The North American Menopause Society (NAMS) met in Philadelphia October 11-14 2017.  This organization was founded in 1989. It is a non-profit whose mission is to promote the health and quality of life of women during midlife and beyond. The membership (approx 2,000 leaders in the field of mid-life) includes clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education.

Since we share the same mission, I pay close attention to what they report at these conventions.  Here are some of the key takeaways from the conference:

Are you sleepless and depressed?  NAMS reported that insomnia is affecting 30-60% of peri and postmenopausal women.  (This could be why online shopping is giving mall retailers a run for their money!) In addition, depressive symptoms are affecting 25-40% of us in the vagina family. A new study suggests that cognitive behavioral therapy for insomnia can target negative thoughts and behaviors that contribute to insomnia and help you get your zzzzzzz’s back. The study provided promising results. They did cognitive behavior therapy intervention targeting both insomnia and hot flashes which led to meaningful improvements in sleep and depressive symptoms.  It is good to note, that the results were similar regardless of the severity of the depression.

Dry Vagina, Sexual Dysfunction or Urinary Problems anyone? A new study that reviewed the WHI (Women’s Health Initiative) data confirms that vaginal estrogen (often called Local Estrogen Therapy- LET) is not only effective but also safe.  It does not increase your risk of heart disease, breast or endometrial cancer.  Dr. Carolyn Crandall, a lead author of the study from the University of California in LA says, “These results should help reassure women regarding the safety of vaginal estrogen.”

Are you having less sex? As we age, it is common for our sexual activity to decline. (Unless you are living in a nursing home according to Saturday Night Live!) A new study suggests that this decline in postmenopausal women is due to vulvovaginal atrophy and lower urinary tract problems. (I know, that’s a mouth full.)  Now they want to rename these issues Genitourinary Syndrome of Menopause. Get the OPI nail polish brigade to rename this, please! For now, let’s call this GSM.

GSM includes symptoms of painful sex as a result of thinning of the vaginal walls, along with bladder problems that can lead to urine leakage during sexual activity (oh joy!), as well as other unpredictable times.  So how does one enjoy sex with these issues?  Let me not count the ways!  In addition to these lovely symptoms, they found that fear of pain during sex causes women to avoid intimacy even greater than bladder issues.  If you would rather mop your bathroom floor than get in bed with your lover, and you aren’t sure why, sit down with your Menopause Specialist and speak openly about these issues. As mentioned above, LET is an option that is extremely successful and safe and works wonders!

Is menopause giving you a migraine?  You are not alone!  Migraine’s affect one in four women. This is often due to changing estrogen levels. A new study reviews the WHI data to demonstrate that hormone therapy (HT) may benefit migraine sufferers without an increased risk of heart disease.

“Hormone therapy usage has been on the decline ever since the WHI clinical trials.  Newer data has brought further clarity to its safe use, especially in younger women (age < 60) who are closer to the time of menopause (within 10 years of the menopause),” says Dr. Peter F. Schnatz, immediate past president of The North American Menopause Society and one of the study’s authors. “Based on this newer data, hormones still have a major role in treating menopausal symptoms and preventing bone loss. A number of these women will have migraines. Hence, knowing the risk/benefit profile of hormone therapy in these women is critically important.”

NAMS went on to report that there have been very few studies demonstrating the effect of hormone therapy on migraines and subsequent cardiovascular disease.  Hormones have often not been prescribed for migraine sufferers because of the association between exogenous estrogen use and an increased risk of stroke in women who have migraines.  This led to the recommendation that combined oral contraceptives (better known as birth control pills) should be used cautiously or avoided entirely in women with a history of migraines, depending on whether or not the migraines were accompanied by an aura.

Data for 67,903 participants of the WHI clinical trials were analyzed to further examine the relationship between migraines and cardiovascular disease events and their interaction with hormone therapy use.  It was discovered that women with migraines tended to drink and exercise less than those without migraines and had higher vitamin D and calcium intake.  Migraine sufferers were also more likely to have night sweats and hot flashes.  Importantly, researchers did not detect a significant risk of cardiovascular disease events associated with a history of migraines.  Most significantly, from the treatment safety perspective, there was no impact from hormone therapy on this relationship.

If you are a migraine sufferer please read my interview with Dr. Susan Hutchinson, director of the Orange County Migraine & Headache Center in Irvine, CA: MENOPAUSE MONDAYS®  Migraine Headaches and Menopause.  Dr. Hutchinson says, “The choice may come down to whether birth control is needed in the perimenopausal woman who could still get pregnant. If birth control is not needed in a perimenopausal woman, then bioidentical hormones especially non-oral are my preferred treatment,” Dr. Hutchinson explains.

For now, this is enough to digest. Stay tuned for more updates next week!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

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