Our Approach to the Menopause
I have listened to the stories of thousands of women. I hope to reach women who suffer from symptoms of Menopause but have been scared or misinformed by the media or other practitioners about hormones, women who do not normally have access to an Endocrinologist and women who want to hear every side of the story so that they can make an informed decision.
I advocate a sensible approach to Menopause, devoid of media hysterics. I have nothing to sell. I have no agenda. Most Internet sites hope to sell you a product and, in order to be heard above the din of the marketplace, represent themselves as the only purveyors of the truth about Menopause. As a result, extremism has become more common than common sense. Extreme point of views in Medicine are almost always wrong. There are no absolutes in Medicine, just an ever changing conception of the way things are.
Menopause is not a disease: it is a natural event in every woman’s life.
If you have bothersome symptoms of Menopause, you should be treated for them: you should not be told to “live with it”.
Hormone preparations from horse urine (Premarin) are no longer appropriate.
Synthetic hormones such as those used in birth control pills are sub-optimal.
If a close relative (mother, daughter, sister) has breast, ovarian or uterine cancer, you may want to re-consider the use of hormones.
Estradiol is the major hormone lacking in Menopause. It is the hormone that makes women, women.
It is not a cure-all but clearly helps the Brain, Sleep, Weight, Skin and Bones.
You should always be on the lowest effective dose.
You should not be on hormones forever. Treatment from 1 to 5 years with hormones is most likely quite safe.
You (and only you) must balance your fear of cancer in the long term against potentially improved quality of life now.
Estrogen is most beneficial if taken early on in Menopause, not years later.
Oral Estrogen preparations have untoward liver side effects; Creams and Gels are preferred.
If you still have your uterus, you should be treated with Progesterone in addition to Estradiol.
It is not important to have your periods back.
If your sex drive does not return with Estrogen alone, then Testosterone may be required.