New study: majority of menopause sufferers don’t seek treatment
A new Mayo Clinic study finds nearly three-quarters of women ages 45 to 60 surveyed experience menopause symptoms that greatly affect their daily life at home and at work. The data also shows those menopause symptoms remain undertreated despite available help.
More than a third of the respondents said they had moderate to severe menopause symptoms such as sleep issues and weight gain. What鈥檚 interesting is that more than 80% of the women surveyed said they did not seek medical treatment for those symptoms.
Menopause is a natural part of aging when the ovaries gradually produce less estrogen and progesterone, which are the hormones that control the menstrual cycle. This can lead to issues such as hot flashes, night sweats, trouble falling or staying asleep, changes in mood or trouble with mental focus, vaginal dryness and incontinence.
So why don鈥檛 many women ask for help when dealing with these symptoms?
鈥淢any women don鈥檛 seek medical care for menopausal symptoms due to a variety of reasons, including being too busy, a lack of awareness about effective treatments, and concerns about the safety of hormone therapy,鈥� says Dr. Marcia Klein-Patel, chair of AHN Women鈥檚 Institute who specializes in menopause treatment and midlife medicine. 鈥淎dditionally, according to the research, some women reported feeling judged by their health-care providers or embarrassed by their symptoms, which can create barriers to seeking help. This suggests a need for increased awareness, supportive health-care environments, and destigmatization of menopause and midlife care. It鈥檚 essential that women understand care is available to them, and they do not have to suffer with their symptoms.鈥�
That leads to the question of whether the medical community needs to do a better job of getting that information out there to women.
鈥淚t鈥檚 clear that our field needs to do a much better job of disseminating accurate information about available menopause treatments,鈥� says Klein-Patel. 鈥淭he misconception that effective treatments don鈥檛 exist is a significant barrier to care.鈥�
To many women, the idea of menopause treatment focuses on hormone replacement therapy (HRT), but that鈥檚 not the only option.
鈥淲hile hormone therapy is a cornerstone, ongoing research is expanding our understanding and options,鈥� Klein-Patel adds. 鈥淪o the idea that treatments are lacking is outdated and can be harmful 鈥� women need to know they don鈥檛 have to suffer with their symptoms when there are therapies and management options out there for them.鈥�
While HRT has been the standard for decades, there has been conflicting research and messaging about whether it鈥檚 safe, and that has left women frustrated and confused. Klein-Patel says the latest in menopause treatment centers on a more nuanced understanding of Menopausal Hormone Therapy (MHT).
鈥淲hile MHT replaces declining estrogen and progesterone, recent research has clarified its safety profile, particularly when initiated within a decade of menopause onset and for women under 60,鈥� she explains. 鈥淭he removal of the 鈥榖lack box鈥� warning by the FDA reflects this evolving understanding allowing for more informed discussions about who can safely and effectively benefit from MHT for symptom management and long-term health.鈥�
With that being said, she cautions that MHT is still not the right solution for every woman.
鈥淚t鈥檚 important to understand that there are certain patients who may not be ideal candidates for MHT 鈥� it鈥檚 important to speak with your OB/GYN for more information on what may be right for you.鈥�
The catchphrase 鈥渉ormone rebalancing鈥� has caught on in recent years when some people refer to MHT, but it isn鈥檛 a precise medical term.
鈥淥ngoing research continually explores how to optimize hormonal health and alleviate menopausal symptoms through various interventions,鈥� Klein-Patel adds. 鈥淲ith rebalancing, the goal is really to manage symptoms and, depending on where the patient is on her menopausal transition, her symptoms should be managed specifically. Sometimes hormone therapy is not yet the right answer.鈥�
She also cautions that 鈥渉ormone rebalancing鈥� often refers to compounded bioidentical hormones obtained outside of standard medical channels.
鈥淲hile some women report benefits, these compounded hormones are not FDA-approved, meaning their safety, efficacy, and consistent dosing are not regulated or rigorously tested,鈥� Klein-Patel says. 鈥淭his raises concerns about reliability and safety, which is why insurance companies typically do not cover them, as they lack the robust evidence required for standard medical practice.鈥�
In addition to hormone therapy, there are other menopause treatments available with ongoing research into new therapies.
鈥淪elective Serotonin Reuptake Inhibitors (SSRIs) can indeed be helpful for managing hot flashes, night sweats, and mood changes in some women,鈥� says Klein-Patel. Other new therapies have also been approved in recent years, including a new non-hormonal pill called Lynkuet (elinzanetant) which was approved to treat moderate to severe hot flashes and night sweats. This drug works by focusing on regulating body temperature by blocking brain pathways that control it. Another non-hormonal treatment for hot flashes called Veozah (fezolinetant) also works on how the brain controls body temperature.
One takeaway from the Mayo Clinic study is that it is found women often do not voluntarily talk about menopause or their symptoms with their doctors, and the researchers stress menopause care needs to be destigmatized to encourage women to ask questions and seek treatment. Mayo Clinic researchers say they are working to develop ways of doing this with smartphone apps, digital tools and questionnaires to help patients identify symptoms, learn about treatments and feel more comfortable asking their doctors for help and advice.