I recently read an article titled “Better Training for Menopausal Management Urgently Needed” in Medscape Medical News. I found the article both fascinating and dismaying.
It only confirmed what I have seen in our medical practice. Menopause is grossly untreated. The article also states that doctors need to look beyond what they are taught in medical school and keep up to date on the newest literature. Unfortunately, most doctors continue to practice what they learned either in medical school or residencies.
Owen Montgomery, MD, chairman of the Department of Obstetrics & Gynecology at Drexel University in Philadelphia, Pennsylvania believes that “Medical educators have remained fixed in the time since the WHI came out saying estrogen kills, but if they kept up with the literature, estrogen keeps women alive longer,” Dr. Montgomery said. “Young doctors are being told hormones are terrible and don’t prescribe them, but if you look at the data, they actually save lives.”
Part of the problem is that following the publication of the results or the WHI, or the Women’s Health Initiative study, doctors stopped prescribing hormone replacement therapy. An 80% decrease in the use of hormone therapy developed since the WHI. The study had major flaws, but it definitely set back women’s menopausal health for years. In addition, the furor over increased risk of breast cancer has led many women to miss out on the many benefits of hormone replacement therapy. The American College of Obstetricians and Gynecologist published their opinion this month :
“Among women with a history of estrogen-dependent breast cancer who are experiencing urogenital symptoms, vaginal estrogen should be reserved for those patients who are unresponsive to nonhormonal remedies,” the American College of Obstetricians and Gynecologists committee writes. “Data do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms.”
We at Mitchell Medical Group have been saying this for years. I am glad to see that the medical community has finally caught up. But there is still a long way to go. The WHI only studied synthetic hormones and not bio-identical hormones. I believe that using synthetic hormone replacement therapy is outdated and just bad medicine. Bio-identical hormones have been around for decades and have a much greater safety profile. They were compounded and many still are by compounding pharmacies. The trouble for most physicians is that compounding pharmacies are not regulated by the FDA. Not that all medications that the FDA has approved have proved harmless, but that’s another story. Suffice to say that Big Pharma took note of the usage of bio-identical hormones and began to manufacture them. Many patients are not aware that they can get their bio-identical hormones, covered by insurance, from a regular pharmacy.
At Mitchell Medical Group, after a careful history, physical, and bloods, determine what types and doses of bio-identical hormones are right for you.
– Dr. Ricki Mitchell
Mitchell Medical Group, NYC & Long Island