Search results for menopause industrial complex

Wednesday Bubble: not your mama’s menopause?

Posted by Liz on Aug 17, 2011 in Boomer, menopause | 17 comments

I have been writing about the medicalization of menopause for several years now. So I was intrigued when I stumbled across a review in the Journal of Aging Studies discussing how the social construct of menopause has shifted to “an increasingly more medicalized perspective that emphasizes the biological deficits of the aging female body.”

In this piece, researcher Rebecca Utz reports on qualitative interviews that she conducted with a small group of pairs of mothers and daughters, divided by generation and apparently, attitudes towards menopause. Medicalization, she writes, “is defined as the way in which the apparently scientific knowledge of medicine is applied to a range of behaviors that are not self-evidently biological or even medical, but over which medicine has control.” Therefore, in the case of menopause, our definition has shifted from something that a natural part of our development to an illness-based perspective “requiring medical intervention.”

Accordingly, when she interviewed both groups of women (mothers born during the 1920s and 1930s, and daughters born in early to mid-1950’s) she discovered that despite the commonality of physical symptoms, attitudes were significantly different:

• The older women did not perceive menopause as a problem or disease but rather, something that “just happened.” As such, it was not part of their narrative and most were uncomfortable discussing it, primarily because they considered it private and “inappropriate for public discourse” much like sexuality or emotional instability. And the steps taken to address it: Watch and wait for it to be over.
• The daughters, on the other hand, were likely to seek medical treatment as soon as symptoms appeared. This behavior is consistent with the premise that menopause has been increasingly medicalized. However, it wasn’t simply menopause that the younger women were fighting but on a larger level, aging. “In other words, menopause was just the beginning of a long, downhill battle that cannot possibly be won,” but can be controlled and self-managed. Moreover, these women’s fear was not necessarily entrenched in hot flashes and night sweats, but in what the start of menopause meant in terms of the delineation between youth and middle/old age and even “end of life as we know it,” a new older life stage that was unwelcome. The “cure” of course, were hormones and other pharmaceutically-derived interventions, which represented a way to “suspend old age” and control the physiological aspects of aging.

Not surprisingly, Utz also points to the ‘Menopause Industry:’ a “profit-seeking enterprise comprising pharmaceutical companies and perpetuated by the media intent on “turning 40 million baby boomer women into patients for life by defining menopause as an estrogen deficiency disease requiring significant medical intervention.”  While the companies create the drugs, the media (whose increased attention attention to menopause, largely fueled by the wave of 1970s feminism and in part, funded by corporate interests) not only provide women with access to the information and resources that they seek but also contribute to perceptions of personal control among women who do not want to “sit back and let menopause just happen to them.” The result is that the Menopause Industry has not only developed products that these women crave that allows them to win their battle against old-age, but, continues to highlight the need for them.

Where does this leave us?

Although some women have fallen off the HRT wagon post-WHI study findings, others have remained. And even more expect the pharmaceutical industry to come up with something different to “quell the realities of their aging bodies.” Are we/they in for a surprise? Perhaps, because as Utz writes, aging is inevitable, even with quick fixes, and that at some point “the perceived autonomy and need for personal control may make [these women] more vulnerable or less prepared than their mothers to face the realities of old age.”

I’d like to offer another, more positive construct up for consideration:

Taking control doesn’t have to mean that the aging process is denied, stopped or obliterated, medicalized or industrialized. Rather, it means taking charge to feel better, more vibrant, healthier so that you/we/I can live the best life I can live while we are alive. For me personally, that doesn’t mean hormone replacement or botox or lipo; it means trying to make more healthier decisions, control or address my symptoms with evidence-based alternatives and accept the transition as a natural part of my journey. So, much like the mothers in this research, I consider this time an opportunity for shifting priorities and interests that open all sorts of possibilities. And like the daughters, I want to take the experience out of the closet and foster discussion and sharing. Ultimately, I’d like the see a more natural course driven by women themselves, as opposed to societal expectations and stigmatization of the aging process and as opposed to the Menopause Industrial Complex.

What about you?

Nonhormonal versus non-pharmaceutical

Posted by Liz on Oct 8, 2012 in hot flash | 0 comments

HRT has suffered quite a hit in recent years and as a result, the Menopause Industrial Complex has been scrambling to find a viable replacement. And while I would like to believe in that altruism is driving the train, the cynic in me truly believes that it’s mostly profit motivated. That being said, I do admire the tenacity of industry to attempt to find a reasonable replacement for HRT (and hopefully a safer one) for women who want a fix for troublesome vasomotor symptoms — hot flashes and night sweats — and don’t want to make the effort or don’t understand how to navigate the landscape of alternative strategies.

