The new Sterling B. Williams, MD, PhD, Memorial Lecture Series on Menopause and Hormone Therapy will include a look at the latest information to help clinicians help their perimenopausal and menopausal patients.
Nanette Santoro, MD, professor and chair of the Department of Obstetrics and Gynecology at the University of Colorado School of Medicine, will present “Managing the Menopausal Transition and Beyond” via video today at 9 am in Room 104.
Her lecture will be the first of three during the day under the umbrella of this new lecture series. John E. Buster, MD, associate division director at Women & Infants’ Center for Reproduction and Infertility at Tufts Medical Center in Boston, will present “Postmenopausal Estrogens: Pills, Patches, Pellets, and Gels” at 10:30 am, and Roger Lobo, MD, professor and fellowship director in the Division of Reproductive Endocrinology at the Center for Women’s Reproductive Care at Columbia University Medical Center, will wrap up the series with “Use of HT in Women with Medical Diseases” at 2 pm.
Dr. Santoro will talk about the evolution in the knowledge of how hormones change through the transition into menopause and beyond. She will review some of the longitudinal studies of women progressing through the transition, including the U.S.-based SWAN cohort that she’s been involved with for about 20 years.
Researchers have found that women tend to have the biggest increase in symptoms when the late transition begins. This transition, on average, starts at age 49, with the average age of menopause coming at age 51.
Women in the late transition stage are more vulnerable to the classic menopause symptoms such as hot flashes, sleep disruption, mood changes, and vaginal dryness, Dr. Santoro said.
“We used to wait until women were fully menopausal before we treated them because we were afraid to layer on too many hormones,” she said. “I think that doesn’t make sense because symptoms start to get pretty significant prior to a woman’s final menstrual period, so it’s worth considering ways to treat women when they are symptomatic and not wait.”
Mood disorders especially seem to increase in the late transition stage, Dr. Santoro said, and those most vulnerable appear to be women who have no history of mood disorders. That’s the opposite of what Dr. Santoro and others have thought for decades.
“Women may come in with vague symptoms that are odd or not directly referable to depression, and the clinician is going to have to ferret that out and help them figure out what’s going on,” she said.
Dr. Santoro also will talk about the consequences of early menopause, which has become more common as women at high risk for cancer choose to have oophorectomies in their 30s or 40s. As this practice continues to gain in popularity, Dr. Santoro said clinicians need to make sure to balance the discussion of the benefit of freedom from cancer vs. the increased risk of prolonged and/or worse menopausal symptoms, heart disease, mood disorders, and dementia.