Several studies have shown that menopausal vasomotor symptoms (hot flashes and/or night sweats) and sexual symptoms are undertreated in all age groups of women. In fact, an article published in Menopause last February found a “high prevalence of untreated moderate to severe vasomotor symptoms and sexual symptoms even in women aged 60 to 65 years”. This large study evaluated 2,020 Australian women aged 40 – 65 years of age over a period of 18 months.
As new research continues to verify the presence of bothersome hot flashes and sexual symptoms persisting later in life, the medical industry must consider rethinking its approach to menopause treatment in older women. In response to these findings, the North American Menopause Society issued a statement encouraging the consideration of hormone therapy after 65 years of age when appropriate and when benefits outweigh risks. The society’s medical director stated, “the use of hormone therapy should be individualized and not discontinued solely based on a woman’s age”.
This is an important finding, as insurance companies often choose to deny coverage and physicians may also refuse to prescribe hormone therapy because of supposed safety concerns in older women. This has traditionally been justified on the basis of a standard list of medications that may harm older people, known as the Beers list, which includes hormones. Furthermore, many guidelines still recommend against systemic hormone use for women more than 10 years after menopause or after age 60 (and to use them for only a limited time, ideally for 3 – 5 years). Considering that the average length of menopause symptoms is now thought to last approximately 7.5 years, traditional recommendations leave both patients and physicians in a conundrum. It also means that women age 60 and older who have really bothersome menopause symptoms are often left without many options.
I am really pleased to see the North American Menopause Society (NAMS) stepping up to the plate here with the reminder to healthcare professionals that many women in this age group are still experiencing symptoms and deserve appropriate care. According to NAMS, “the official position is that there should not be any hard and fast rules against hormones after age 65.” This goes without saying that a complete medical history that evaluates the pros and cons of hormone therapy in older women should absolutely be performed and is a vital part of appropriate prescribing. However, I think these recent findings and the response from NAMS not only encourages the medical profession to stay up-to-date on the current research and thinking but also provides relief from an antiquated belief that hormone therapy must be limited due to age.
At A Woman’s Time, each of our physicians is well trained in hormone replacement therapy, including bio-identical hormone prescribing. In our practice, we always aim to start women on the lowest possible effective dose and customize our hormone delivery methods for each woman to maximize benefits and mitigate side effects. Likewise, a woman’s individual risk factors are always discussed and taken into consideration. We take the whole spectrum of health into consideration and also have the ability to guide patients with non-hormonal, natural treatments that may be used alone or in conjunction with bio-identical hormones. If you are experiencing menopausal symptoms at any age, please schedule an appointment with any of our knowledgeable providers at (503) 222-2322. At A Woman’s Time, we are dedicated to the health, well-being, and care of women in all stages of life.