However, let’s be clear: there is a distinction between nonhormonal treatments and non-pharmaceutical treatments, hence, when you start hearing about ‘nonhormonal’ options, be sure to ask what that means, because it’s likely that it means ‘not HRT,’ such as a new non-hormonal pharmaceutical alternative to HRT: LDMP, better known as low-dose paroxetine. For those of you who are unfamiliar with paroxetine, it is a type of SSRI  used in the treatment of depression, panic disorder and social anxiety disorder; the popular antidepressant Paxil is a form of paroxetine.

Paroxetine is not the first antidepressant to be studied in menopausal women and you may recall that I wrote about the use of Lexapro for hot flashes about a year and a half ago. You can find that post here.  However, paroxetine is the antidepressant that’s all the buzz right now, since Noven Pharmaceuticals presented two studies last week at the North American Menopause Society annual meeting. Note that it’s been reframed as ‘low-dose non-hormonal therapy for menopausal vasomotor symptoms,’ but ya still gotta call a spade a spade and what it is is an antidepressant.

Here’s what you need to know:

In one of two studies, 568 women (40+ years of age) who experienced 7 to 8 moderate or severe hot flashes on a daily basis of 50 to 60 on a weekly basis took either 7.5 mg of LDMP or placebo daily over six months. By the end of the first month (and in contrast to the study’s start), women who were taking LDMP experienced 28.9 fewer hot flashes per week (compared to 19 fewer per week for women taking placebo pills). By the third month, this increased by roughly 10 fewer per week in both groups. The severity of the hot flashes also significantly decreased. Safety wise, women taking LDMP reported nausea and bronchitis.

In the complementary study, which lasted for three months, 606 women in the same demographic took the same dose of LDMP or placebo. Decreases in mean number of flashes per week were pretty much on par with the first study (33 compared to 23.5 for placebo) and similarly, a trend towards maintaining and growing benefits were observed. Severity of hot flashes also declined but by the study’s end, were not significantly different than placebo. This time, women who took LDMP most frequently reported dizziness and fatigue.

Dr. James Simon, one of the studies’ investigators and a professor of ob/gyn at GWU School of Medicine claims that symptoms of menopause often go untreated when women are unable or unwilling to take hormone therapy, which is not entirely true. Another investigator — Dr. Andrew Kaunitz from the University of Florida College of Medicine in Jacksonville notes that if LDMP is approved by the FDA, “it could be the first nonhormonal option available for women.” Again, this statement is not entirely true.  LDMP has the potential to become the first nonhormonal treatment APPROVED by FDA for vasomotor symptoms in menopausal women. There are other options out there but on the most part, they are not embraced by Western practitioners. Take note: while many Western practitioners will argue until they are blue in the face that alternative strategies have no role, are no better than placebo, and do not have evidenced-based trial data to support their use, they are simply incorrect. An unequivocal statement about every alternative strategy available to wo-man is bad medicine at best and at worst? Sheer ignorance.

Back to LDMP…LDMP appears to effectively diminish hot flashes and sweats but it is not without side effects. And while the dosage is considerably lower than full-strength antidepressants, we don’t have enough information to know if it will ultimately mimic its higher dose partner; the most common side effects reported in these trials are the very same that have been reported with Paxil. Another common side effect of Paxil that has not been explored (at least not publicly) in these trials is the effects on libido and it is a well known fact that as many women go through menopause, they experience declines in sex drive, lubrication and the ability to reach orgasm.

I say that the verdict is still out. And that based on the way that communications about this agent are being framed, that it’s about the spin. I guess that time will tell.

Your Weather Forecasting is Spot On! Guest post by Susie Hades, Founder, Personally Cool, Inc

Posted by Liz on May 7, 2012 in hot flash, HRT | 0 comments

You may recall that about a week ago, I took the mick out of ColdFront, a new personal cooling system designed to cool those hot flashes. The day that the post ran, ColdFront inventor and Personally Cool Founder Susie Hades posted a comment with an offer to provide with me a sample so that I could try it for myself. Although I turned Susie’s offer down, I did reach out to her via email and phone and we had a lengthy conversation about her vision and the product. And you know what? I was impressed by her philosophy and approach, so much so that I offered her a guest spot on Flashfree.

Part of my mission is to reveal products and agents that work and that don’t, to uncover snake oil approaches and provide data-driven alternative solutions. Mostly though, I believe that information is truly power AND empowering, and that by educating ourselves, we are in a better position to play a role in driving and shaping decisions about our health and our healthcare.

Susie’s goal is not unlike mine and I encourage you to show some love. And Susie? I am glad that we had a chance to exchange ideas and start what is certain to be more than one conversation. We need more of those exchanges if we are ever going to move menopause out from under the Menopause Industrial Complex and into the hands of women who want viable and safe solutions.

I founded Personally Cool in 2007 because I couldn’t find what I call an “and” product for hot flash relief: drug-free; AND effective; AND safe; AND convenient; AND discreet; AND elegant; AND eco- and wallet-friendly.

