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.