“My theory on menopause is that your body’s like, ‘oh you’re 50? Thank you for your service. I’m taking away your estrogen, now go die.’ Although they took the word ‘replacement’ out of hormone replacement therapy, it is actually a replacement. Your body took it away and we’re putting it back to avoid the badness that can affect your brain, bones, and heart,” Dr. Sophia Yen, Physician, Professor, Adolescent Medicine and Maternal and Child Health Expert.
Learning about menopause used to be in hushed conversations with our own Mothers or older relatives. But finally it’s getting attention in mainstream media. In part, because how we manage it, has huge implications for our mental, physical, and emotional health. Including longevity and perhaps more importantly, quality of life or health span, during those years.
As a Physician and Professor with specialities in pediatrics, adolescent medicine, in addition to maternal and child health, Sophia’s work revolves around life stages with big hormonal changes. And she’s learned, there’s a lot we can do to tailor and improve our experiences.
Menopause is About More Than Hot Flashes
Until recently, treating menopause was almost synonymous with treating its known symptoms. Which vary, yet are generally considered “treatable” if they’re hot flashes, painful sex, or frequent urinary tract infections (UTI’s.) But what’s less known, is that menopause also puts women at greater risk for serious illnesses. Sophia explains, “Replacing estrogen is not only to treat symptoms. We’re seeing data that it can prevent osteoporosis. And we’ve always known about its implications for cardiac health and dementia.”
Because Our Bodies go Into Hormonal Withdrawal
Estrogen is a bit like oxygen for female bodies. And when it naturally declines, along with its companion progesterone, it impacts every system in our bodies. So, hot flashes, are only a small part of the larger story about treatment. Sophia said, “They way underestimated the size of the market for menopause. Because if the recommendation is only ten years of hormone replacement, that gets most women to age 60. But we know the average life span is 80, and a lot of us want to live to be 100.”
Which Impacts Mental and Emotional Health
Although it can happen earlier or later, perimenopause, aka ‘pre-menopause’ tends to start in our forties. And can last for 10 years before menopause. During that time, insomnia and sleep disruption is common. But even if your sleep is solid, the hormonal shifts alone can increase mood swings, anxiety, depression or rage. So, be proactive with your doctors and healthcare providers about your mental and physical health needs. Especially if you’ve had a history of depression.
And Puts Us at Risk for Serious Illnesses
Women, for a number of reasons including pregnancy, have been excluded from clinical trials. And are still underrepresented in health research. Which means, the data isn’t there yet to answer many of the questions about long-term hormone replacement, or genetic differences in what we need.
Hormonal treatments of any kind, including fertility or birth control, can affect people differently. Sophia said, “There are 40 different birth control pills and 8 different progesterone’s. And most physicians are taught to pick a pill and if that doesn’t work then try the next one.”
Like With Birth Control, There Can Be Trial and Error
Sophia explained, “For example, the birth control pill we learned about in medical school works great for Caucasian females who want to bleed every month. But not for a woman of color. I talked to my fellow Asian and Black doctors, and they’re like ‘Oh yeah, that pill does not work for our people.’ And from personal experience, I had to go through three different birth control pills.”
So, Sophia categorized the 40 different birth control pills by their likely symptoms and side effects. Everything from mood swings to the munchies. Brilliant right? So, work with your health care practitioner, to learn more about your options and tradeoffs based on your health history.
So, Get Savvy About Your Options
There are two ways to take estrogen treatments. “Systemic estrogen, goes through your blood to every tissue which is probably the best for bone and heart health. But then there’s also local estrogen, which is just cream around your vagina,” Sophia explained. She also said the infamous Women’s Health Initiative study, which caused many doctors to stop prescribing hormone replacement therapy out of fear it would increase cancer risk, was deeply flawed.
To Personalize Your Experience
In our research most Moms don’t engage in basic self-care, like sleep, nutrition or movement. Although the health span and longevity movements are gaining in popularity, it’s mostly with men. But personalized medicine is within reach for many of us. Including genetic testing, to understand if you’re at greater risk for serious conditions. So, how can Mothers harness the energy to optimize their hormonal health?
