Menopause: Update on how to manage symptoms

Hot flashes, night sweats, insomnia, those are just a few symptoms of menopause. Now, the American College of OBGYNs has updated its guidance on how to manage the symptoms. Joining us this morning to talk about the guidance, Dr. Kumar. Great to see you, Dr. Kumar, as always, every Wednesday. Okay, so what are the updated guidelines? So, you know, the pendulum has swung. You know, so back when I first started in medicine, you know, routine hormone replacement therapy was recommended. for all postmenopausal women we thought that we'd reduce the risk of breast cancer and heart disease and then when they looked at these uh bigger studies in the early aughts in 2000 or so they went oh you know actually we're increased in the risk of heart disease by putting everybody on routine hormone replacement therapy let's not do that and hormone replacement therapy really got a for a generation got just poo-pooed and nobody did it out of the fear of embolism and heart attacks and so what they didn't account for is that as people get into perimenopause and menopause even without heart disease risk and the other things that the symptoms are very frustrating you know like you just mentioned you know hot flashes insomnia depression you know as these hormone fluctuations occur you know these symptoms are real and uh there was very little you know medical guidance for these perimenopausal and menopausal women to get treatment and what they found is that you know these hormone replacement therapy for menopausal symptoms not for routine everybody should have these hormones is actually quite safe and effective and so the American College of OB-GYN has just released the latest guidelines letting us know that is in fact okay to use menopausal hormonal treatment and non-medical therapy to treat these real symptoms that tens of millions of women suffer from so this is great news right it is it is great news back you know in the mainstream of medical care rather than on the fringes where you were using you know like holistic therapy or are people that specialized in it without the rubber stamp approval of the medical community this is now straightforward mainstream you know hormone replacement therapy is safe and effective so do you think this is going to kind of get rid of most symptoms i think that more women will make a veil of all these symptoms that they've quietly suffered with looking for solutions that you know that are less effective than right down the middle you know the reason they suffer is because as you go through the change of life you know your estrogen and your progesterone they're all fluctuating and if you can replace these things as the ovaries are shrinking and and your childbearing years are coming to an end you don't need these hormones as much. And so as you start lacking in them, there's other symptoms that can crop up. Now, what's interesting about the American College of OBGYN's recommendations, highly advocate non-hormonal therapy as well for depressive symptoms. Antidepressants are certainly advocated. And even non-medical therapy like cognitive behavior therapy, acupuncture, sleep therapy, they have a list of other ways to treat these that are evidence-based that if you are not inclined to take medication there's alternatives for women that can achieve relief from these really really plaguing symptoms when will doctors start acting on these guidelines i know it took a while right for the previous ones in 2014 yeah you know i mean i think it's already there i think what these guidelines are doing they're reflecting common practice yeah i know so many people that are you know they're not going to wait they're like they suffer and they're going to find solutions and the solutions are really hormone replacement therapy And there's enough practicing physicians that already engage in this that hasn't been lacking. But now, you know, with the mainstream, they're coming on board. I think that more women in the mainstream are going to have availability to these really safe and effective therapies. A lot of people, this is not menopausal related, or I guess it kind of could be, say that progesterone is like a big glass of red wine. So a lot of people are going to want some progesterone if they're low. You know, maybe I'll try that. I don't know, Dr. Gormer. I don't know if you want that. No, maybe not. Maybe I'll just drink a big glass of red wine. There you go. Maybe I think I'll just do that. Extra big. There you go. Thanks, Dr. Gormer. That'll take for my progesterone experiments. Great to see you. You too. We'll be right back.