Menopause can severely impact quality of life with symptoms like hot flashes and disturbed sleep. Hormone replacement therapy (HRT) is controversial due to conflicting information. A study linked HRT to increased risk of breast cancer, leading to a decline in its use. However, Joanne Manson, a leading expert on HRT, suggests that HRT should not be avoided at all costs. Joanne Manson, a professor at Harvard, joins the podcast to discuss the topic.
Menopause is getting a lot of press at the moment, having previously been almost never mentioned. Have we been too slow to take it seriously?
Do most women experience symptoms during menopause?
Should most women consider medication like HRT when going through menopause?
Is HRT safe for most people? Yes. With some qualifications, which we'll get into.
Can HRT prevent menopause weight gain? No.
I've stopped having periods, but never had menopause symptoms. Should I consider taking HRT? No.
The biggest myth is that women who do have bothersome symptoms should just suffer through these symptoms because there's no help available for them.
The menopause marks the end of menstrual periods due to the loss of ovarian function and reduction in estrogen levels. Perimenopause is the time when menstrual periods become irregular, often accompanied by hot flashes and night sweats. This transition has a significant impact on women's lives.
There has been a shift in the way menopause is discussed, with more emphasis on seeking help for symptoms. Hormone therapy is now considered appropriate for some women with moderate to severe symptoms, but not all. The decision to start hormone therapy should be made after careful consideration of the benefits and risks.
Risk factors for experiencing menopausal symptoms include racial, ethnic, and cultural differences, smoking, higher body mass index, comorbidities, and stress. However, it is difficult to predict who will have bothersome symptoms until they are experienced.
A significant percentage of women experience burdensome symptoms during the menopause transition, impacting their work productivity and overall health. The advocacy and activism of the patient population have contributed to increasing attention to this neglected topic.
It is important to take menopausal symptoms seriously and not shrug them off. While medication and hormone therapy may be beneficial for some women, lifestyle modifications such as avoiding triggers and increasing physical activity can also be helpful.
Diet and weight have been associated with the severity of menopausal symptoms. A high-quality diet has been linked to lower risks of hot flushes, sleep disturbances, brain fog, and anxiety. Lifestyle modifications are recommended for their overall health benefits.
Sarah Berry emphasizes the importance of regular physical activity, a plant-based diet, and avoiding triggers like alcohol and smoking to help with menopausal symptoms and overall health.
She mentions that soy products and marine omega-3s may benefit some women, but there is no clear evidence for dietary supplements in reducing hot flashes and night sweats.
Sarah Berry discusses the benefits of hormone therapy (HT) in replacing estrogen to alleviate menopausal symptoms and the importance of considering bioidentical forms of estrogen and progesterone for safety.
The use of testosterone in women has been controversial, but many women feel it is making a difference for them and are interested in taking it.
The Women's Health Initiative trial led to a misunderstanding about hormone therapy, but it was focused on women in their 50s to 70s, and the risks outweighed the benefits for prevention of chronic diseases in that age group.
For women in early menopause with bothersome symptoms, the benefits of hormone therapy likely outweigh the risks, especially with lower doses, patch estrogen transdermal formulations, and micronized progesterone.
The decision to stop hormone therapy should be individualized, considering the overall risk profile of the woman, her symptoms, and health factors.
Hormone therapy does not work immediately, taking about four weeks to see the benefits, and it may help with weight management during menopause, but does not eliminate weight gain or changes in body composition.
Regular physical activity, high-quality diet, limiting alcohol, and real food like tofu may help alleviate menopausal symptoms.
Finding the right doctor is important, and there is help available to alleviate menopausal symptoms.
Jonathan Wolff thanks Joanne for joining him on Zoe's Science and Nutrition and promotes Zoe's personalized nutrition program for improving health, offering a 10% discount. The podcast is produced by Yella Huynhs-Martin, Richard Willan, and Alex Jones.