Why won’t my doctor provide hormone replacement therapy for menopause?5 years ago | Menopause
By pH health care professionals
Middle aged-women often experience hot flashes, trouble sleeping and hormone changes as they go through the process of menopause. Their quality of life is affected, so they look for solutions, scouring the Internet to learn about their dropping estrogen and progesterone levels.
Interested in hormone replacement therapy, they schedule appointments with their doctors. But ever since the Women’s Health Initiative (WHI) in 2002, which found the risks outweighed the benefits, many doctors now shy away from hormone replacement therapy. Many women take matters into their own hands, ordering plant-based hormone creams online or visiting their local compounding pharmacies.
The use of non-FDA-approved bioidentical hormones (plant-derived compounds that are chemically and molecularly the same as hormones produced in your body) continues to rise. Hormones from compounding pharmacies are generally not as regulated as prescriptions, so the risks and side effects may not be widely known or disclosed to the consumer. Working with a doctor can help ensure you are using the appropriate dosage for the best possible outcomes.
So why are doctors shying away from hormone replacement therapy?
It’s all a big misunderstanding, medical professors Dr. Joann Manson and Dr. Andrew Kaunitz recently wrote in the New England Journal of Medicine.
“At the time when WHI was initiated, it was becoming an increasingly common practice to start hormone therapy in women more than a decade past menopause for the purpose of trying to prevent heart disease, cognitive decline, and many other chronic diseases,” Manson wrote for Medscape. The WHI sought to weigh the benefits vs. risks of hormone therapy for preventing chronic disease, a practice that included women even in their 60s and 70s, beyond the prime menopause years.
Unfortunately, the study put the brakes on the use of hormone therapy even for women in their 40s and 50s who could benefit due to “hot flashes, night sweats, disrupted sleep and impaired quality of life.”
Is hormone replacement therapy safe for menopause?
Manson points out that most professional societies that address midlife women’s health endorse hormone therapy for managing menopause symptoms in “appropriate candidates” (your doctor can assess your risk factors and help you make that decision). These include the North American Menopause Society, the Endocrine Society, the American College of Obstetricians and Gynecologists and others. Manson noted that these societies emphasize that risks associated with hormone therapy are lower in younger women. It may not be as safe in your 60s and 70s.
So what happens now?
Manson and Kaunitz hope to clear up some of the confusion in the medical community. They know that many medical students and primary care doctors just don’t feel comfortable managing menopausal symptoms and haven’t received the appropriate training. “We need to train and equip the next generation of health care providers,” Manson wrote, in order to meet the needs of middle-aged women.
Our doctors practice integrative medicine, meaning they are well-versed in traditional and complementary treatment options that can help you improve your quality of life. Contact us to schedule your pH Health Assessment with pH’s own Dr. G, who specializes in anti-aging and prevention.
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