Menopause and the Mixed Messages from Health Officials
The Department of Health and Human Services recently announced that hormone replacement therapy (HRT) would no longer carry a severe warning. The warning had suggested that HRT could cause cancer and stroke. The FDA decided to remove this warning, stating it was based on outdated and overblown research.
Doctors Welcome the Change
Many doctors treating women with menopause symptoms—such as hot flashes, brain fog, and insomnia—welcomed the decision. The Menopause Advocacy Working Group praised the move, saying it would help eliminate unnecessary fear.
Criticism and Concerns
However, not all doctors agreed with the claims made during the announcement. Some argued that the panel overstated the negative effects of menopause and questioned the benefits of HRT.
- One doctor stated that menopause does not cause divorce.
- Another noted that menopause does not shorten women's lives, as women generally 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 due to health conditions, including:
- History of blood clots
- Stroke
- Certain blood conditions
- Breast cancer
Controversial Claims on Breast Cancer and HRT
One panel member suggested that lifelong vaginal estrogen therapy helps breast cancer patients live longer. However, another doctor disagreed, stating there is not enough evidence to support this claim. Breast cancer patients are usually advised to avoid most forms of HRT.
Disagreement on Testing Estrogen Levels
The panel recommended testing estrogen levels in perimenopausal women, but the North American Menopause Society disagrees. They argue that estrogen levels fluctuate too much during this time. Instead, doctors should prescribe HRT based on a woman's symptoms.
FDA's Broader Review and Criticism
The FDA's decision to remove the warning was part of a broader review. The agency claimed it was listening to women who have been challenging medical paternalism. However, some found this statement ironic, as the FDA has recently added warnings to other proven-safe medications.
Concerns Over Antidepressants and Abortion Pills
- The FDA convened a mostly male panel to discuss antidepressants for pregnant women, leading to calls for a black box warning on SSRIs. Reproductive health experts fear this could increase stigma for women who need these medications.
- The FDA also plans to review the safety of mifepristone, a drug used in medication abortion. Over 100 studies confirm the pills are safe and effective, but advocates worry the review could restrict access.
Rise of Doctor-Influencers
The announcement also highlighted the rise of doctor-influencers. Two speakers at the event have large social media followings and offer expensive treatments and memberships. However, one doctor cautioned against relying on influencers, emphasizing that lifestyle changes are more important than hormones for staying healthy.
