Therapies

Hey Doc, I’m talking to you

“I’m only 37 but I’m starting to have hot flashes – is that even possible?…”

“I’m suffering but my doc told me to wait six months and come back for a check up…”

“My doctor didn’t know anything about how long my brain fog would last…”

“I couldn’t get an appointment to see a specialist at the menopause clinic. I have to wait eight months for an opening….”

“My family doctor just isn’t interested in hearing about my symptoms anymore and she doesn’t have time during my appointments…”

“There is no need to check your hormones anyway…”

If any of these statements sound familiar, we’re not surprised. Here at Herstasis, we are told the same stories from women over and over again. And they all have the same plot – healthcare professionals don’t seem to know or care about the impacts of perimenopausal symptoms, even when those symptoms are interfering in the quality of everyday life. 

After all, its just menopause, all women go through it. 

“My family doctor just isn’t interested in hearing about my symptoms anymore and she doesn’t have time during my appointments…”

“I couldn’t get an appointment to see a specialist at the menopause clinic. I have to wait eight months for an opening….”

As women, we are sadly used to having our health concerns ignored or minimized. So hearing from your doctor or other healthcare provider that there isn’t anything that can be done, that they don’t want to hear about your problems anymore, or that you’ll just have to endure it may not be a surprise. But it sure is wrong. 

When women’s bodies and minds start to show symptoms of menopause, they usually start looking for answers by approaching their doctor or other primary care provider. 

Oops. 

Too bad for the estimated 6000 women starting their menopause transition EVERY DAY, that training in menopause is not a routine part of medical school or residency training.[1] Without this training, healthcare providers are not able to give the care their patients both deserve and are entitled to. It is common, for example, for healthcare providers to misunderstand (which is bad) or dismiss (which is crazy-making) menopause symptoms, including basic ones like irregular periods, breakthrough (heavy) bleeding, anxiety, depression, mood changes, vaginal changes and insomnia. 

What we can tell you is that:

  • The menopausal transition is a universal female experience.
  • The experience of menopausal transition is highly variable amongst women.
  • It starts at different ages (it is unusual but not unheard of for women in their 30’s to start experiencing symptoms of perimenopause). 
  • It is affected by the underlying mental and physical health of patients. 

All of these factors can have an impact on how symptoms of the menopausal transition are perceived by individual women and presented to clinicians. Herstasis exists to help women get the information they need to understand and manage their symptoms and to advocate with their health care provider for good, meaningful therapeutic interventions. 

There is hope though. A brand new paper published by the Society for Women’s Health Research Menopause Working Group [2] offers the following five priority recommendations to healthcare providers to improve patient health-related quality of life (HR-QOL) during and after the menopausal transition:

  1. Clinicians need to view menopause as a normal part of life, not as a deficiency or a disease
  2. Prepare women early (as young as age 35) for better overall health during the menopausal transition and postmenopause (eg, cardiovascular health, genitourinary health, bone health, mental health)
  3. Explore alternative interventions (eg, medical, non-pharmacologic, and lifestyle) to address a whole-person perspective for individualized care
  4. Gather additional data to address menopause-related health disparities to better inform insurance coverage, affordability, access, and education/awareness
  5. Develop interdisciplinary cross-sector coalitions to address individual and systemic needs in the healthcare and workforce landscapes [2]

In other words, menopause happens, it’s normal, so get information out there to women BEFORE they hit the menopausal transition so they can be proactive about their care. 

Do more research on how to treat the whole woman (not just pieces of her) and pass that information along to any group on the healthcare spectrum so that the shortage of information and options for women can be addressed. 

Finally, get decision-makers across the economy to talk to each other about how to support women. 

How hard is that? 

In the perfect world, of course, providers would understand how to treat symptoms across diverse populations and be qualified and confident to develop personalized care plans. [2] Women would not need to make significant efforts to find the answers they seek. This mismatch between the health system and women’s needs is a huge gap. Hopefully, though, it is getting noticed. All that is needed is real action to ensure that it is being addressed quickly. [1] 

[1] JoAnn E. Manson, M.D., Dr.P.H., and Andrew M. Kaunitz, M.D. Menopause Management — Getting Clinical Care Back on Track, New England Journal Med 2016; 374:803-806

DOI: 10.1056/NEJMp1514242

[2] Aninye, Irene O. PhD; Laitner, Melissa H. PhD, MPH; Chinnappan, Shivani BA; the Society for Women’s Health Research Menopause Working Group Menopause preparedness: perspectives for patient, provider, and policymaker consideration, Menopause: October 2021 – Volume 28 – Issue 10 – p 1186-1191

doi: 10.1097/GME.0000000000001819 

Written By:

Jennifer Vander Zalm

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