Using hormone therapies for menopause

Gloria Richard-Davis MD, MBA, NCMP, FACOG:

I'm Dr. Gloria Richard Davis. I'm a professor in the Department of OB/GYN at the University of Arkansas for medical sciences. I'm a reproductive endocrinology and infertility specialist by training.

What was your session at ACOG about?

Gloria Richard-Davis MD, MBA, NCMP, FACOG:

So, we basically capsulated a lot of information in 1 hour, called Menopause 101. And specifically, what we try to achieve in that session is to provide an update on the status of hormone therapy post Women's Health Initiative (WHI). We’re 20 years post WHI, and still there is lingering concerns that resulted from WHI as it relates to hormone therapy, and those concerns are exaggerated as we knew from over 10 years ago, but it continues to plague providers who are trying to provide education and options for symptomatic healthy menopausal patients.

What is the significance of this topic?

Richard-Davis:

About 5000 women per day enter menopause. If you look at the US population, that is one of the largest growing segments of the population. And of the menopausal women 80% of them have symptoms, 15% to 20% of them have symptoms severe enough that it is disrupting their life. And so, if we as providers are not able to provide access, provide education, provide options for for treatment of those symptoms, then it impairs the quality of life. There's even been studies that have looked at the economic impact, because many of those women are in their prime years, and with regard to their career, they are at the pinnacle, the height of their careers. So, some of them choose not to go up for promotion, because their their vasomotor symptoms, their menopausal symptoms, it's so disruptive, the sleep disturbances, they feel like they have cognitive dysfunction is impaired, because of the lack of restful sleep of REM sleep. And they fell the fatigue that comes with it. So, they feel like they can't take on the additional stressors of a promotion or the additional challenges of promotion.

What are 3 takeaways from your presentation?

Richard-Davis:

The first takeaway is women should not have to suffer in silence when we have safe, effective options to treat vasomotor symptoms, which is the most common. The second thing is that there are individual variances or differences in the way that women experience menopause. It's not a 1 size fits all. So, individualizing therapy, and in particular for women of color, being aware of the fact that they have symptoms that are more severe or longer, and that they are being under treated. So, we have to do a better job of serving all of our patients. And thirdly, the WHI is we're 20 years past WHI. We need to accept the fact that it was a flawed study and we now have enough data, post post hoc analysis, and other studies that have demonstrated that it's a timing issue, if we start hormone therapy early in young, healthy, postmenopausal patients, it is safe. If they're more distant from menopause ,10 plus years, then that's a further conversation that needs to be had. And that there are other non-hormonal options for patients who cannot take hormone therapy.

How has the conference been for you?

Richard-Davis:

So far, it's been a great conference. It's always exciting for me to see colleagues from around the country that I don't get the opportunity to see you on a daily basis, so that's always fun, and to see people who I’ve trained who are out in the world providing care and making a difference.