Gather Information from Trusted Sources
There’s a lot of information, out there about all things women’s health, including menopause. But make sure it’s coming from a trusted source. Sophia said, “If you follow people for this on TikTok discussing medications make sure they’re an MD, no offense to alternative medicine, but it has to be evidence-based.”
Although current treatments are indicated for specific symptoms, they’re FDA approved. And have undergone randomized clinical trials. If you enjoy taking a deep dive into the research, Sophia recommends the book, Estrogen Matters. But there are also many podcasts, and other resources online, including from the telehealth company she co-founded.
Build Your Care Team
Although the first stop is often to see your OBGYN, not every OBGYN has the latest and greatest information about menopause. Sophia said, “There are approximately 1300 menopause society certified practitioners in the nation. I believe only about 20% of OBGYN programs teach about menopause. And then there’s the question of who’s in charge of menopause, is it the OBGYN or internal medicine? And your insurance may limit who’s available to you. Specialists are harder to get into and may be more expensive. But realize that doctors can’t know everything.”
And Ask Questions
In many cases, you can assert your preferences. Sophia said the medical community has become more receptive to shared decision making. “A lot of women will say to doctors, ‘you’re going to have to pry this hormone out of my dead hands. Because I’ve come off and I’ve experienced the hot flashes, the weight gain and all of the bad evilness!’ Because yes, if you come off hormones, you’re going to return to having side effects.”
She recommends asking your doctors questions about their backgrounds and treatment plans. Like, “Have you had menopause training? How much have you had? And when they say, ‘you know I want to take you off your hormone treatment’ ask for the evidence behind that.”
Aging is Natural but Suffering May be Optional
The good news? This area of women’s health research is getting renewed attention, which will lead to more clarity. Sophia said, “We are in a murky area because we don’t have all of the research yet about what’s going on with your brain and bones. But it will grow.”
Why are we just learning about this? In part, because women are socialized to deal with discomfort, which can be problematic when it comes to our health. But now, more women are building innovative solutions to advance change.
We can take charge of our hormonal health by getting familiar with the options, being open about our needs and asking the right questions, with the right health experts.
Many thanks to the talented Dr. Sophia Yen, MD!
Learn more about her company Pandia Health on their website, Instagram, TikTok, Facebook, YouTube and X. And follow her great adventure on TikTok and LinkedIn.
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About Sophia:
Dr. Yen is Board Certified in Adolescent Medicine with 20+ years of experience in medicine. She graduated from MIT, UCSF Medical School, and UC Berkeley with a MPH in Maternal Child Health. She serves as a Clinical Associate Professor at Stanford Medical School in the department of Pediatrics in the Division of Adolescent Medicine.
Beyond her medical work: Dr. Yen co-founded 3 non-profit organizations/projects in her endeavors to improve the lives of women: The Silver Ribbon Campaign to Trust Women,SheHeroes.org, and FFFL.co (Female Founded, Female Led) a B2C campaign to get consumers to choose Female Founded, and Female Led.
Dr. Yen co-founded Pandia Health because she believes no one should suffer from ?pill anxiety? – the fear of running out of birth control and the stress of obtaining birth control each month. Her latest health campaign is to educate the public about #PeriodsOptional and women?s reproductive rights.
Dr. Yen enjoys educating the public and other physicians about birth control, #PeriodsOptional, acne, weight management, and other adolescent health issues. She has spoken at SXSW, TEDxBerkeley, Facebook, TEDx Silicon Valley Women, UC Merced, UC Davis, UC Riverside, Stanford University, local high schools, Boys and Girls Club of the Peninsula, given grand rounds and noon lectures at various academic institutions from Stanford Pediatrics and Internal Medicine to UCLA Internal Medicine.
She has been featured in many publications for her work in reproductive health and as CEO of Pandia Health.
