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DFW Menopause Treatment

(Reuters Health) - Many women with severe menopausal symptoms are not being treated for them even though safe, effective remedies are available, a study from Australia suggests.

The findings may be applicable to other countries, too, according to senior author Dr. Susan R. Davis from Monash University in Melbourne.

"From my interactions with colleagues from across the globe, I do not believe that what we have observed is Australian-specific," she told Reuters Health by email. "The management of menopause has been relatively similar in the UK, the USA and in Australia."



Up to half of women in menopause experience so-called vasomotor symptoms, such as hot flashes and night sweats. Hormone replacement therapy (HRT), which generally combines estrogen plus progestin, is very effective. But after the initial findings of the Women’s Health Initiative study showed that HRT can increase the risk of breast cancer, stroke and other serious problems, many women stopped using it.

As reported in the journal Menopause, in 2013 and 2014 Davis and her team analyzed survey responses from nearly 1,500 women ages 40 to 65.

Seventeen percent were having moderate to severe vasomotor symptoms, and 18 percent reported moderate to severe sexual symptoms.

But most were not receiving any kind of treatment. Only 11 percent reported use of HRT, and less than 1 percent were using any type of therapy that didn't involve hormones.

The women who did use hormones were mostly taking pills containing estrogen, rather than preparations that are absorbed into the skin and that are potentially safer, the researchers found.

"Extrapolating our findings to 3.7 million Australian women aged 40 to 64 years, we found that 455,000 women are likely to have moderate to severe vasomotor symptoms, with most women (385,000) remaining untreated," they write.

In addition, very few women were receiving vaginal estrogen therapy for sexual symptoms. Vaginal dryness is common with menopause and affects sexual functioning. Vaginal estrogen preparations are very safe and effective for this problem but were prescribed to less than 5 percent of the women, the authors say.

Why are so few women being treated?

"Overall, there is the uncertainty of women and of doctors as to what the options are, what is and is not safe, and of the safe options - what and how to prescribe them," Davis said.

There is also, she said, a complete lack of understanding that for most women, these symptoms are not fleeting.

"It isn't 'grin and bear it for a few months' and it will all pass, as many women suffer severe symptoms for five-plus years," she said. "Women and doctors simply are not aware that symptoms can last this long."

Finally, many women don’t realize that non hormonal options can be safe and effective, she added.

Dr. Wulf H. Utian, medical director of the North American Menopause Society, agrees that many reasons may underlie the lack of treatment. "It is partly 'fall out' from the controversy over hormone therapy," he told Reuters Health in an email.

But overall, he said, it is a combination of patients not wanting therapy or not having information about it, and also the provider not prescribing it.

SOURCE: Menopause, online July 31, 2015.



5 Signs Your Hormones Are Out Of Whack! #DFWhormones


Raise your hand if, in the last few weeks, you've felt tired, bloated or cranky. Sound familiar? Then you know the drill: Every month, your hormones -- the body's itty-bitty secret weapon -- come out to play, wreaking havoc on your mood, skin and mind. While levels generally stabilize after your period, various factors, like stress (yup, keep those hands raised) and anxiety can throw them off balance. So how can you tell if your symptoms require an office visit? Alyssa Dweck, M.D., an OB-GYN at the Mount Kisco Medical Group in New York, shares the five red flags that might merit a doctor's note.

Exhaustion is one of the most, well, exhausting symptoms to a doc, since it has so many possible causes. "If you're tired after a week of final exams or late nights at work, then you're probably fine," says Dweck. "But if you constantly feel worn out and notice weight gain, appetite fluctuations and a change in bowel movements, it could be a sign of an underactive thyroid." Yes, fatigue happens to everyone, but if yours doesn't feel logical, then it's worth getting it checked out.

Skin Changes
You're breaking out -- again. While those sudden zits could be caused by one too many nights of going to bed without washing your face, they may be indicative of something more. "Adult acne or cystic acne around the lower half of your face could suggest a high level of testosterone," says Dweck. Although not a life-threatening problem, breakouts can take a toll on your psyche. Luckily, your doc can prescribe you medication to stabilize your hormone levels and clear up skin.

Hair Growth
We're talking really fast hair growth. "If you all of a sudden grow a beard within a month or notice coarse, dark hair popping up on your chest, back or arms, that could be indicative of a testosterone-secreting tumor," explains Dweck. But don't freak out: Tumors are rare, she notes, and can often be treated with drugs or surgery.

Weird Periods
Just like fatigue, a messed-up menstrual cycle can be the result of many factors, like stress, thyroid issues, low estrogen or polycystic ovary syndrome (PCOS). "The hallmark of PCOS is irregular or absent periods, but it could also present with difficulty losing weight or strange hair growth," says Dweck. Generally, PCOS is managed through diet, exercise and birth control pills, but your doctor will work with you to develop a multi-faceted plan if she finds this to be the cause of your period problems.

Night Sweats
Unless it's unusually warm in your bedroom, waking up feeling overheated and sweaty could be the result of lower estrogen levels and infrequent ovulation -- a.k.a. perimenopause. "Perimenopause can occur up to 10 years before you're even near the age of menopause," says Dweck, "so unless you're having major menstrual issues before age 40, there's a good chance your phantom sweating could actually be early menopause." Either way, Dweck recommends making an appointment with your doc to make sure it's nothing more serious.

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Menopause Myths Debunked!

Menopause Myth #1: Going through menopause is horrible

Perimenopause, the years leading up to menopause can be a time of biochemical chaos in the body as your estrogen, progesterone and testosterone levels work to establish balance, and  fertility begins to decline and finally ceases altogether. During this period, women can experience things like:

  • Hot flashes 
  • Lowered libido
  • Unusual mood swings or depression
  • Weight that goes on easy and is hard to get rid of
  • Lower energy levels

That may sound ghastly at first, but keep in mind that women rarely experience all of the above. Most experience one or two and they occur gradually over time, at varying degrees of inconvenience. In fact, only about 40% of women say they experienced significant symptoms of menopause, and most of them only experienced symptoms for a brief span of time. That means the majority of women never have anything more than mild symptoms.

Menopause Myth #2: Menopause symptoms never stop

It is very rare that menopause symptoms don't disappear or significantly retreat once menopause has been reached. While most of those hot flashes occur very sporadically. If your doctor has determined you have reached menopause (when you have ceased menstruating for 12 months in a row) and you are still experiencing menopause symptoms, it is a sign that your hormones are out of balance. Have them tested by using MedAmiLabs today to find out a treatment option.

Menopause Myth #3: Menopause means the end of your sex life

The hormone shifts that occur during menopause can cause a decrease in your natural lubrication and a thinning of the vaginal tissues. However, this is rarely enough to ruin a woman's sex life. And, in fact, many women report that their post-menopausal sex life is better than ever because they no longer need birth control, they are more comfortable with their bodies, financial worries and other stresses have diminished and the kids are out of the house (or will be soon!), which means you are no longer worried about privacy. Most of the post-menopausal changes that affect libido, or your physical comfort, can be addressed using over-the-counter lubricants, position changes or mild natural hormone therapy.

Don't fall prey to scary menopause myths. Instead, talk openly and honestly with a trusted healthcare professional regarding your fears, symptoms and concerns. Better yet, consult with our office and use accurate hormone testing to determine whether or not you would benefit from the bioidentical hormone therapy that can stop those dreaded hot flashes after menopause.

The more educated and informed you are, the more empowered you will be to embrace this new phase in your life.