Menopause and the Mixed Messages from Health Officials

The Department of Health and Human Services recently made a big announcement. They said that hormone replacement therapy (HRT) would no longer carry a severe warning. This warning had suggested that HRT could cause cancer and stroke. The FDA decided to remove this warning, saying it was based on outdated and overblown research. Many doctors welcomed this change. They treat women who suffer from menopause symptoms like hot flashes, brain fog, and insomnia. The Menopause Advocacy Working Group praised the decision. They said it would help eliminate unnecessary fear. But not everyone agreed with the claims made during the announcement. Some doctors said the panel overstated the negative effects of menopause. They also questioned the benefits of HRT. For example, one doctor said menopause does not cause divorce. Another said menopause does not shorten women's lives. On average, women live longer than men. The panel also claimed that HRT improves the lives of all women. But this is not true for everyone. Millions of women cannot use HRT because of health conditions. These include a history of blood clots, stroke, certain blood conditions, and breast cancer. One panel member said that lifelong vaginal estrogen therapy helps breast cancer patients live longer. But another doctor disagreed. She said there is not enough evidence to support this claim. Breast cancer patients are usually advised to avoid most forms of HRT. The panel also recommended testing estrogen levels in perimenopausal women. But the North American Menopause Society disagrees. They say estrogen levels fluctuate too much during this time. Instead, doctors should prescribe HRT based on a woman's symptoms. The FDA's decision to remove the warning was part of a broader review. The agency said it was listening to women who have been challenging the paternalism of medicine. But some people found this statement ironic. The FDA has recently added warnings to other medications proven to be safe. For example, the FDA convened a panel to discuss the use of antidepressants by pregnant women. The panel was mostly male and called for adding a black box warning to SSRIs. Reproductive health experts say this could increase stigma for women who need these pills. The FDA also plans to review the safety of mifepristone, a drug used in medication abortion. More than 100 studies have confirmed the pills are safe and effective. But reproductive rights advocates are concerned. They fear the review could lead to restrictions on access to the pills. The announcement also highlighted the rise of doctor-influencers. Two of the speakers at the event have large social media followings. They offer expensive treatments and memberships. But one doctor cautioned against relying on influencers. She said lifestyle changes are more important than hormones for staying healthy.