Margery Gass, MD, incoming director of the North American Menopause Society

Roberta Speyer:  This is Roberta Speyer reporting for OBGYN.net. I am here on a beautiful day in San Diego and we are just wrapping up this years' meeting, 2009, the North American Menopause Society, who a lot of us know as NAMS. This year I have the pleasure to interview one of the past presidents of NAMS, Dr Margery Gass, who is also going to be the new incoming director. Dr Wulf Utian has retired and Margery is moving to Cleveland with her family and going to be taking that position. I was hoping she would tell us a little bit about what her platform, and what her plans for the future are? These are exciting times for NAMS and I would like to know more about what you have in store.

Margery Gass, MD:  Well, Roberta thank you, it's very exciting times. My platform for menopause and our organization, the North American Menopause Society is to continue our mission of improving the health and quality of life for mid-life women and beyond. So there are plenty of things to keep us busy doing that. We want to improve the education that is coming to the clinicians and the practitioners. We want to get helpful messages out to women as they go through this major transition in their lives, and support new research. We still don't have all the answers but we keep making progress each year.

Roberta Speyer:  What is going to be the future with all of the technology that's at our disposal for communication tools in this new century? How do you see the North American Menopause Society fitting in on a global platform?

Margery Gass, MD:  We try to get as much of our information on the Web as possible, so that people around the world can access it. We are becoming far more interactive than we used to in terms of trying to set up two-way communication on the Web. We'll be moving forward with some of those options. We've incorporated technology into our meeting so that the participants can actually text the speaker, and those questions and comments can be addressed in real time. We had a blog open before the meeting so that people could give their questions to the speakers before the speaker even started, so lots of exciting advances in that way.

Roberta Speyer:  That's certainly something that's going to be even more as time goes by. I suppose you are getting a lot more interest in membership and participation also because of that on a global basis.

Margery Gass, MD:  Definitely! We have a lot of foreign members and international participants who come to our meeting, and we still believe that face-to-face contact is so valuable. Most people say they feel so invigorated by having been here and they are more inspired to go back to their home offices and do an even better job. So yes, technology is wonderful. It certainly can eliminate travel cost and things like that. But there is something truly exciting about face-to-face contact with the experts in the field.

Roberta Speyer:  I agree, you notice I'm here. Even though we run a website we know that if we don't come out and see what's going on, and interact with the doctors and professionals personally, you really miss so much.

Margery Gass, MD:  You do, and we're so appreciative that you're here because the media is so vital to getting messages out to the public. I really appreciate the fact that you're here.

Roberta Speyer:  Thank you very much. The website is www.menopause.org. It is not just a website for professionals, it is a website that serves the media and it also serves the consumers and the patients and the women who are looking for information.

Tell me about what you found at this meeting, maybe you see some new trends, or new things. My take on it was I see that there's a lot of interest in the quality of sexual function, for the menopausal, perimenopausal, post-menopausal woman, which seems to be kind of a new trend, or maybe more focus on that. Can you comment on that for us Dr Gass?

Margery Gass, MD:  Well, it has been getting more and more attention over the years, and rightfully so. Expectations are changing. People can talk about it publicly now. People are expecting to have their sexual life continue much longer, and they want it to be of good quality. So, we are focusing a lot of research on that and new developments are occurring. There are still a lot of unanswered issues there. There are certainly pain situations that are not fully understood, but little by little we are making progress on that and we want to make sure that's a key part of our program.

Roberta Speyer:  What is the research showing? Do you think that we have any future of looking at what we like to call the ladies viagra, or the female pill, or cure for this? It's referred to as the female sexual arousal disorder by some, or dysfunction. Is there any research that's supporting that we're moving in that direction? Or is it more of a psychological and combined therapy of things that are already out there?

Margery Gass, MD:  Often it is a combination of factors but there has been progress. There are products under development that could help various aspects of female function. We find that for women the main issue as they grow older is low desire, and that's where there could be some pharmacologic products that could help. We know that desire has a strong origin in the brain, and as things happen in the brain some of the neurotransmitters may even play a role in that - the chemicals that go through our brain circuits because we know that certain medications can depress some desire. So there are a lot of things that can affect the source of desire, which is probably most of the time located in the brain.

Roberta Speyer:  Are you saying that there are drugs that perhaps we are taking now for other conditions that may affect women sexually? May or may not do so for men, but definitely for women that they may not be aware of?

Margery Gass, MD:  Well, definitely there are and we know that for sure that when men take some antihypertensive medications for their blood pressure they can lose their erectile function. For women sometimes those medications, or sometimes some of the antidepressants, will actually suppress their ability to reach orgasm, and affect their desire. Different medications, not to mention problems with relationships and too much stress from other sources, can all affect desire. It takes considerable communication with a provider to determine the real source of the problem and then to see what we have to treat it.

Roberta Speyer:  There is a designation that if a woman is looking for a physician that has been trained and certified, or studied and specialized in menopause, that is conferred on them. Could you tell us just briefly about that so that women will know that if they are having problems specifically menopausal and they want to find a physician like that, what is that accreditation? What would that look like, or what should they ask?

Margery Gass, MD:  Yes, that accreditation is called NAMS Certified Menopause Practitioner; that's the North American Menopause Society’s certified menopause practitioner. That means that these individuals have demonstrated a special interest in menopause in their practice, and that they have acquired the knowledge to pass a written examination. We really feel that distinguishes them from other people. And it is not just one speciality. You might find a practitioner with that certification in the OBGYN world, in the family practice world, in the internal medicine world, but they are telling the public that they are specially interested in menopause, and not all doctors are. That can vary from office to office. 

Roberta Speyer:  Most of us, as women, our experience with our doctors is through obstetrics and then through maybe some gynecologic problems, or not. So the fact that if we are experiencing issues we may or may not be seeing someone historically that has that special interest, so it is incumbent upon us, I am glad you told us about that as women, to make sure that if we are looking for help with the various issues, whether they be hot flushes or whether they be sexual response, or many different things that come up as you are going through menopause and perimenopause, that there are special doctors out there they can find. That would be the North American Menopause Society Certified Menopause Practitioner.

Margery Gass, MD:  Yes, and actually we have put that service on our website, www.menopause.org. If women are in search of somebody who has had that special training they can get on that website and put in their zip code and find people in their area that have that certificate.

Roberta Speyer:  That's fantastic! We'll make sure that we have a link from this article and interview when we put it up on OBGYN.net to that specific part of your website so women can make sure that if they're looking for someone it's just an easy jump over for them to find that out.

So next year, where's it going to be Dr Gass?

Margery Gass, MD:  It will in Chicago next year.

Roberta Speyer:  Well, we're looking forward to it. We're certainly looking forward to talking to you again. It's going to be a hectic year but I'm sure it's going to be also a very bright and interesting one, and we wish you all the best in the world.

Margery Gass, MD:  Thank you Roberta.

Roberta Speyer: Thank you.