Menopause: Are you being adequately treated?

As I complete my annual continuing education units (CEUs) to maintain my license as a naturopathic doctor, it has become evident that many women are not receiving the appropriate care for their menopausal symptoms. Notably, these symptoms can begin before menstrual periods cease and may continue for the rest of a woman’s life. They

can manifest as:

• Hot flashes

• Vaginal dryness

• Mood swings

• Depression

• Anxiety

• Urinary issues

• Low libido

• Joint pain

Women deserve effective treatment for these challenges. However there are not many providers who have the depth and breadth of education and clinical experience to address these issues adequately. 

The Importance of Hormone Therapy

Beyond merely alleviating symptoms, the absence of hormone therapy can significantly elevate the risk of serious health conditions post-menopause. For instance, hormone therapy is known to help prevent osteoporosis, and while the potential for it to reduce the risk of Alzheimer’s and dementia is not fully proven, studies have indicated a risk reduction. Recent studies from the past two years have shown that women undergoing hormone therapy had a decreased risk of all-cause mortality, meaning a lower likelihood of dying from any cause.

Misconceptions from the Women’s Health Initiative

For years, hormone therapy has faced demonization and fear, largely stemming from misinterpretations of the Women’s Health Initiative (WHI) study conducted around 20 years ago. While this study offered valuable insights, its findings were often misunderstood. There has been extensive analysis and reinterpretation of WHI data over the last two decades, especially following new research released recently.

One major misconception, even among medical professionals, is the belief that all types of hormone therapy increase cancer risk. This is simply not true. Estradiol and even synthetic estrogens, when given alone, have not been linked to an increased risk of cancer, as demonstrated by the WHI results. The component that may elevate breast cancer risk is actually the progestogen, specifically synthetic progestins. Notably, bio-identical progesterone was not included in the WHI study, but subsequent research has not shown a similar risk, indicating that bio-identical progesterone is likely breast-neutral. Furthermore, the increase in risk associated with synthetic progesterone corresponds to only one additional case of breast cancer per 1,000 women treated, a risk that is relatively low compared to various other modifiable lifestyle factors. 

Evaluating Your Treatment Options

So, are you receiving adequate treatment for your menopausal symptoms? Have you been previously denied hormone therapy? It’s essential to note that hormone therapy is not suitable for everyone, but it should be seriously considered if you meet the criteria for starting it and shouldn’t be dismissed purely out of fear of developing cancer.

If hormone therapy isn’t an option for you, countless non-hormonal treatments should be discussed with your provider, including:

• Diet and lifestyle modifications

• Herbal therapies

• New non-hormonal medications that show promising results

Additionally, menopausal hormone therapy isn’t limited to estrogen and progesterone; testosterone and DHEA also play important roles and should be evaluated. In my practice, cortisol levels are another critical factor, along with cardiovascular risk assessment and advanced lipid testing. Don’t overlook the importance of thyroid hormone evaluation and essential nutrient levels.

If you have been feeling like you are not being adequately treated for your perimenopausal or menopausal symptoms please reach out to us at Integrity Naturopathic.