why are we unprepared for menopause?
Dr. Ricki Pollycove
Why are we unprepared for menopause? And what can we do about it? (Dr. Ricki Pollycove)
I want to strongly encourage you to watch these videos and to share them with your sisters and friends. What I and some of my other friends are experiencing watching Dr. Pollycove's webinars is a mixture of disbelief and anger about how misinformed we've been about risks of Hormone Replacement Therapy (HRT), current research about the benefits of HRT as well as research about women's increased health risks for osteoporosis, heart disease, inflammatory conditions, dementia in menopause. I have had some vague association of HRT as bad and increasing risk of breast cancer, none of which is born out in the research. What disturbs me even more, if I'm honest, is that I haven't taken the time to learn more about how my body works and what I/it needs as I age.
I've been reflecting about the amount of unnecessary physical pain and discomfort women are pushing through as we age. What if insomnia, osteoporosis, arthritis, vaginal dryness are not inevitable parts of aging? What if in Dr. Pollycove's words "We could take a different route?"
Mostly our doctors are not giving us a full picture of our options, making the connections between our health issues and peri/menopause hormone imbalances and even when making bioidentical HRT available dispelling our myths about the risks. Very few people are advocating for our health, well being and thriving. In some cases that includes ourselves. While I am more and more convinced about the benefits of bioidentical hormones, I am not advocating their use. I'm advocating for us being informed of options, having a holistic view of our health, informed about current research around menopause and HRT treatments so that we can make our own informed decisions. And advocate for ourselves in informed ways when we need to.
Shades of Menopause
Access for many women to accurate information and support around Hormone Replacement Therapy (HRT) treatment options is minimal at best, but for Black women and women of color that support is often non-existent.Dr. Louise Newsomhosts apodcastthat explores women's health with a particular focus on perimenopause and menopause. This particular episode features Dr Nneka Nwokolo and Dr Martina Toby and "discusses some of the socioeconomic and cultural factors, as well as gender inequalities that affect a woman’s experience of healthcare, and the unfortunate lack of research around use of HRT in women of colour."
Dr Nneka Nwokolo and Dr Martina Toby have also set up Shades of Menopause, an Instagram group that uses social media to support women of color around peri-menopause and menopause.
Thoughts on 1st Dr. Pollycove Workshop
Going into the workshop my assumption was that I would take the "natural" route (and not do hormone replacement therapy) as I move into menopause. For context Dr. Pollycove talked about the idea that for most of human evolution women didn't live into menopause and that our bodies haven't yet evolved to manage the estrogen deficiency that comes with living on average 30 years post menopause. The question that came to me in response to this was if estrogen deficiency increases risk of osteoporosis, high cholesterol, inflammatory conditions (arthritis, frozen shoulder), heart disease and we end up taking medications for these conditions, how "natural" is aging?
This is not to say that every woman should do hormone replacement therapy, but I think we all deserve to have accurate information about what's available in terms bioidentical hormones and what the current research says about health risks with and without HRT. None of my doctor's have talked to me about these options and according to Dr. Pollycove many doctors are just not informed about treatment, dosing and current research.
From the San Francisco Integrative Gynecology website:
The average age of full menopause is 51.5 worldwide and 85% of women suffer moderate to severe early symptoms like hot flashes, sleep difficulties (insomnia), lower moods, joint stiffness and pain (feels like arthritis has set in). Yet the majority of women who are not on systemic contraceptive hormones are unprepared for these changes and therefore can’t anticipate and deal with them successfully.... To make matters worse, ample fear-producing confusion surrounds topics like HRT, bioidentical hormones, natural progesterone vs synthetic progestins, and potential risks versus benefits of hormonal support short and long term. Even after seeing a doctor, many women receive unsympathetic responses and encounter lack of provider awareness of the details of hormonal changes and how to optimally manage them.... After menopause, estrogen production by our ovaries ceases, usually “bottoms out” and prolonged very low estrogen often creates an ever-increasing series of negative symptoms. Every woman journeys through this transition in her own unique way, some with profound life disruptions and others with few or minimal symptoms.