• Catherine Hansen MD, MPH

Menopause: Madness or Magic?

Updated: Jan 28



There has been a lot in the news about menopause lately and that speaks to the importance of this topic for the largest and fastest growing segment of our population – Women at midlife!


A sample of current events in the news:

1. “A self-injectable medication recently approved for treating low sexual desire…is raising many questions, including whether the therapy is effective in a real-world sense, and if it will be safe over the long-term.(1)

2. Clinicians commonly prescribe testosterone to women off label [not approved for use] for [low libido], as well as for a variety of other symptoms, including low mood, depression, fatigue, memory loss, hot flushes, migraine, and breast cancer prevention. The evidence regarding (effectiveness) for these symptoms is either weak or nonexistent. (2)

3. While the FDA inspects outsourcing facilities regularly…we also rely on them to do their part in alerting us to issues that may endanger the health of patients….We recently called attention to…a particular issue associated with compounded hormones (specifically, in the form of pellets). During an inspection in 2018 of BioTE Medical, our investigators uncovered information about 4,202 adverse events [side effects] that had never been reported to the agency (and this) suggested compounded hormone pellets were possibly associated with endometrial (uterine) cancer, prostate cancer, strokes, heart attacks, deep vein thrombosis [blood clots], cellulitis and pellet extrusion.(3)

4. In a safety communication released on July 30, 2018, the FDA cautioned healthcare providers: "Be aware that the safety and effectiveness of energy-based devices [lasers, radio-frequency] to perform vaginal 'rejuvenation' or cosmetic vaginal procedures has not been established. Understand that the FDA has not cleared or approved any energy-based medical device for vaginal 'rejuvenation' or vaginal cosmetic procedures, or for the treatment of vaginal symptoms related to menopause, urinary incontinence, or sexual function." (4)

5. Laser therapy for the vagina shows excellent promise for the treatment of (some vaginal symptoms) in some women; however, complications such as fibrosis, scarring, agglutination [vaginal wall sticking together], and penetration injury [holes in the vagina] have been documented. (5)


There are over 6000 women entering menopause each day in the U.S. and these women will enjoy almost 40% of their lives still ahead of them. It’s a time of profound change and increased attention on personal pursuits. Women find energy to re-focus on the beauty of deeper relationships, upward career progression, all-but-forgotten dreams or finding new purpose in their lives. As such, women don’t have time for the physical symptoms that often accompany mid-life to hold them back or create distance between them and their intimate partner.


When confusion exists, a crevice is open for predators to creep in and offer something “too good to be true”. The menopausal wellness space has become open season for providers to capitalize on those of us who just want to get onto bigger and better aspirations.


Women are even more vulnerable to exploitation because, as a group, we are the single most powerful driver of the economy and make the vast majority of healthcare decisions for our families. Women hold more undergraduate and master’s degrees than men and have equaled or surpassed our male counterparts on most academic and economic benchmarks. While this hasn’t, yet, equated to equal pay or more corner offices, we are a force to be reckoned with and people want our money and we have money to spend.


A woman shouldn’t be forced to waste vital energy on understanding an increasingly complex healthcare universe in order to protect her body or her bank account.


Women should be spending their mid-life doing the things they’ve always wanted to do and completing their well-earned bucket list.


The questions women ask are not complicated but the place to answer them is not in a 15 minute clinical visit, on an impersonal blog post or while you are spread-eagle in stirrups. Yet, often, we are forced to cram short answers to big questions into these unforgiving, sterile spaces. This is not good for women and it’s less-than-ideal for me to impart my expertise in the most impactful, personal and life-changing ways, as I deeply aspire to do.


For this reason and because it is MY passion to educate, equip and empower women to embrace their brilliance, beauty and significance, the Empowered Women’s Circle will be hosting its first (free) Menopause Café on October 9, 2019 at 12pmCT/1pmET (Recording posted HERE after the event).


For women who seek safe, science-backed answers, this event and the ensuing Meaningful Menopause Workshop will be a compassionate space to turn for clarity, support and trustworthy guidance at this important stage of life. Spaces for the Workshop are limited. Register HERE!


References:

1. https://www.ewcircle.com/blog

2. https://www.medscape.com/viewarticle/915229?nlid=130522_2581&src=WNL_mdplsnews_190705_mscpedit_obgy&uac=178850CG&spon=16&impID=2019459&faf=1

3. https://www.medscape.com/viewarticle/917561?nlid=131468_5421&src=WNL_mdplsfeat_190910_mscpedit_obgy&uac=178850CG&spon=16&impID=2089858&faf=1

4. https://www.fda.gov/news-events/press-announcements/statement-improving-adverse-event-reporting-compounded-drugs-protect-patients

5. https://www.medscape.com/viewarticle/916188

6. https://www.medscape.com/viewarticle/911004

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