Women should address the "hormonal chaos" of their 40s and not be afraid to seek treatment for perimenopausal symptoms, advises an internationally recognized expert in reproductive endocrinology from Wake Forest Baptist Medical Center.
Sarah Berga, M.D., professor and vice president for Women's Health Services at Wake Forest Baptist, has participated in the National Institutes of Health (NIH) and the National Center for Research Resources since 1994. As a translational clinician-scientist she investigates areas critical to reproductive and women's health, including the impact of stress and sex hormones upon brain plasticity and aging. Her team pioneered the use of cognitive behavior therapy for stress-induced infertility.
Berga often speaks to community groups on women's health issues and a recurring topic is hormones and the question of "what's new?" It's a subject that women find confusing, she said.
The pendulum has swung in every direction when it comes to hormone therapy recommendations, Berga said, but when it comes to perimenopause women in their 40s should be talking to their doctors and aware of the following:
•Perimenopause is the precursor to 'The Change' and starts in the early 40s. It is often signaled by hot flashes, night sweats and mood swings. Berga said it's best to seek treatment at the onset and not suffer needlessly.
•Doctors are moving to an individualized approach. One size does not fit all. "As clinicians, we have to take all of the new science and the studies and translate it to every day practice working with our patients on what's best for them based on their health and medical history," Berga said.
•Hormones taken at an early stage in menopause can be very beneficial. The NIH Women's Health Initiative study was halted three years early in 2002 because the data showed an increased risk of cancer and heart disease. However, said Berga, a re-analysis of the data has found that the age at which women start hormone replacement therapy and a shorter duration of treatment minimizes the risks. New data shows that the risks only apply to older menopausal women who begin taking hormone therapy late into menopause. "We just have to be very careful by translating the information into everyday practice and applying it to individual women, but overall, we have found that timing makes all the difference."