North American Menopause Society: Treasuring the Past – Shaping the Future

Sixteen years since its inception, The North American Menopause Society has become the leading organization focused on promoting the health and quality of life for women through an understanding of menopause. The organization has experienced phenomenal growth through the years, and present-day NAMS leaders look to the future with confidence.

“As we look to the future, we must always remember the past,” says Wulf H. Utian, MD, PhD, Executive Director and honorary Founding President of NAMS. “It’s important to realize that it has been a long journey to get to where we are today.”

Dr. Utian has devoted his life to the study of menopause and has been instrumental in educating the consumer and scientific populations on the subject. Generations ago the subject of menopause was surrounded by misconceptions and myths and largely ignored, both by the healthcare community and society. Women were on their own to deal with problems linked to the loss of their ovaries and low levels of estrogen.

Today’s women may spend half their lives living beyond this natural part of aging. The North American Menopause Society has helped women worldwide face the second stage of life in a different light, one filled with new discoveries, fresh challenges – and hope.

Discovery of a Passion

Dr. Utian was born, raised and educated in South Africa and completed his residency in 1966 at the University of Cape Town, one of the leading teaching and research institutions in the country. At that time, he had no interest in practicing medicine and planned to spend his career in academia. During his search for a PhD thesis subject, a colleague asked him to review a narrative paper on estrogen. It was during his review of the medical literature that he became intrigued on the subject of menopause.

“In those days when anyone had surgery, they remained in the hospital for ten, sometimes fourteen days,” say Dr. Utian. “When women had hysterectomies, regardless of their ages, their ovaries were removed because the belief was that they would become infertile anyway and there was no point in leaving them in as they might end up cancerous. Within 48-72 hours of surgery, I noticed younger women began complaining of severe hot flashes and their doctors would say ‘its part of the trauma of surgery, and you will get over it.’ Six weeks later we’d see these same patients in postoperative clinic and they were still complaining.”

Dr. Utian’s fascination with the subject of menopause continued and he searched through medical literature for more information on the subject. 

“There was literally nothing, no real research on menopause,” he says. “I suspected the ovaries played a larger role than just being organs related to fertility. They were producing hormones, and I believed there must be something else going on.”

It was the late 60s and Dr. Utian began his thesis entitled, “The Clinical and Metabolic Effects of Ovariectomy and the Role of Replacement Exogenous Estrogens.” His goal was to find out what happens clinically and metabolically to women of reproductive age when they are given replacement hormones after their ovaries have been removed surgically. He simultaneously began an endocrine fellowship in the Department of Medicine at the University of Cape Town in South Africa and published the first scientific papers and reviews on the subjects of menopause and ovariectomy.

“As my research developed, I realized that I really wanted to discover what the real symptoms and effects of the menopause were and try to tease that out from the associated aging factors,” he says. “So began my 40-year passion on the subject of menopause. I’ve been involved in it ever since.”

Birth of the North American Menopause Society

In 1970, Dr. Utian traveled for the first time to the United States to present a paper on menopause at the combined meeting of the American College of Obstetricians and Gynecologists and the International Federation of Gynecology and Obstetrics. At that time in the states, there was little interest in the subject of menopause. His paper was the only one presented on the subject of menopause and was scheduled during the final session of the meeting. Only a handful of interested people attended his session.

The following year Dr. Utian presented, once again, the only paper on menopause at the annual meeting of the British Congress in Obstetrics and Gynecology. While at the meeting, he met with Pieter van Keep, MD, PhD, Director General of the International Health Foundation in Geneva. Dr. Utian describes the day of their meeting as THE most historic day in the history of menopause.

“Pieter was interested in menopause from the psychosocial aspect and had done some research in Europe on the socio-economic impact of menopause in five European countries,” says Utian. “I was only interested in the science of the menopause, having just completed my PhD on the clinical and metabolic effect of ovariectomy and the role of exogenous replacement estrogens. It was the first science on the subject and was incorporated into the first randomized trial on hormone therapy ever done. We had a meeting of the minds and decided to create a club and bring together researchers who were interested in the subject.”

Utian and van Keep shared a great passion on the subject of menopause. They invited other researchers who shared their interest to a series of meetings under the auspices of the International Health Foundation in Geneva and published each meeting as a proceeding. In 1976, they held the first international meeting in France where 150 people attended from all over the world. At the next meeting in 1978, the International Menopause Society was formed.

