Dr. JoAnn Manson considers the evolution of menopause management and hormone therapy (Brigham & Women's Hospital)
A decade after women tossed out their hormone pills in disgust and prescriptions for drugs like Premarin and Prempro plummeted, the management of menopause and its related symptoms has become much more personal, with highly individualized treatment plans and more nuanced assessments of risks and benefits.
Dr. JoAnn Manson, of Brigham and Women’s Hospital and Harvard Medical School, was a principal investigator at the Boston site of the pivotal Women’s Health Initiative hormone trials, and says the initial results and subsequent analyses triggered a radical transformation of clinical care that “really changed women’s lives.”
“The WHI is an historic trial that has changed clinical practice and, ultimately, has helped lead us towards a more rational interpretation of the place of hormone therapy in menopause management,” Manson writes in a new editorial commemorating the 10th anniversary of the WHI trial report, published in the journal Menopause with co-author Lubna Pal, of Yale University School of Medicine.
This “more rational” approach to menopause management involves a much closer look at a woman’s personal medical history and specific risk factors, an in-depth discussion with a well-informed clinician on the risks and benefits of drugs and an honest assessment of how bad the symptoms are (whether hot flashes, or night sweats, sleeplessness or sex issues) and what the individual woman is willing to risk in order to alleviate those symptoms.
Manson offered the top takeaways for women currently facing menopause and wondering how to handle it:
1. If You Are Suffering
Hormone therapy continues to have a clinical role in the short-term treatment of hot flashes and night sweats, notes Manson. “If women have symptoms that are interfering with sleep or undermining quality of life, they should talk to a health care provider to see if they’re appropriate candidates for hormone therapy.”
2. Don’t Take What You Don’t Need
Women should not take hormones if they’re asymptomatic, she says. Continue reading