Originally posted on Women's Voices for Change
What could be worse than hot flashes in this heat? Menopause specialists are besieged with women who were just barely functioning in early June and are now overcome by the high and humid temperatures that have plagued much of the United States over the last few weeks.
Patients have lost patience. They don't want to hear about cold water and cold cloths. They tell me that nothing is working to control the hot flashes and sweats; the flushed face and chest that lasts now for what seems like hours when it used to be just a few seconds. So there is a rush on for medical relief of menopausal symptoms. When the internal temperature button won't reset properly, women experience sleep disruption, daytime fatigue and the consequences of this cascade: irritability, volatility, fuzzy thinking and yes, occasionally, feeling hopeless. It is hard for women who are suffering these symptoms in this weather to integrate the message of "This is just temporary, it will pass." They want relief now.
I believe that doctors should listen to their patients and help them with symptom management and symptom relief. We need to counsel patients about the risk of short-term use and avoid giving these drugs to women at risk of serious side effects. But sometimes I feel as though the public (and many doctors) act like low-dose short-term systemic hormone therapy has a risk profile like that of heroin. I think that it's time for some balance.
So if you are one of the many women whose doctor has discouraged you from choosing some form of hormone therapy for relief of your symptoms, find a doctor who understands that you need to function during this period of hormonal transition. Gynecologists who have a special interest in menopause can help you choose a low-dose estradiol and progesterone formulation that is approved by the Food and Drug Administration and can help you find the dose and route of delivery that works for you. Avoid "anti-aging" doctors who test your saliva for hormone levels and change your hormone dose based on numbers. I would recommend that you use the lowest dose available at first and recognize that the goal of this systemic delivery of hormones is to make life manageable -- not to take away all symptoms.
Then enjoy the return of an internal thermostat that works again and manage the heat wave like everyone else: with common sense, lots of water and sports drinks, cool foods, and clothing that moves and is made from natural fabrics. When the time comes to take a break from hormone therapy, time the process of weaning off the hormones so that it happens in the fall -- say 18 months from now. The cooler weather will make the transition off hormone therapy easier. Some women need treatment longer, but many can manage after brief hormone therapy.