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.