"Oh, don't worry," the doctor said in a kindly voice, "these little hot flashes will disappear on their own."
Just one of the things that angers me about the general level of medical practice. A new study addressed the common wisdom (sic) that hot flashes last less than five years. The authors followed 1500 women and found that the median duration of disturbing hot flashes and night sweats was seven years, which means that half of those women had symptoms for more than seven years.
Three big areas of ignorance lie within the kindly doctor's (false) reassurance. First, for most women, hot flashes are distressing because they interrupt sleep. Loss of sleep is implicated as a contributing cause in various diseases from breast cancer to cardiovascular disease. There is no justifiable reassurance for something that consistently interrupts womens' sleep. Secondly, problematic hot flashes are frequently if not usually accompanied by more distressing symptoms, from mood and cognitive problems, to osteoporosis, increased heart disease, and increased risk of other inflammatory diseases. Finally, and deserving of its own article (coming soon), we have been sadly misled about hormone treatment in menopause.
You've all seen the headlines: Hormones (or HRT) causes breast cancer, or it causes heart disease. Actually, those findings seemed partly true for a portion of the hormone treatments studied in the massive WHI study suspended and publicized a bit over a decade ago. The study found that women treated with horse estrogens (whoever thought that was a reasonable idea?) and synthetic drugs (with just a few of the same effects as human progesterone), had more breast cancer and more heart disease. I will never understand why it wasn't publicized that women receiving just estrogen (even the horsy kind) had less breast cancer and heart disease. Seriously, there was clear money to be made by the horse-suppliers!
More concerning is the almost complete absence from the general media about bio-identical hormone therapy: what happens when menopausal women with zero to low hormone levels are treated with estrogen and progesterone identical to the hormones they made themselves before menopause? What happens is that when they are properly (individually) balanced, women feel a lot of the same mental, emotional, physiological and just overall juiciness of life that pre-menopausal women experienced when their hormones are properly balanced. Proper hormones are the nectar that sweetens life. Even women who have had hormone-sensitive breast cancer can enjoy some of the benefits. But, as I said, that is a topic for a future article.
For now, the news to women is: ahah, you were right! Those hot flashes can last a really, really long time!
