Gen X women demand better menopause care as new treatments emerge

“Why didn’t our mothers tell us?” seems to be the predominant feeling about menopause on the part of Gen X women, those approximately between the ages 46 and 61. For my mother’s generation and those that came before her, it was simply “The Change.” Just get on with it.

And doctors don’t seem to pay it much mind either, even though it affects half of their patients and comes with 34 known symptoms ranging from hot flashes and irregular periods to night sweats and mood changes.

“Doctors seem to think we are either pre-pregnant, pregnant or invisible,” one woman commented.

In the last few years, though, the conversation has been shifting. Women are more assertive about getting treated for menopause symptoms, new treatments are emerging, and it seems some doctors are increasingly recognizing the need for better menopause care.

And celebrities aren’t shy about it, either. Actor Naomi Watts said on Instagram that she felt like she had been hit by a truck. “How could I figure this out when no one was talking? … It's oddly like an unwritten code of silence: Women should suck it up and cope, because that's how generations past have done it.”

In perimenopause, which can start in a woman’s late 30s, and menopause, estrogen levels begin dropping, which is what brings on a host of physical and emotional symptoms. Each month after puberty, your body prepares for pregnancy. In menopause, the ovaries stop that process, sometimes gradually and sometimes abruptly, as when a woman undergoes a hysterectomy that also removes the ovaries.

There seem to be two main themes surrounding the discussion of menopause today: Better treatment and management of symptoms and the sense of empowerment a woman can gain when her child-bearing years are past.

Menopause is a natural process, not an illness or condition. Hormone replacement therapy (HRT) has long been in use as a front-line treatment for easing menopausal hot flashes. It also eases other menopause symptoms and slows bone loss. It's best used by people who are younger than 60 and within 10 years of the onset of menopause.

Not everyone can use estrogen because of cancer risks, although low-dosage creams or rings that can be inserted into the vagina are generally helpful for vaginal dryness, urinary issues and painful intercourse.

It’s encouraging to see new therapies emerging and new uses being found for existing medications. Low-dose antidepressants (SSRIs) and the antiseizure medication gabapentin have been shown to reduce hot flashes, one of the most common complaints. Medications to slow bone loss and additional calcium are helpful. Soy may also reduce frequency and severity of symptoms.

Researchers are working to develop treatments that effectively manage menopausal symptoms while minimizing risks associated with HRT. A new nonhormonal treatment from AbCellera just completed a successful phase two clinical trial in which participants reported 83% fewer hot flashes and better sleep. It works by targeting a receptor that helps regulate body temperature.

I think the most promising development in menopause treatment is the “matriarchal revolution,” the realization that post-menopausal years can be a time of increased empowerment and leadership, as women find new opportunities to embrace their wisdom and life experiences.

Gen X won’t let their daughters and granddaughters suffer, either. As one woman wrote on social media, “We’re going to be out there teaching Gen Z and Gen Alpha about what to expect and how to treat symptoms.”

You go, girl.

• Teri (Dreher) Frykenberg is a registered nurse and board-certified patient advocate. She is the author of several books on advocacy and founder of Nurse Advocate Entrepreneur, which equips medical professionals with the knowledge and skills to start their own advocacy businesses. Contact her at Teri@NurseAdvocateEntrepreneur.com.