As promised, this is part II of my updates from the North American Menopause Society (NAMS) that met in Philadelphia October 11-14 2017. If you missed part I, which brought you the latest updates on insomnia, depression, dry vagina, painful sex and migraines you can read all about it here.
Since 1989, NAMS has been promoting 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.
Here are a few more important takeaways from the conference:
Can transdermal estradiol help with treating and preventing perimenopausal depression? A one-year intervention was conducted by a team of doctors at the University of North Carolina at Chapel Hill, Dr. David Rubinow and Dr. Susan Girdler, that demonstrated that transdermal estradiol was effective in preventing clinically significant depression among women in early menopause transition. This study suggests that stabilizing fluctuating estradiol levels (which occur during a women’s menopause transition) with a transdermal estradiol patch, may be a great option for preventing perimenopausal depression. Apparently, the treatment was most effective in women who reported a greater number of stressful events in the six months preceding the enrollment in the study.
Long-term treatment of osteoporosis was clarified. As I have mentioned in previous blogs about bone health, osteoporosis is a common problem among postmenopausal women. Sadly, there is no cure for osteoporosis. Long-term treatment is often needed to help protect against fractures. The question remains how long does one stay on some of these treatments? If you are on bisphosphonate therapy a commonly prescribed treatment for osteoporosis, it would be helpful for you to know that The American Society for Bone and Mineral Research has clear recommendations about, “bisphosphonate holidays.” It was stressed that the concept of a “holiday’ from taking treatment only refers to bisphosphonate drugs, not to other osteoporosis treatments, such as raloxifene, teriparatide, and denosumab. If you stop those treatments, the beneficial affects (protection from fractures) are lost quickly.
Dr. JoAnn Pinkerson, NAMS Executive Director states, “Prevention of osteoporosis should be a goal for those treating menopausal women, as up to 20% of bone loss occurs within the first five years of menopause. Once diagnosed with osteoporosis, the goal becomes lowering the risk of fractures as fractures can be life changing and life limiting.”
Despite the fact that the current data points to the effectiveness of Hormone Therapy (HT) for the relief of menopausal symptoms, women are still so skeptical. The current published evidence from the WHI (Women’s Health Initiative) suggests that HT is a relatively safe solution for menopausal women under the age of 60 or within 10 years of postmenopause. In addition, HT does not need to be routinely discontinued in women aged older than 60 or 65 years and can be considered for continuation beyond age 65 years for persistent hot flashes, quality-of-life issues, or prevention of osteoporosis after appropriate evaluation and counseling of benefits and risks. (You can read more about HT here.)
One of the issues causing women to hesitate to get the help they need is that the healthcare providers have “knowledge gaps” on the safety of HT. (That’s a nice way of putting it!)
Granted today, we have many other options available to us. But, it is important to note, that HT still ranks as the most effective treatment for those often life changing and debilitating symptoms of menopause.
“This study tells us that there remains an unmet need to educate women about the safety and effectiveness of hormone therapy for most symptomatic women. The benefits go beyond the relief of hot flashes and include improvement in night sweats, sleep disruption, prevention of bone loss and fewer heart events,” says Dr. JoAnn Pinkerton.
I am post-menopausal, but I remember how confused, scared and clueless I was when I started my perimenopausal journey. That is why I want to help impart the latest information as it comes out to help you base your healthcare decisions on facts instead of fear.
Please pass this information onto your family, friends, and co-workers. Let’s all do our part to help the sisterhood so that we can all lead happy, healthy lives during our perimenopause, menopause, and postmenopausal years!
Remember: Suffering in silence is OUT! Reaching out is IN.
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2 thoughts on “2017 North American Menopause Convention Updates on Transdermal Estradiol/Depression, Osteoporisis, and Hormone Therapy”
Thank you so much, Ellen, for posting this very important information! I just printed out the 26 page NAMS 2017 hormone therapy position statement and plan to read it while I’m waiting to get my DEXA bone scan today.
Great, Randie. So happy it is helpful!