Skip to content
My WebMD Sign In, Sign Up

Menopause Health Center

Font Size

NIH Panel: Menopause Is Not a Disease

Report Calls for Less Emphasis on Hormone Treatment
By
WebMD Health News

March 23, 2005 -- Menopause should be "demedicalized" and treated as a normal phase of women's lives instead of as a disease, a federal scientific panel concluded Wednesday.

The group issued a report concluding that many women go through menopause with few symptoms and without hormone treatment; only women with more severe and debilitating menopausal symptoms should use hormone replacement therapy drugs.

"Most physicians should not treat this as a medical condition. It is not something that has to be treated automatically," says Carol Mangione, MD, who chaired a National Institutes of Health consensus panel on menopause treatment.

Widespread use of estrogen alone or in combination with a progestin by menopausal women was thrown into doubt in 2002 when a large study was halted because of evidence that using the drugs increased the risk of heart disease, breast cancer, and dangerous blood clots. This study was not designed to study women with menopausal symptoms but rather to test whether hormone therapy could prevent chronic diseases.

The study, known as the Women's Health Initiative, suddenly raised questions as to whether using hormones to prevent hot flashes, dizziness, and other symptoms of menopause was worth a potential increased risk of disease. It also led the Food and Drug Administration and others to recommend that women using hormone therapy take the lowest effective dose for the shortest possible duration as a way to minimize the risk of dangerous side effects.

The study also helped expand an already rapidly growing market in alternative treatments ranging from dietary and herbal supplements to behavioral and psychological treatments.

Experts said Wednesday that relatively little research has been conducted on the effectiveness and safety of most alternative treatments, making it impossible to make recommendations on which work and which don't. Instead they called for more research on alternative therapies as well as trials testing the effectiveness of hormone treatment in a racially diverse group of women with menopause symptoms.

The report also narrowed the list of menopause symptoms that have shown solid evidence of being treatable with hormones. Hormone therapy has shown effectiveness against night sweats, hot flashes, increased vaginal dryness, and sleep problems. But other symptoms, including lowered mood, memory problems, and urinary incontinence have shown little evidence of responding to hormone treatment, it states.

"It gives women and health care providers the information they need to insulate themselves from quacks and poor choices," says Deborah Briceland-Betts, PhD, senior vice president of the Sutton Group, and a member of the NIH panel.

The group endorsed already-recommended strategies of using lower doses for shorter periods of time for women with more severe symptoms, though it cautioned that research has not conclusively shown which doses can be deemed safe.

Mangione, who is a professor of medicine at the University of California at Los Angeles, said that some women do experience debilitating menopausal symptoms and that such women should weigh the benefits of symptom relief with the risk of side effects. But most other women tend to improve without drugs or other treatments, she added.

She noted that several studies have shown that up to one-third of women taking placebos instead of drugs still see their symptoms subside. It's a larger improvement than is seen with placebos in most medical studies, though researchers still do not understand why the effect is so large.

"It suggests that there is a big segment of the population out there who probably are going to be better without any treatments," she says.

Today on WebMD

woman walking outdoors
How to handle headaches, night sweats, and more.
mature woman holding fan in face
Symptoms and treatments.
 
woman hiding face behind hands
11 ways to keep skin bright and healthy.
insomnia
Is it menopause or something else?
 
senior couple
Video
mature woman shopping for produce
Article
 
Alcohol Disrupting Your Sleep
Article
mature couple on boat
Article
 
mature woman tugging on her loose skin
Slideshow
senior woman wearing green hat
Article
 
mature woman
Article
supplements
Article
 

WebMD Special Sections