We are back with a health read this week! The New Menopause by Dr. Mary Claire Haver is a book that has taken social media by storm. It has really opened the door for conversation related to Menopause for younger Gen-X and older Millenials.

Dr. Haver is an OBGYN who was trained to treat everything (as most OBGYNs are), but she notes she received very little training on menopause. It wasn’t until she went through it herself that she really pushed to make a change in the way she treats.

If you are in your late 30s to late 40s, I think this book is a good primer in the history of menopause care in the US, while also providing a guidebook to patients on hormone replacement therapy (HRT) and it’s benefits.

She begins with a thorough history of menopausal care, going all the way back to the ancient greeks, then fast forwarding to the early 1900s when estrogen was discovered. HRT was the standard of care for a long time in the US. The US government started a long term study in the late 90s called the Women’s Health Initiative (WHI) that was terminated early due to an increase risk in breast cancer in the group that was receiving estrogen therapy.

Now if you don’t know much about the history, this seems completely valid response. The reported risk was a 25% increase in the likelihood of breast cancer. In reality, they were reporting on the RELATIVE risk, not the absolute risk which is a better representation of risk in a clinical setting. The ABSOLUTE risk increase was 0.08. In other words negligible.

“Naomi, you don’t prescribe meds why are you mentioning this”. This study, which was ended in 2002, is still affecting people’s beliefs around HRT (including physician’s beliefs). Sure I don’t prescribe meds as a PT, but it is within my scope to understand how medications work in a big picture way, provide education for patients, and encourage conversations between a patient and their physician so that they receive the best outcomes possible. When I see peri and post menopausal patients, I have to spend a lot of time undoing the harmful effects of the WHI reporting in my office when I recommend my patients talk to their doctor about HRT in any form. There have been so many developments in HRT in the last 20 years and they can make a significant impact on someone’s symptoms that are safe and effective. It is worth having a candid conversation with your doctor.

The last part of this book is a symptom guide. Did you know “Burning mouth syndrome” is a symptom of peri-menopause? I sure didn’t. Dr. Haver goes through every related symptom in the literature, explains our theories as to why this is happening and what current treatment options are available. This is not an end all be all. This book is already 3 years old. The research will continue to change, so really use this as a jumping off point.

I would highly recommend this book to all of my patients, but especially those on the cusp of perimenopause! It is so helpful to be an informed patient, in order to be a good collaborator with your provider.

-Naomi