You would have to be living under a rock to not notice all the recent discussions around perimenopause and menopause. Finally, the medical community is recognizing this critical junction in a woman’s life and dedicating resources to it. Despite my educating women about the actual risks and benefits of hormone therapy for the past 20 years, many women were simply too scared off by the risks present by media, friends, and even their own doctors to use them. They thought hormones=breast cancer. Women struggling with menopausal symptoms would be brushed off by their medical providers and left with inadequate suggestions or treatments. Many women were so desperate for some relief that they turned to non-evidence-based treatments like compounded hormones, hormonal pellets, supplements.

So, now that the word’s out on the menopausal transition, every woman is getting the care they deserve, right? Wrong!! More women are getting appropriate discussions and care, but there are also more non-medical and medical opportunists making money from us perimenopausal and postmenopausal women. Celebrities are backing unregulated supplements to make even more bucks.

In the past couple of weeks, I saw several patients who were experiencing usual menopausal symptoms of hot flashes and night sweats who went to their gynecologists but instead of getting a discussion about all their treatment options, they got SOLD pellets. There was no discussion about FDA-approved menopausal hormone therapy which is effective and economical and can have other benefits. They got testosterone pellets that they had to pay cash for—and then they experienced side effects (acne, hair loss, facial hair growth) because their testosterone levels were 7-8 times the normal female level. One patient suffered from severe painful cystic facial acne and back acne with pellets, and her gynecology NP told her to stay the course and offered a prescription medicine to try to overcome the side effects. What the what?! Cue up dog chasing its tail people! Another patient consulted the gynecologist she had been seeing for years and just got put on pellets—no discussion about other options. She started educating herself about menopause by reading books written by board certified gynecologists and menopause providers and realized she wasn’t getting the whole story.

Last year, I went to a dinner sponsored by a testosterone pellet company because I wanted to hear about their studies, their science. Welp, I didn’t get any of that–I got a lengthy salespitch about how much money I could make and how that pellet was better than their competitor. The speaker who was the VP of sales kept showing us his backside and talking about his experience with pellets. Ick. They didn’t have a science-y person in sight–just salespeople! Bye Felicia.

HERE ARE 3 TIPS FOR GETTING THE CARE YOU NEED:

1. Find a gynecologist who is up-to-date on evidence-based treatment for perimenopause and menopause. That may be your own gynecologist or you can go to The Menopause Society webpage, menopause.org, to find a Menopause Society Certified Practitioner. To become an MSCP, a provider must pass an exam focused on care of the menopausal woman. Don’t go to a “hormone clinic.” Don’t get medical advice at a clinic that does only aesthetic stuff–botox, weight loss, personalized/compounded hormones, pellets.

2. Make sure you’re getting the whole story. If you’re seeing a provider and they are only recommending one treatment (usually pellets), get the heck out of there! If you must pay cash for the treatment/medication, it’s probably not evidence-based or FDA regulated. Get a second opinion!

3. Make sure you are being heard! Your provider should be working with you to treat the things that are bothering you and important to you. If a treatment isn’t working, they should be willing to go back to the drawing board and try something else.