New Approach to Menopause Treatment Urged

Worried that women in the United States may be turning too quickly to treatments for symptoms of menopause, a panel of medical experts suggested that those without severe problems simply wait out the changes their bodies were undergoing.

Evidence links sleep disturbances to menopause, which is associated with hot flashes, night sweats and vaginal dryness, a National Institutes of Health panel said Wednesday.

The panel found less evidence that menopause led to mood swings, difficulty thinking, back pain and tiredness. Studies were mixed as to whether urinary incontinence was a symptom of menopause.

Determining which symptoms are associated with menopause and which are the result of aging can be challenging, the panel said.

“We found very few symptoms that are tied to the natural fluctuations in hormone levels during menopause, and this distinction may have serious implications for women’s treatment decisions,” said the chairwoman of the panel, Dr. Carol M. Mangione of UCLA. “For women who don’t have very serious symptoms, waiting it out may be the best strategy.”

Hormone therapies for the treatment of menopause can pose a risk, the panel said. Although hormone therapy can be effective for women with severe menopause symptoms that diminish their quality of life, the treatments may have serious side effects that women should consider before deciding on treatment, the panel said.

The group complained that little was known about the effects of some alternative therapies and called for more study.

For years, hormone replacement therapy was offered as an effective treatment for such symptoms as hot flashes and night sweats.

Use of hormones plummeted after 2002, when a major study found hormone therapy slightly increased users’ risks of heart attack, stroke and breast cancer. But as many as one-fourth of women who stopped using the hormones returned to them because of debilitating symptoms.

“One of the things that really struck us ... is the fact that menopause is not a disease, yet at the same time there are subsets of women who clearly have disabling symptoms from menopause that affect their quality of life and their ability to function,” Mangione said.

The group sought to determine the best and safest treatment, she said, but there wasn’t “really a best treatment that we could identify.”