herbs or HRTs at any of our locations.
Be well,
David Edelberg, MD