>> The transition into menopause
is an inevitable part of life.
For many is accompanied by a
range of symptoms including hot
flashes, insomnia and weight
gain.
It continues to be understudied
and undertreated.
Ali rogin has Mo as a
part of our series >>.
Someone officially entered this
the series of life 12 months
after their last period.
Symptoms also begin after
perimenopause.
It is something many people go
through but just one in five
ob/gyn residents have any
training in it.
Studies show many menopausal
women are not getting any
treatment and often don't talk
about it with their doctors.
We wanted to find out more about
why the stage of life is
frequently ignored especially in
the United States and why
getting treatment for its
symptoms is often such an
afterthought.
I'm joined by the director of
the mayo clinic center for
women's health and the medical
director for the North American
menopause society which promotes
women's health during midlife
and beyond.
Thank you so much for joining
us.
For something as so ubiquitous
as menopause why is it so
stigmatized?
>> I think it has been
stigmatized in the past because
it is so tied to aging.
The mean age of menopause in the
United States is 52 so I think
that is part of it.
It is also a mysterious women's
event and just like menstrual
cycles and puberty and all of
the sort of thing, pregnancy,
childbirth, lactation, it has
been one of those things that is
not as talked about but it is
doubly so for menopause because
it is tied to aging.
Menopause does have that stigma.
If you look up Google images of
menopause you see harried, hot,
angry women.
That is not the reality for most
of us but it does have a
negative stigma.
>> You mentioned angry, hot,
sweaty.
Let's talk about what the
symptoms tend to be and what
sort of treatments are
available.
>> The typical symptoms of
menopause and let's just say
some women have none.
The lucky few that have none.
Most women will have some
symptoms and the most common are
motor symptoms which are hot
flashes and night sweats.
A lot of women have sleep
disturbances in mood
disturbances like irritability
and anxiety.
There also someone's many people
don't necessarily associate with
menopause like joint aches,
palpitations.
>> And even still, we found
12021 study that said 73% of
women are not getting the
treatment they need further
menopause symptoms.
Why is that?
>> Not everyone needs treatment
for the menopause symptoms but
for those women who do have
symptoms women end up in bunch
of different doctors offices and
are not necessarily putting it
together this is menopause
related.
When they do end up in a
physician's office, there
sometimes dismissed as -- they
were told there symptoms are not
important or bothersome enough
to be managed.
>> A related element seems to be
there is not a lot of training
happening in menopause
management.
Why is it so understudied?
>> I think that is a great
question.
We published a study a few years
ago on how much training medical
residents who were getting and
those were residents in internal
medicine, family medicine and
ob/gyn and the bottom line is
none of those programs were
receiving much in the way of
education on menopause.
About one to two hours at most.
The majority of those residents
felt uncomfortable managing
menopause when they graduated
their programs.
But also I think many physicians
feel there is not anything to do
about the symptoms.
I think the women's health
initiative has contributed to
this that there is a big fear of
hormone therapy.
>> You mentioned the women's
health initiative.
Can you explain briefly what
that was and the impact it had
on the treatment of menopause?
>>>> The women's health engine
type study looked at women
between the ages of 50 and 79
years of age.
Their goal was to see if hormone
therapy was good for chronic
disease prevention.
That is the way it was designed.
The women answering the trial
were not necessarily and for the
most part did not have menopause
symptoms at the time.
They carried on the study for
several years and after five
years in 2002 the combination
therapy arm was stopped due to
increased risk of cardiovascular
disease and breast cancer.
There are a number of concerns
raised about it at the problem
with this study is that the mean
age of the women in the study
was 63 years of age which is not
the age of the women we commonly
see in our offices having
trouble with menopause symptoms.
The results were analyzed by the
entire group at one time and not
a decade of life.
The key findings were a little
bit misleading initially.
>>>> What was the result once
those findings were released?
>> When the findings were
released, there was a dramatic
drop-off in hormone therapy use
rates in the United States such
that we went from roughly 40% of
women using hormone therapy
postmenopausal to roughly 4% and
that has not rebounded much
since then.
>> How does the medical field
need to change to better serve
patients going through
menopause?
>> We need to educate providers
on what can be done about
menopause symptoms.
Not everyone needs hormone
therapy but providers should be
comfortable with understanding
the risks and benefits of
hormone therapy and who would be
a good candidate for it as well
as the non-hormonal options we
have for management of menopause
symptoms.
>> Stephanie Fabian with the
mayo clinic and the American
menopause society.
Thank you for your time.
♪♪