Sue Richards, regular Canadian gal, heats up as her reproductive Best Before Date expires.
Thursday, 5 April 2007
I get daily news alerts for issues relating to menopause. Even though menopause can be a hot experience, the subject is not a hot topic.
Today’s three headlines offered me pretty much nothing except a desire to be snarky and sarcastic in my response. Given it’s snowing outside - again - and our previously greening landscape is white, I do have a bit of an attitude today - so might just as well let it rip on my news review.
First Headline: Hot flashes may raise blood pressure
Apparently women who have hot flashes also have higher blood pressure than the non-flashing woman.
As a flasher, does this not strike you as obvious?
Headline Two: Estrogen-Only Hormone Therapy Approved for Menopause Relief
When the Women’s Health Initiative study on HRT reported their grim results in 2002, millions of women flushed their drugs down the can. Ever since then, makers of HRT have been twisting in the wind to find a way of recouping that incredibly lucrative market. According to this report, younger women within 10 year’s of menopause - that being the moment that you have gone a full year without a period - can safely consider HRT provided it is estrogen only.
Here’s some math. The first study lasted fifteen years before it was aborted. This new research would not have been started until after 2002 thereby making it five years old at best. All I can say to this is nice try boys but your research is just too young.
Headline Number Three: HRT Not So Bad For Women Entering Menopause
This is the same story as number two except with more tentative language. Call me menopausal but “not so bad” does not inspire confidence in me.
I would like to make a plea to the news makers of lame menopause stories.
Please do a friggin story on menopause with some teeth. Maybe investigate how meno-women are treated in the workplace or report on what family members can learn that will be helpful for all parties of a heavily hormone deficient household? Provide some helpful news about a real life situation, a life stage that effects millions - instead of this thinly veiled, regurgitated same old same old. I know you’re all under thirty or male but for crying out loud, get in the program.
Sue Richards
Menopause Tags: My Menopause Blog, my menopause blog,Sue Richards, peri-menopausal, menopause relief, guelph blog, baby boomer, womens health news, menopause symptoms .
April 5th, 2007 at 5:16 pm
I also am feeling a little snarky today(and no snow in sight)…after reading your post I had to just lower my head and raise my fist. Thanks for pointing out reality.
April 5th, 2007 at 7:04 pm
Good idea to tell the media what women need to know about menopause,
April 6th, 2007 at 1:32 pm
“As a flasher, does this not strike you as obvious?”
This is certainly true. But what I think this information expands upon is a direct physiological link for something that was pretty much considered an “all in your heads” phenomenon, as in: if you poor little wimps weren’t so suggestible and feeling sorry for yourselves, this wouldn’t be a problem. Medicine as a discipline is evidence-based, which means doctors put total credibility in research, despite its reductionist flaws, and total incredibility in anecdotal reports (what we actually experience, in other words). So when we can point to a study, we do gain credibility in that a doctor can now treat this as an actual mechanism instead of a delusion on our part. These are the rules of the game, and we just gained another play.
Beyond that, though, I see another value in elucidating this link. Because many women become hypertensive with the onset of menopause, especially women who go through the more rapid and hence traumatic surgical transition, many doctors explicitly withhold hrt because they conflate the risk of stroke due to hypertension with the risk of stroke due to the clotting enhancement provided by oral hrts. This tends to create a feedback loop whereby the woman in severe hormone deficiency finds her BP increasingly resistant to treatment because the primary mechanism, hormone normalization, is denied. In fact, women in surgical meno who receive hrt find that their BP tends more often to stabilize than not. This study provides a link, then, that may allow women to challenge their doctors’ initial impression–withhold hrt–with other information they may find valid. I think that is a real gain.
“millions of women flushed their drugs”
May I share with you the fact that this terminology for hrt makes me wince? HRTs are really much more like supplements, making up something our bodies produced on their own but may now produce in amounts below our level of need, rather than drugs that impose an abnormal function on our bodies in pursuit of a therapeutic goal. Menopause is not an illness and we don’t need medical treatment; it is a lifestage characterized by adapting to a post-fertile level of hormone supply. For those of us who are unable to meet our post-fertile hormone needs, those minimal levels needed for continued healthy physical function, hrt use represents supplementing that supply with something that is either identical to what we previously made ourselves (the whole realm of hrts identical in molecular makeup) or has actions similar to our own production (the synthetics), just like insulin makes up that same deficit in those who suffer the hormone deficiency called diabetes or those who supplement their thyroid output by taking supplements of that hormone. While it’s confusing that these supplements are regulated in the same way as drugs, I think that conceptualizing them as supplements rather than drugs is one step in de-pathologicizing menopause.
“‘not so bad’ does not inspire confidence in me.”
Does a 70% enhanced all-causes mortality risk on the part of younger women in surgical meno who do not supplement their hormones to functional levels inspire any greater confidence? There are risks on both sides, and each woman has to start from her own individual health situation and plot her path through those risks. We do ourselves and other women a disfavor when we see all of the boogeymen only on one side of the situation. Demonization of hrts is just as devastating and demeaning to women as the other side of the coin, the relentless marketing by those who profit from their use. They are highly complex tools about which far too little is fully understood. Every research study helps us gain a tiny piece of that understanding that will help us better our use of this and other tools. But by rejecting the complexity of both menopausal lifestage changes and hrt metabolism, we deprive ourselves of a chance to make a sophisticated and nuanced personal decision for our own best health.
“Please do a friggin story on menopause with some teeth. ”
Amen. But also please do not be holding your breath. It’s too complex, too personal, too conditional to reduce to the simplistic format appropriate to the sell, and we need to never lose sight of the fact that the publishing media are there to sell, not to inform.
Truly, I wonder about this a lot, how we can do a better job of getting this information out there in a non-sales way. Women are busy and they don’t want to embark on learning endocrine physiology at the very time they are feeling most deranged by it. They want answers and, sadly, this is a situation in which someone else’s answers are not going to carry them through. To say to women “this is about your personal needs and how you define them” and when they ask how they measure their needs the answer is “as you experience them” is just not satisfying in a world where we expect to have medicine give us the tools to produce firm answers. Medicine is wholly oriented, by definition, to recognition and treatment of disease; menopause is a lifestage, not a disease, and who is there to help us with that? I don’t have this answer but I surely would like to see all of the wonderful minds of menopausal women somehow forge a good one.
April 10th, 2007 at 11:01 am
I’d never heard of the link between HBP and hot flashes. I certainly have them both! I’m exercising a lot more, hoping that it will reduce both of them, but so far it’s staying about the same.
Great blog and great comment by Framboise. Interesting reading.
“menopause is a lifestage, not a disease, and who is there to help us with that?”
Perhaps the answer is to acknowledge that it is a transiton phase and our lives will be different. It’s a physical happening at a time when our children leave home and our interests change. We may focus more on work, or decide to ditch it all for a year at the shore finding our inner soul. But in order to make these choices, as well as understanding what’s going on with our bodies, we need to take the time and stop trying to be wonder women.
April 10th, 2007 at 1:50 pm
Terrific comments everyone - I will dedicate a blog post to this discussion….
Sue