By the mid 1980’s Dr. Utian had traveled the world to at least twenty countries, helping medical communities establish their own national menopause societies. Between his travels and his work within different societies, he had developed quite a network of colleagues in every major city in the world. As interest in the subject of menopause grew, experts in the field began to make important connections. One of the pioneers in osteoporosis research, Chris Norden from the Mineral Metabolism Research Institute in Leeds, attended a meeting with one of his promising young investigators, Chris Gallagher, who would later bring his knowledge and expertise to the United States.

“I was instrumental in starting menopause societies around the world,” says Utian. “It became an embarrassment that there was not a society in the Unites States. I put up announcements and asked if people were interested in forming a society in the States, but got a really poor response.”

After rumors began circulating about the creation of an American menopause group, Dr Utian met with a colleague in New York to discuss an upcoming New York Academy of Sciences meeting. During that trip, he contacted a lawyer for legal advice about developing a not-for-profit scientific menopause organization. The first step was to develop a board of trustees, so Utian contacted people around the United States and Canada who were involved in different aspects of menopause research. Dr. Utian agreed to be a trustee as well.

The North American Menopause Society was founded in 1989, and later that year about 300 people attended the first meeting of NAMS in New York as a joint meeting of the Academy of Sciences and North American Menopause Society. Historic ground was broken at the meeting as Utian’s vision of a multi-disciplinary meeting came to fruition. The meeting brought together professionals representing a variety of disciplines who were intellectually interested in menopause, including clinical and basic science experts from medicine, nursing, pharmacy, anthropology, sociology, psychology and complementary/alternative medicine. The results were phenomenal and the entire meeting was published as the full annals of the New York Academy of Sciences.

The NAMS Focus Expands

In 1989, Dr Utian was named Chair In Reproductive Biology at Case Western Reserve and the Director of Obstetrics and Gynecology at University Hospitals of Cleveland. University Hospitals supported NAMS for the next five years, and by the mid-90s, their offices became flooded with letters from women all over the country with questions on how to deal with menopause symptoms, how to find a doctor and how to access healthcare. It became quite obvious that there was tremendous consumer need, so Dr. Utian and his colleagues added a new facet to the NAMS mission – it would become a reliable, trustworthy and evidence-based source of information to the consumer. NAMS officially became an outreach to consumers through the birth of the organization’s URL at http://www.menopause.org

Today more than 6,000 women reach menopause each day in North America alone, and the public health challenge has never been greater. NAMS will continue to focus its considerable expertise to promote scientific truth about menopause.

NAMS dedicates its efforts toward the activities, services and sponsorships that:

• Stimulate, recommend, recognize and support research on physiological, medical, genetic, psychological and culture aspects of menopause and its translation into clinical practice;
• Promote the exchange of multidisciplinary scientific knowledge of menopause through efforts that include the annual scientific meeting and the journal Menopause;
• Delineate the scope of, and promote excellence in, menopause-related clinical practice;
• Develop and distribute continuing professional education for healthcare providers, researchers and educators that increases understanding of menopause;
• Enable women to participate actively in menopause-related healthcare decisions by providing them with culturally sensitive, scientifically accurate information;
• Serve as the definitive, independent resource on menopause for healthcare professionals, researchers, the media and the general public.

More Work To Do

The NAMS Annual Scientific Meeting remains the preeminent annual meeting worldwide on menopause and the society’s journal, Menopause, remains in the top three of the Science Citation Index (SCI) rankings. Millions of NAMS printed materials have been received by consumers all over the country and the website receives five million hits each month. Both consumer and scientific education programs continue to be updated and developed. The NAMS competency examination is recognized as the sign of excellence for those who earn the credential.

The success of NAMS stems from the efforts of NAMS members, other health professionals, the Central Office staff and the passion of a young scientist who would not stop until his work was done. Throughout his impressive career, Dr, Utian has juggled many positions – as clinical practitioner, academic administrator, research center administrator and executive director of NAMS. Many times, he says, he came very close to relinquishing his responsibilities with the organization, but has committed to stay involved through 2009, twenty years after founding NAMS.

Dr. Utian says that the NAMS organization has taken a life of its own and is devoting his final three years to raising money through philanthropy to create menopause related medical education programs for nursing schools and residency programs in medical schools.

“The NAMS organization has grown phenomenally,” he says, “and the quality of the meeting has flourished and will continue growing. The committees and people involved are extraordinary and we are at a huge growth curve. I know when I give it up after twenty years; I will have made a difference.”