[Forbes] Menopause Symptoms

Science is so slow to evolve:  As one who tries very hard to learn from his patients, it is unbelievable that it has taken 100 years since the isolation of estrogen to  “discover this secret.”  Women begin having symptoms of menopause in my experience 8-10 years before menopause.  The missing link still however is what to do about it??  Here’s part of the conclusion of the study: “Research about the epidemiology and management of LRS symptoms, anticipatory guidance for women, and education for clinicians who care for them warrant increased attention.”   This is their conclusion, yet it is very simple to piece together the idea that this represents declining circulating estrogen or more episodic up and down secretion of estrogen causing the symptoms.  The treatment is also so simple:  supplement estrogen.  We have treated thousands of such patients now who have their life back.

Women suffer unmeasurably during the menopause transition which includes this 10 year transition leading up to menopause (for the average menopause age of 51 this starts at age 41-43).  The age range, however, is 20-43.  Symptoms include: irritability, mood changes, memory problems, anxiety, depression, sleep disorders, increased headaches, skin wrinkling, hair loss, acne, weight gain, night sweats, bladder urgency and frequency, vaginal dryness, decreased sex drive, etc, etc).  These symptoms are the opposite of what all women wish for.  The simple treatment of estrogen supplementation reverses everything , yet the medical community has become very frightened of hormones and estrogen use.  There are many reasons for this overall fear of estrogen that has boiled over from the medical pot into the lay public where patients are very fearful of estrogen use.

I saw this play out first hand in the first year that I started practice when my then new partner, now 92 years old, had to have two big surgeries back to back and he was out for the better part of 6 months with me covering his patients.  He also was an avid observer of his patients and he started women on estrogen when they had the first complaint referable to low estrogen.  I was amazed at how young his 40-60 year old patients looked which at the time spurred me to consider what was really happening.  Not only did they look young but they were healthy, happy and looking through their charts they were not gaining the 20-50 pounds during their 40’s as other patients not on estrogen seemed to do.  I had the wonderful opportunity to peer into another doctors long term experience very early in my career, something that the vast majority of physicians never see.  I can now make plausible arguments, based on science, where a woman would be at higher risk of breast cancer and cardiovascular disease without adequate estrogen at all points in life.

While women are very concerned about taking estrogen for their low hormone symptoms, it is a completely different story with men.  I have never seen a male question being supplemented with testosterone, in fact they usually demand it.  Only recently have males been evaluated and treated for low testosterone.   Just food for thought, but women would have a much better existence with hormone use beginning as soon as the warning signs listed above begin to surface.  For patients with diminished ovarian reserve (endometriosis), this may occur in the 20’s!  You won’t find these concepts written anywhere in the medical world!