We tackle that question and others about menopause with Lauren Streicher, MD, clinical assistant professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University in Chicago and author of The Essential Guide to Hysterectomy.
Q. I feel like my doctor isn’t in tune with my changing body. How do I know if it’s time to shop for a new gynecologist?
A. If you feel like your doctor isn’t paying attention, switch now. This is a typical problem since gynecologists are often also obstetricians. Many women are frustrated that the doctor who delivered their babies isn’t as involved with them now that they’re dealing with perimenopause or menopause. Menopausal women tell me they’re tired of sitting in waiting rooms with pregnant women and feeling like no one is paying attention to them. I’ve been hearing this for years. The bottom line: If you feel that you’re not getting the attention you deserve or that your questions are going unanswered, go elsewhere.
Q. If you start hormone therapy can you stay on it for life?
A. It depends on the symptom you’re dealing with. For example, if you have vaginal dryness and are using vaginal estrogen, you’ll use it for as long as you care to be sexually active. If it’s for hot flashes, most of those stop within five years after menopause begins. Some women use hormone therapy to feel better or have better cognitive function. I have many patients in their 80s who take hormones and have taken them since the onset of menopause. It’s extremely individual. In the end, while many women need to take hormones short-term for symptom relief, there’s a group of women who take it for life. (See The Estrogen Debate.)
Q. Are there any developments on the horizon that you’re excited about on the perimenopause or menopause front?
A. There’s a lot of research going on in hot flash control and more emphasis on the understanding that it has a major impact on women’s lives. It’s no longer OK to simply say “get out your fan.” For example, one researcher is focusing on developing a nerve block to control hot flashes. There’s also exciting pharmaceutical research going on that is looking at ways to address temperature control centers in the brain.
The second development has to do with vaginal dryness. I think there’s more of an emphasis today on the fact that a woman’s sexuality remains important during her perimenopausal and menopausal life. We have a lot more data on vaginal estrogens and there’s an increasing comfort level with these products.