In the online perimenopausal community, there appear to be some battle lines drawn. If you thought these virtual watering holes were full of women supporting one another with no judgement or disagreement, then you would be mistaken. Just as in real life, factions are present, and strong opinions drive polarities that sometimes erupt in typed jabs and laughing, angry and crying emojis.
One of the more obvious and ever-present ones is the pharmaceutical vs. natural camp.
Simply put, one group of women is more open and receptive to prescribed medications that have been battle-tested in clinical trials, and this includes FDA-approved hormone therapy (estradiol and progesterone) that is produced by major pharmaceutical companies and available in generic and name brand formulations (vs. hormones made by compounding pharmacies). This group of women may include those who tried natural remedies that proved inadequate, harmful or ineffective as well as those who trust conventional medicine because it has been trialed, tested, in many cases with proven efficacy, and is produced according to regulations, with known and documented side effects.
The other group of women trends toward the “natural at all costs” philosophy. This is the group that may discourage going to conventional doctors and favors naturopathic and functional medicine practitioners instead. They are also the ones likely to caution against using prescribed medications, such as antidepressants (including but not limited to other drugs prescribed off label to help with perimenopausal hot flashes, night sweats, anxiety and more), as well as pharma-grade HRT. Their rationale may be that Big Pharma drugs have harmed them personally or those they know, that there is an unsavory profit motive involved in the practice of medicine that doesn’t put people first and that natural alternatives can’t harm you.
Naturally (pun not intended), there is a deep affinity among women thrust into perimenopause to try what’s close at hand, readily available and perceived as harmless. So many of us had no warning and little or no education about what would happen to our bodies and minds in midlife. We just knew that when we hit our late 30s to mid 40s, we started feeling different, off-kilter and a bit abnormal. Thus, we are fending for ourselves – at least those of us with the grit and resilience to even try to address the panoply of hormonal change symptoms. And that self-advocacy often starts with over-the-counter supplements and various concoctions, potions and pills recommended by word of mouth and easily obtained.
The problem is that just because something is natural, doesn’t mean it’s good for you, beneficial to your individual biochemistry or without side effects. Here are some commonly suggested natural remedies, bandied about through the grapevine among communities of women, or offered to us by supplement companies and holistic non-MD providers whose biggest competitors are, in fact, the commercial pharmaceutical industry and the very few mainstream physicians skilled in caring for midlife women (oh, those precious few!).
As you can see, there are side effects and risks associated with “natural” agents as well as pharmaceutical prescriptions – the most commonly cited and warned against in perimenopause being antidepressants and HRT. Coincidentally, many of the side effects of these supplements mirror some of the side effects associated with certain medications.
Many supplements have not been thoroughly tested through randomized, double-blind clinical trials, and many reports of potential benefit for the symptoms they are said to address are limited at best. In perimenopause and menopause, women ultimately must decide which options work best for them. For some, it will mean medications of any type are off limits. For others, they will embrace FDA-approved medicines. And many, many more will adopt an integrative approach, blending options from both worlds.
The Real Peri Meno is devoted to all things perimenopause - the science, treatments, care, understanding, personal experiences, relationships, culture and more. The brain child of Keisha D. Edwards, The Real Peri Meno developed out of her own shock-and-awe experience with perimenopause and navigating the disjointed U.S. medical system in search of answers, support and relief.
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