I must have bought and tried one of almost every type of hot flash relief product available with the exception of bio-identical or hormone replacement therapy (HRT). Even though the efficacy was unquestionable, the data tell a larger story for HRT.

In 2002, increased risks of breast cancer, stroke, and a number of other side effects were widely expressed across various studies. As a result, prescriptions of Prempro (a leading Wyeth/Pfizer HRT product) dropped 80% by the fourth quarter of 2003.[1] Women, frightened and confused by the findings of these studies, wanted other choices.

Our own research (both initial and a just-completed survey of 300 women) confirms that women are still looking for safe alternatives to HRT. We also learned a number of other interesting facts – from how often and with what severity women hot flash, to how they handle them. Two poignant realities were derived from this last point. First, more than 80% of the women we surveyed had either never used HRT or they stopped at the advice of doctors or of their own volition. Second, more than 55% of the women currently experiencing hot flashes – given the choices they’ve faced until now – deliberately choose to do nothing at all. In other words, they literally sweat them out.

I invented coldfront to be the “AND” product that other products aren’t, and I am proud to say that it is. A test panel conducted late in our product development to make sure that we got it right was critically helpful. We abandoned certain product features that we loved but that our intended audience didn’t. After testing coldfront for three days, over 80% of our panelists reported that they’d never use anything other than coldfront to relieve their hot flashes. This was huge!

Yes, coldfront is great at cooling a hot flash, but we couldn’t ignore larger forces at work – the enormous need for psychological and social relief from the stigma of menopause. Although we’re living up to a third of our lives post-menopause, our society still sees menopausal women in an unflattering light. Among women my age, there is a growing desire to reassert control over our own lives and bodies, and to put a stop to allowing other people to define for us what this time of life should mean. Personally Cool wants to change the perception of midlife women and create our own conversation. When we say, “we make menopause cool,” we mean it – on a number of levels!

With coldfront, we are encouraging women to take charge of their own relief, which – in our case (pun totally intended!) – is no farther away than your handbag and no more complicated than what we already know works – cold – especially when it’s in the palm of your hand. It is so discreet and convenient that it allows most women to get through a hot flash without letting anyone know they’ve even had one.

And this, ultimately, is what sets coldfront apart from every other cold therapy product available today:

1. coldfront was designed in every way to be compatible with the life of a menopausal woman who defines herself, simply, as a woman. It is the least intrusive, most effective, complete, and portable cold therapy system for hot flashing women on the market.
2. coldfront can go right from the freezer to your bag because it was engineered to be condensation-free. Your bag, phone, or iPad will not get wet; you won’t be uncomfortable; and you don’t have to worry about batteries or enlarging your “carbon footprint.”
3. Each woman experiences hot flashes differently and in different parts of their bodies. The two palm packs are formulated to last the average length of a hot flash, 1-3 minutes, and they can go wherever a woman needs them. After replacing them back in the case, within 20 minutes they will be cool again and ready for use.
4. Hot flashes make you sweat! The antimicrobial super absorbent cloth wicks away moisture and is easily washed.
5. Your day is long, and you’re not always near a freezer. coldfront will continue re-cooling the palm packs for up to 12 hours.
6. Unlike one-time use cold packs, which can create over 600 pounds of toxic waste over the course of five hot-flashing years, and literally cost thousands of dollars, coldfront is phthalate-free, non-toxic, and costs less than $100 over the life of the product.
7. Everything in the system is reusable and is designed to last.

Liz, thank you for the opportunity to contribute to your community and to speak about our product. Because women all experience menopause and hot flashes differently, we know that coldfront won’t be for everyone. But, we believe deeply that coldfront is something special – not just because it works, but because it speaks to a societal issue we believe we can change.

Here’s to a new kind of coldfront moving in!

Susie

Wednesday Bubble: Designer What?!

Posted by Liz on Mar 7, 2012 in aging, appearance, sexual health | 1 comment

Rarely do I run across editorials in medical journals that catch my attention at the first sentence. However, this one wins my vote, not only for its candor but also for its attempt to clear the air, so to speak about ‘designer vaginas.’

Designer what?

You may recall that I ran a piece in early February about vaginal rejuvenation and the promise the procedure offers to millions of women who are concerned about their aging va-jay-jays.

Hold on for one sec! You may want to reconsider getting a facelift ‘down there.’ At least according to two physicians from Yale.

Burstable? You bet!

Drs. Alexandra Pencow and Marsha Guess from Yale University School of Medicine say that the purported benefits of female genital cosmetic surgery (FGCS), namely that there is a “normal or standard in vaginal aesthetics,” or that FGCS will “result in improved sexual function” are misleading. They write (in the April issue of the journal Maturitas):

“The ‘designer vagina’ sounds like the name of a ‘Sex in the City’ episode, and may evoke a variety of responses, from enthusiasm for anything that can make the vagina more modern and user-friendly, to mistrust for unproven treatments for conditions that have not been clearly defined.”

