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Menopause-Why Do So Many Women Go Untreated?
A study published online from Menopause in July of this year gave statistical support to something that many women have known for a long time. Many women experience menopausal symptoms of hot flashes and night sweats and go untreated by their doctors year after year. According to the results of this study which examined women's symptoms and methods of treatment via survey methodology only 11% of survey respondents were availing themselves of hormonal replacement therapy or HRT. Although this study was conducted in Australia according to the researchers it is likely that these results can be extrapolated to the United States. So the big question is why are all these women going untreated?
Hormone replacement therapy is one of many forms of therapy that may be used to combat hot flashes and night sweats, two of the most common symptoms of menopause. After the Women's Health Initiative (WHI) Study was published in 2002 many women stopped using hormones in droves and many more women that have entered the climacteric period since 2002 still have not availed themselves of this type of therapy. Although it is true that hormone replacement therapy does come with some increased medical risks such as cardiovascular disease, increased blood clot risks, and increased risks of breast cancer it is also true that certain methods of hormonal therapy have a safer risk profile than the traditional oral therapy that was used in the WHI study. The other concern that this study highlights is in regards to the low use of vaginal estrogen which also has a different risk profile than traditional HRT. The use of vaginal estrogen has been shown to have a big impact on the quality of intercourse as well as being an important factor in decreasing infections. So the big question remains....why are so many women left untreated year after year?
The true answer to this is likely secondary to several different factors. For one many women and their doctors were completely scared off their hormone therapy by the first wave of published results from the WHI study. In many cases so scared off that many never came back to review the secondary and tertiary studies that showed the flaws of the study as well as the difference in side effect profiles in terms of route and dose of therapy in all the research that has come out since 2002. So the truth is that although the study definitely provided some useful information it wasn't perfect in analyzing all risks in all groups of women or with all different types of therapy. Because of this many women still have the perception that hormone replacement therapy of any kind is unsafe and according to many published studies doctors are not typically changing this perception during the office visit if they are even discussing treatment options at all.
So what's a hot, sweaty, grumpy woman with possibly a dry vagina to do? First off know that although this too shall pass although it typically doesn't pass quickly. Depending on what study you go with most women have symptoms from 5-7 years! Can you just think of how much extra laundry you would have on sheets and nightgowns alone? So that means that you can't usually just get through this very well without some type of help. Second, make sure that you bring up what you are going through at your doctor's visit and know that there are both effective hormonal AND non hormonal options that can help you through this period. If all you get back is a blank stare or the "brush-off" that you can just live through this my advice would be to get a second opinion by someone who specializes in hormonal therapies and menopausal treatment. If you don't have a provider who lives close to you, don't know where a provider is close to you or you are an international woman suffering from the symptoms of menopause don't give up hope as often these types of specialists can also consult with you online and then work with your local provider to treat your symptoms. To find out more about scheduling virtual second opinion for menopausal symptoms and treatment please click here.