M

any women suffer from 
menopause symptoms — 
hot flashes, night sweats, 
mood swings and brain fog —which 
can be very debilitating. Years ago, 
symptoms were downplayed by some 
health providers and treatments were 
limited. In addition, some medications 
were believed to increase the risk for 
certain cancers, but the outlook has 
changed for the better.
“Women think they have to suffer 
through menopause. They aren’t going 
crazy. Having options 
is very important,” says 
Andrea Eisenberg, M.D., 
a board-certified obste-
trician/gynecologist who 
is an associate clinical 
professor at Oakland 
University William 
Beaumont School of 
Medicine. She is affiliated with the 
Michigan Women’s Health practice in 
Farmington Hills. 
Until the release of the federal gov-
ernment’s extensive Women’s Health 
Initiative (WHI) studies, which began 

in 1998, many women had relied on 
hormone replacement therapy (HRT) 
for decades to offset reduced estrogen 
after menopause and alleviate symp-
toms. But that large-scale research 
indicated that while HRT 
was effective for symptom 
relief, it increased the risk 
for breast and additional 
cancers and was not help-
ful in reducing post-meno-
pausal heart disease and 
other conditions. 
“Everyone went off hormones, and 
some doctors won’t prescribe them,” 
says Steven Dean, M.D., who is in 
practice with his son, Joshua Dean, 
M.D.; both are board-certified obstetri-
cian/gynecologists at True Gynecology 
in Troy.

NEW VIEWS REGARDING 
HORMONAL THERAPY
But in recent years, physicians’ views 
have changed because some aspects 
of the WHI study have been ques-
tioned; Dr. Eisenberg describes it as 
“very flawed.” According to Danny 

Benjamin, M.D., a board-certified 
obstetrician-gynecologist and chief 
of obstetrics and gynecology at DMC 
Huron Valley-Sinai Hospital, the 
view of hormone therapy is “turning 
around. The risks of estrogen are really 
small,” he says.
Now some gynecologists agree 
that HRT is useful and safe as long as 
patients are screened for a history of 
breast cancer, blood clots and heart 
issues, and monitored regularly. 
“HRT works well to alleviate symp-
toms,” says Dr. Joshua Dean. These 
include hot flashes, night 
sweats, mood swings, cog-
nitive issues and vaginal 
problems.
Hormone therapy may 
be given as pills contain-
ing estrogen alone or with 
progestin to reduce the 
risk of uterine cancer when a woman 
still has her uterus. Hormone treat-
ment is also available as a cream, gel or 
lotion for use on the skin to treat vagi-
nal dryness, thinning skin and painful 
intercourse. 

46 | NOVEMBER 28 • 2024 
J
N

New treatments expand options for menopausal women.

Relief from 
Menopause Symptoms

SHARI S. COHEN CONTRIBUTING WRITER

HEALTH

Andrea 
Eisenberg, 
M.D.

Steven 
Dean, M.D.

Joshua 
Dean, M.D.

What Is 
Menopause 
and What 
Are the 
Typical 
Symptoms?

Menopause is a natural 
Menopause is a natural 
stage of a woman’s life 
stage of a woman’s life 
— typically occurring 
— typically occurring 
during the early 40s or 
during the early 40s or 
50s. The clinical defi-
50s. The clinical defi-
nition of menopause is 
nition of menopause is 
one year without ovu-
one year without ovu-
latory cycles and men-
latory cycles and men-
strual periods. However, 
strual periods. However, 
many women have 
many women have 
symptoms several years 
symptoms several years 
prior to menopause 
prior to menopause 
(perimenopause) and 
(perimenopause) and 
for a few, these symp-
for a few, these symp-
toms continue into their 
toms continue into their 
70s. 
70s. 

As a result of reduced 
As a result of reduced 

estrogen production, 
estrogen production, 
women can experi-
women can experi-
ence night sweats 
ence night sweats 
that impede sleep, hot 
that impede sleep, hot 
flashes, brain fog, and 
flashes, brain fog, and 
mood swings including 
mood swings including 
anxiety, irritability and 
anxiety, irritability and 
depression. After meno-
depression. After meno-
pause, some women 
pause, some women 
experience hair loss, 
experience hair loss, 
osteoporosis and vagi-
osteoporosis and vagi-
nal dryness. According 
nal dryness. According 
to Dr. Benjamin, approx-
to Dr. Benjamin, approx-
imately 80% of women 
imately 80% of women 
have significant meno-
have significant meno-
pause symptoms while 
pause symptoms while 
the remaining 20% have 
the remaining 20% have 
mild or no symptoms. 
mild or no symptoms. 

“It’s a spectrum. Risk 
“It’s a spectrum. Risk 

factors are based on 
factors are based on 
the patient’s ethnicity 
the patient’s ethnicity 
and medical issues,” 
and medical issues,” 
says Dr. Joshua Dean. 
says Dr. Joshua Dean. 

For more information, 
For more information, 

visit www.womenshealth.
visit www.womenshealth.
gov/menopause.
gov/menopause. 

