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NIH panel promotes a revised view of menopause

A close look at the science uncovered scant evidence for safe and effective alternatives to estrogen.

By Susan J. Landers, amednews staff. April 11, 2005.

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Washington -- Menopause is not a disease, stressed a panel of experts assembled by the National Institutes of Health last month to sort through the research behind the symptoms and treatments for this natural transition that some women and their physicians continue to find problematic.

The panel members noted that many women move through menopause with few disabling symptoms and said the tendency -- in the United States at least -- to "medicalize" this life change could lead to the overuse of risky treatments.

Effective treatments for such symptoms as hot flashes, night sweats and vaginal dryness pretty much vanished overnight when serious health problems associated with the use of estrogen, which worked well to banish those ills, turned up in the 2002 Women's Health Initiative.

Doctors and patients have been struggling since then to find safe and effective alternatives. Unfortunately, the panel did not discover any magic potions.

After two days of hearing from experts, the 11-member panel drafted a state-of-the-science conference statement that is more a collation of the research rather than a presentation of new information, said panel member Cassandra E. Henderson, MD, chief of maternal and fetal medicine at Our Lady of Mercy Medical Center in Bronx, N.Y.

Nevertheless, panel members did find that estrogen in low doses of 0.3 mg per day could help women whose postmenopausal symptoms create a serious burden in their lives. "We found very little downside to starting low and going slow," said panel Chair Carol Mangione, MD, professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles.