BETHESDA, Md.-Doctors may be over-treating women for menopause symptoms, and this tendency can put women’s health at risk, a panel of National Institutes of Health (NIH) advisers has declared.
Menopause treatment can be risky because the most consistently effective therapy, estrogen, has been associated with cardiovascular events and breast cancer, the 12-member panel said. At the same time, alternative therapies, such as herbal remedies, are unproven and may carry unknown dangers.
In its “State of the Science” draft statement, released yesterday, the panel urged doctors to stop treating menopause as a disease. Instead, they should think of it as a normal, healthy phase of women’s lives. Many women go through menopause with few disabling symptoms.
Pointing out that “menopause is medicalized in contemporary American Society,” the advisers said that “medical care is best focused on women with the most severe and prolonged symptoms, and barriers to that care should be removed.”
For managing the common symptoms of menopause – such as hot flashes, night sweats, and vaginal dryness – low-dose estrogen, either alone or combined with progestin, remains the best choice, said the panel, which was chaired by Carol Mangione, M.D., of UCLA.
.”There are many potential alternatives to estrogen,” the panelists wrote. “However, their effectiveness and long-term safety need to be studied in rigorous clinical trials in diverse populations of women.”
The panel also urged further study of the natural history of menopause. “Knowing how many women transit menopause with few symptoms, and how many manage menopause largely on their own, can lead to public health information that empowers women and increases their self-reliance,” the panel said.
For women whose menopause symptoms create a serious quality of life burden, the potential risks and benefits should be carefully weighed before starting treatment, the panel advised.
Primary source: National Institutes of Health
National Institutes of Health. State-of-the-science conference statement: management of menopause-related symptoms. March 21-13, 2005.
Additional source: National Institutes of Health
National Institutes of Health. Press Release: NIH state-of-the-science panel calls for “demedicalization” of menopause. March 23, 2005.