The word “menopause” conjures up dread of hot flashes, night sweats and a host of other unpleasant symptoms in the minds of many women. While all women will go through it, symptoms will vary, with some remaining relatively unaffected and others finding their symptoms intolerable and debilitating. Several mechanisms are likely responsible for triggering menopause, but the changes mainly occur within the ovaries. With the end of ovulation, a woman’s ovaries stop producing estrogen in response to the body’s other hormonal signals. The end result is low estrogen and levels will fluctuate around menopause as the body readjusts to a new state of infertility without support from the ovaries. This adjustment results in many of the symptoms women experience during this transition period.
A new study out this week wanted to see how women dealt with these symptoms and how often they looked to alternative methods of relief instead going to their regular MD. Researchers found that many women felt their primary care doctor didn’t take their symptoms seriously and didn’t fully appreciate their suffering. As a result, many sought care from anti-aging clinicians. Many also feared the hormone replacement therapies (HRT) offered by conventional physicians, citing cancer, heart disease, and increased blood pressure as primary concerns that deterred them from accepting HRT.
In place of these therapies, those women seeking out unconventional treatments often opted for “natural hormones” or “bioidentical hormones,” which are treatments with estrogens generally derived from plants like soy. These estrogens are sometimes combined with other hormones prescribed by anti-aging clinicians, who say these combinations are tailored to their patients. However, unlike HRT and many of the fixed-dose bioidentical estrogens, the FDA does not regulate custom preparations and there is little to no data that these custom preparations work better than HRT and have fewer side effects. In spite of this, many women believed these preparations were safer than HRT and had fewer side effects, perhaps because they were unaware of the evidence supporting various treatments.
The researchers also hoped to understand the underlying motivations for seeking treatment at an anti-aging clinic. Counter to expectations, women were not as interested in attempting to regain their youth. Instead, they sought treatment to feel energized and to avoid chronic health problems associated with aging on top of relief from the symptoms of menopause. They also described wanting to return to an optimal state of being and felt the bioidentical preparations offered by anti-aging clinicians were more likely to help with this. According to the researchers, many of the women saw this type of hormone replacement as a solution that would fix many of their existing health problems.
While bioidentical hormone replacement can be similar in efficacy to HRT when taken in a pill form regulated by the FDA, the other custom preparations undergo little to no testing and their effectiveness hasn’t been effectively verified to date. One major reason for this is that each formulation varies, making it difficult to know with certainty how one formulation compares to others and compares to traditional HRT. Each person with menopause can respond differently to medications, so decisions about treatment for menopausal symptoms should always be made with help and advice from a doctor.