Women can spend more than half their life in menopause, but women’s health experts say there are still many misconceptions about menopause care.
“A lot of women think hot flashes is menopause. That's one thing but, really, estrogen affects so many parts of your body -- your bones, your brain, your skin,” said Pat Handler, a nurse practitioner and a certified menopause provider at the Center for Sexual Medicine and Menopause at Northwestern Medicine.
Handler explained the difference between perimenopause, which can start in your early 40’s, and menopause.
“Perimenopause is when a woman's hormones begin to fluctuate,” Handler said. “Menopause is when a woman has completely stopped making estrogen.”
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The symptoms are similar for both and include:
Hot Flashes
Brain Fog
Local
Weight Gain
Mood Swings
Insomnia
Vaginal Dryness
“If we can make that better for women, which we can with use of hormone therapy. It's a win-win for everybody,” Handler said.
Hormone therapy, however, took a big hit in 2002, when a study from the Women’s Health Initiative found elevated health risks for women taking hormone replacement therapy.
“At that time, the estrogen and the particular type of progesterone that was prescribed showed a slight increased risk of breast cancer, but we don't prescribe that anymore,” Handler said.
“We've learned a lot since then. We now know that estrogen, in fact, does not increase the baseline risk of breast cancer. We also use different formulations today.So it's a lot of education for both the public and for women that, in fact, hormone therapy for women who are less than age 60 and are within five to 10 years of menopause, it's very effective and safe,” said Handler.
Northwestern Medicine created the Center for Sexual Medicine and Menopause in 2017 to help women navigate menopause and the various treatment options.
While there are non-hormonal options as well, estrogen replacement therapy can include a variety of options -- topical gels and lotions, a vaginal ring or even a small patch that is placed directly on the skin.
Maria Cantu from Chicago was referred to Pat Handler in her late 40’s, after her menopause symptoms came on quickly and hit hard.
“I wasn't feeling myself. I noticed I was able to like lose a little bit of weight. And it was kind of driving me crazy. Also, I was having these sudden bursts of just heat. I would just start sweating,” Cantu said.
Cantu chose to start taking an estrogen patch and a progesterone pill, although her family had reservations.
“My mom was like, that's bad for you. And I said, well, where do you come up with this? How do you know it's bad for you? And she's like, well, that's what I heard,” Cantu said.
Eradicating that misconception is part of Handler’s job.
“It’s still stuck in a lot of women's brains and a lot of doctors’ brains, because the attention has been so much on that study, which we know was flawed in many ways,” Handler said.
She says women shouldn’t be ashamed to talk with their primary care doctor or gynecologist.
“If they aren’t bringing up menopause and you're struggling, don't be afraid to bring it up.Ask the questions. And if they aren't comfortable talking about it, then it's time to come and see us,” Handler said.
“People are gonna go through it. And why suffer? Just go see the experts and get it checked out,” Cantu said.
