For many women, having uncomfortable conversations with their mothers or a health care professional about menstruation was a rite of passage. Today, there is a lot of education available for girls, but what still is lacking is education around menopause.

Mayo Clinic experts hope to change that.

Dr. Stephanie Faubion, a women's health expert at Mayo Clinic and medical director of the North American Menopause Society, is focused on educating women about menopause and the value of having conversations long before that stage of life arrives.

By 2030, the world population of menopausal and postmenopausal women is projected to increase to 1.2 billion, with 47 million new entrants each year.

Early Discussions

"I would argue that women should be starting to have this conversation with their providers at the age of 35 or 40 — so, much earlier than one would expect, because women may start to have symptoms related to the menopause transition six to 10 years before their last menstrual period," says Dr. Faubion.

She adds that for women in their late 30s or early 40s, this can be challenging to discern, since symptoms can vary and include subtle variations in their menstrual cycle length, as well as hot flashes, night sweats, joint aches, vaginal dryness, and mood and sleep disturbances. "This is not something they would even think might be related to the beginning of the menopause transition. It is a big surprise when they begin to experience symptoms that are the same as women who are already in menopause," says Dr. Faubion.

"It's important to have conversations proactively with their providers to say: 'Help me understand what it might be like for me. What can I do about managing symptoms when they start? And what is out there in terms of technology that can be helpful in bridging that care gap that women may be experiencing?'”

It can be even more challenging for a woman to know who to connect with, as they might not have a designated menopause expert.

Where to start

Dr. Faubion suggests starting with your local internist, family physician, nurse practitioner, physician assistant or other members of your health care team. Certainly, it could be an obstetrician, gynecologist or other specialist.

The challenge is that education is lacking about menopause. As such, she recommends women visit the North American Menopause Society website at menopause.org and search its "locate provider" tab to find experts certified in menopause management. "You need to be your own patient advocate. And you need to understand that if you don't feel it's right and you're not getting the answers that you need, you may need to look for another provider," says Dr. Faubion.

She notes that patients often wonder about why it's important to have a specialist certified in menopause management. "The value is that individual will have additional training and awareness about the latest therapies and treatments available to guide women before, during and after their transition into menopause," she says.

Is HRT right for you

This is particularly relevant when women want to understand hormone therapy and if they are a candidate. Cultural disparities often have women believing they are not candidates for hormone therapy, which can increase the gap of care.

Hormone therapy is something many women hear about — and it may be valuable to some — but there are many options, including lifestyles changes, that can assist with the management of symptoms. Speaking to an expert and utilizing new technology can provide additional benefits to women as they navigate the transition, notes Dr. Faubion. The Midday app, launched by Lisa Health, a digital health company, uses Mayo Clinic technology and artificial intelligence algorithms to assess the severity of menopause symptoms and provide education.

"One of the biggest benefits of the Midday app by Lisa Health is that it eliminates some of the barriers to care that woman might experience. And it would give them the information specific to their health risks. As well, it can give them information about whether they might be a candidate for hormone therapy," explains Dr. Faubion.

Being proactive about menopause can help ensure a woman's quality of life long before the transition occurs, notes Dr. Faubion, adding that the effects of menopause are far-reaching. She says that lost work productivity and increased health care utilization due to menopause is estimated to be in the billions of dollars in the U.S. alone. 

The bottom line: "Women don't have to suffer. There are solutions out there and doing nothing doesn't have to be the answer," says Dr. Faubion.

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