Monday, December 11, 2006
The Menopause Catch-22
Menopause isn't a disease.
But for the 150,000 American women entering menopause each month, the mood swings, hot flashes and libido changes that often accompany a drop in estrogen can leave them feeling, "I need help."
Consider: 50 percent of all women go to their doctor for menopausal symptoms. But many women have mixed feelings about taking medications for this natural change of life. Do benefits outweigh risks?
The FDA has revised its guidelines, stating that hormone therapy should be used only for the short-term relief of symptoms - and only for low-risk patients (no smokers, no history of breast cancer) because of the risk of breast cancer, heart attacks and stroke.
Yet, the American College of Obstetricians and Gynecologists maintains hormone therapy is effective at relieving menopausal symptoms, and may even ward off osteoporosis and memory loss.
Dr. Louann Brizendine runs the Women's Mood and Hormone Clinic at the University of California, San Francisco, and is author of the book, "The Female Brain." A neuropsychiatrist, she frequently prescribes not only hormone therapy, but anti-depressants such as Paxil, Prozac and Celexa in small doses to ease irritability and restore libido during a patient's seismic shift in her hormonal self.
"There are all sorts of things we doctors can use nowadays that can get you back to feeling your best," says Brizendine, stressing women may not need medication forever but rather just during the transitional period when they feel most on edge.
But what of this notion, 'this is what nature intended' and if we're out of control, we're bad? Dr. Brizendine, the daughter of protestant missionaries, has a ready anecdote.
While treating Sisters of Charity nuns for their menopausal symptoms a decade ago, she asked them whether their Lord would think it's a sin to take medication.
"Oh no," the nuns assured her. "He'd be upset if we didn't use everything provided by Him to help us be our best selves."
The decision to medicate menopause remains a highly personal one, and each woman must be the arbiter of her own risk. But it's important to know there's an arsenal of drugs out there that target menopausal symptoms and if you're feeling bad, your doctor can help.
As Dr. Brizendine is fond of saying: "The change will set you free."
We'll have more from Dr. Brizendine and the "The Brain on Menopause" this week on American Morning.
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