As symptoms of menopause sneak up on her, Sue Cunningham turns to her older sister for advice on what to expect next. "Now, it's night sweats at 3:15 a.m. Exactly. Every night," said the 45-year-old Pilates instructor.
Like many women, though, she finds it harder to get advice about menopause and its symptoms from medical experts. "Different studies say different things. I'm reading about it and trying to stick to nondrug alternatives for now and trying to stay healthy," Cunningham said.
But now a tool is available to women in their 40s and 50s from the Endocrine Society: the interactive Menopause Map (hormone.org/menopausemap). The website helps women explore menopause treatments and make lists of questions to ask their doctors. It is Cunningham's next stop, she said.
"When we get to the doctor's office, we don't know what to ask or are too embarrassed to ask about symptoms like vaginal dryness," said Dr. Cynthia Stuenkel, endocrinologist at the University of California San Diego and spokeswoman for the Endocrine Society, an international organization consisting of scientists and health care professionals. "The map can help." It is not a diagnostic tool, she said.
Officially, a woman is menopausal when she has not had a menstrual period for a year. But the interval before that, perimenopause, triggers different symptoms for different women. They range from mild to severe.
Creation of the Menopause Map followed a national study by the society that said 62 percent of women ages 45 to 60 have not talked with their primary care physicians or gynecologists about hormone therapy for menopausal symptoms and 61 percent have not asked them about nonhormone options. Half of them have not talked to their doctors about lifestyle changes that could affect their symptoms.
Caucasian women in the study were more likely to talk to their doctors about menopause than were women of color. Women with college degrees were only slightly more likely to talk to them than women with less education.
The Menopause Map asks a visitor questions about her family medical history, menopausal symptoms and treatment. It tells her options — medical and nonmedical — to consider. It suggests specific questions to ask her doctor, such as, "If I take this medicine, what's the lowest dose that will work for me?" It does not recommend brands.
The goal of the map, Stuenkel said, is not to promote drugs but to "validate that women are having menopausal symptoms and they do want to have conversations with their doctors about them."
"I haven't been to the doctor for a while and am going ... so I will use this to decide what questions to ask," said Cathy Schwanebeck, 48, an administrative assistant. "It's too easy to go to the doctor and just say, 'Oh, fine,' when she asks how you're doing."
Artist and art curator Caren Helene Rudman, 47, said the map is helpful, but she urges women to tell their doctors about their cancer risks before considering hormone treatment.
"Women in my family have died from breast and ovarian cancer," Rudman said. "So I couldn't do HRT (hormone replacement therapy) for my symptoms. I was able to use an antidepressant for two years for mood swings, though, then wean myself off of it. And, I ate well and exercised."
The Menopause Map was created 10 years after the well-publicized 2002 Women's HealthInitiative study, Stuenkel noted. The study linked hormone therapy with increased chances of cancer, strokes and heart attacks among some women.
"Many women are still wary of treatment because of the study," said Stuenkel. "It had a seismic effect on doctors and patients, causing many to just throw up their hands in frustration. But 10 years later, we've learned a lot. We know now that if you're in your 50s and generally healthy, some sort of hormone therapy can probably help you. Also, the menu is broader now.
"There are more products, options, more ways of using products such as patches and gels."
Is HRT for you?
Talk to your doctor about what's appropriate for you. TheU.S. Department of Health and Human ServicesOffice onWomen's Healthrecommends that women should not try HRT if they:
* Think they are pregnant
* Have problems with undiagnosed vaginal bleeding
* Have had certain kinds of cancers (such as breast or uterine cancer)
* Have had a stroke or heart attack
* Have had blood clots
* Have liver disease
* Have heart disease