"The many #menopause myths your patients may believe
A look at the many preconceptions (and their related products) your patients may have about menopause."
This is a new story I wrote for the Medical Post/Canadian Healthcare Network which summarizes a talk at a recent #obgyn conference. The site is password protected but free for #doctors and #pharmacists in #Canada. Here are the first few paragraphs:
Myths, misinformation and questionable products for use in menopause abound.
So, what should doctors say when faced with patients asking about supplements, ‘estrogen imbalance,’ expensive tests, or social-media inspired treatments?
At the recent annual meeting of the Ontario regional conference for the Society for #Obstetricians and #Gynecologists of Canada (#SOGC), Dr. Alison Shea, assistant professor of obstetrics and gynecology at McMaster University, addressed these topics.
She emphasized that while information on the internet is highly accessible, menopausal management is highly individualized.
“What somebody may say on social media that really helped them, may lead someone to ask about (it),” she said, stressing that doctors should explain that “what works for one person might not work for you.”
Myths around menopause are common, and social-media material relating to menopause can be associated with product advertising. On Instagram alone, half of the menopause hashtags are for advertisements. And, according to BNN Bloomberg, the global market for menopausal products hit US$15 billion in 2021.
The selling of products should set off alarm bells, Dr. Shea said.
High profile brands
Some high profile brands associated with menopausal products that patients might mention include GOOP, Stripes, the Galvenston Diet, and the Balance #Health App.
Actor Gwyneth Paltrow’s GOOP, and Naomi Watts’ Stripes, both sell various products with little to no science behind them, she said. Yet, some of the Stripes products are decent, such as vaginal moisturizers which are hylaronic acid based. But its advisory board is lacking, consisting of only one ob-gyn, a dermatologist and a journalist.
The creator of the Galviston Diet has some helpful content, but their goal is to sell various products, Dr. Shea said. Some of the supplements appear to be fine for healthy aging, but they may not do much for menopausal symptoms.
The Balance Health App from the U.K. tracks menopause symptoms. This can be useful, but there are free and paid versions.
The vocabulary of menopause myths
Estrogen imbalance: This is the idea that high #estrogen or “estrogen dominance” are the underlying cause for bothersome menopause symptoms and need to be kept in check.
“We know this is not true,” Dr. Shea said. While fluctuating levels of estrogen can stimulate endometriosis, or stimulate some fibroid growth, lower estrogen levels are more responsible for bothersome menopausal symptoms
"Estrogen dominance" is sometimes used to describing an ‘imbalance’ of estrogen and progesterone. However, this is not a scientific term. Some patients may purchase progesterone cream products to help with the supposed imbalance, but progesterone does not work well through the skin. And if it were absorbed it may contribute to a worsening of mood symptoms in some. The only time estrogen may need so-called balancing is if there is an overgrowth of lining the uterus, or proliferative endometrium, she said.
Probiotics are also being sold claiming to influence estrogen metabolism in the gut, but there’s very little evidence.