FGCS refers to surgical procedures that modify the shape, caliber or length of the vagina and external genitals for aesthetic purposes. They include:

• Labiaplasty, to reduce labial size or corrects irregularities (if the labia are too large, elongated or assymetrical)
• Vaginoplasty or vaginal rejuvenation, to narrowsthe vagina and the vaginal entrance
• Clitoral unhooding, geared towards removing the tissue surrounding the clitoris to enhance sexual and genital sensation
• Hymenoplasty, a form of ‘revagnation,’ in which the hymen is reconstructed to mimic virginity
• G-spot amplification, i.e. injecting collagen into the vaginal wall to increase sexual satisfaction/sensitivity

The physicians write that despite the lack of clinical evidence proving benefit, these procedures have increased three-fold or more in both the U.S. and the United Kingdom. They also note that the media, talk shows, women’s magazines and the Internet combined have worked to perpetuate myths about these procedures without properly explaining the reasons why they might be done other than aesthetics. Procedures such as the ones described above can be invaluable following cancer, trauma or pelvic organ prolapse to improve life quality and treat certain symptoms.

Still, when it comes to aesthetics, there is a lack of standards for these procedures to define proper follow up and outcomes. Even more important is the fact that there is no true definition of “normal.” How then does a woman who desires smaller labia or an enhanced vagina temper her expectations?

Sexuality, sexual desire and sexual satisfaction are multifacted and personal, influenced by life stressors, environment, mood, self-esteem, hormones, personality and social and partner support. The new ‘normal’ isn’t supposed to be defined by the medical community and the media, is it? Just as the Menopause Industrial Complex wants to sell you on HRT, so apparently do the Vaginal Patrol wish to convince you that your parts ‘down under’ need a nip, tuck, an ‘Occupy,’ if you will.

Designer vaginas? Evidently, they’re here to stay. The benefits, however? Hard to say.

Newsflash: black cohosh – one of these is not like the other

Posted by Liz on Jan 2, 2012 in herbal medicine, hot flash, menopause | 2 comments

Love the first line of this editorial:

“Black cohosh preparations are not all the same.”

That is,

“Vigilance must be exercised when interpreting data.”

In other words, sometimes it appears that black cohosh is a significant and real alternative to hormones for battling hot flashes and even some other menopausal symptoms. And other times, it appears that it’s not. The reason? Product variability and dosage.

A bit of geek: you may recall that black cohosh is an herb from the buttercup family. Its scientific name is Cimicifuga racemosa. But, there are many different types (or species) of Cimicifuga and researchers say that when the continents split, these plants took different directions and ended up with distinct chemical compositions. Moreover, when they analyzed the products for certain active components, they found significant variability.

Add this to the fact that researchers studying black cohosh have used dosages ranging from 2.8 mg to 160 mg, and that these formulations were pure or were what they call “multibotanicals” (i.e. containing other herbs believed to be effective to qualm flashes and mood swings) and well, you have a veritable melting pot of clinical crap that defies logic. Add in a dash of more scientific geekdom know as a bell shaped response, in which low doses of a drug may be ineffective, moderate doses are effective and at higher doses, benefits disappear again, and well, it’s almost impossible to draw any firm conclusions.

Wow. Pretty scary, right?

The Menopause Industrial Complex will have you believe that the only effective preparations for ‘treating’ the disease they call menopause are pharmacological preparations manufactured by a large company and that has undergone rigorous, controlled scientific analysis. A lot of Western practitioners will have you believe that not only have herbs not be rigorously tested and studied under the same scientific conditions, but that they are downright ineffective and sometimes downright dangerous.

Guess what?

Both camps are incorrect. Because when you peruse the archives of the National Library of Medicine or esteemed journals like Maturitas or Menopause, you will find scientifically controlled evaluations of herbs. And, when researchers take the time to tease out data rather than drawing automatic conclusions (as the authors did in the piece I am referring to, which was published online in Maturitas at the end of December), they find that perhaps, the herbs are more effective than believed and that there are reasons for disparate results.

So, black cohosh, yay or nay?

Let’s get back to the original thought:

Black cohosh preparations are not all the same.

For me, a standardized extract that has undergone rigorous clinical study – Remifemin – works wonders. And I hear that it does for a lot of women. But not all women are the same either.

Two words.

Be vigilant.

Five more:

Don’t believe everything you read.

Happy New Year. Let’s approach this year as the year for opening our eyes and taking back our aging process.

Menopause? It’s not a disease and symptoms can be effectively and safely ameliorated with certain herbs. Just. Be. Vigilant.