I was catching up with an old friend yesterday, and while it was great to hear all the fantastic things that were happening for her professionally and personally, when she told me about her recent experience talking with doctors about how to manage menopause, my blood started to boil.
She has been suffering crazy hot flashes, fatigue, and brain fog – and when she told her doctor that she’d like to avoid HRT, what did the doc do? Prescribed an SNRI, swapping one med for another.
Now, I get that SNRIs and SSRIs (most often prescribed for depression) have shown in some studies to be as useful in calming vasomotor symptoms as estrogen therapy, since the neurotransmitters serotonin and norepinephrine are linked to the body’s temperature regulation. But once again, we are missing the forest for the trees. Why the rush to slap a medical intervention on someone who has asked specifically for an alternative? An anti-depressant may not carry the same level of risk to one’s health as hormone replacement therapy, but it is still a serious drug that does carry side effects. It may very well make her feel better, but it’s a band-aid. It masks the symptom rather than getting to the root of what is causing her discomfort, so whatever is happening internally will likely get worse over time, necessitating a long-term relationship with her pharmacist.
What I wish that doctor would have done is ask my friend a few more questions about what was going on in her life. Maybe if the doc had known that my friend also has a history of GI issues that goes back decades, high stress levels on account of juggling a busy career and single motherhood, and years of debilitating migraines, she could have suggested that perhaps those physical symptoms could be addressed more directly and permanently with tweaks to her diet, supplementing certain nutrients that are missing, and making a few subtle lifestyle shifts.
This is one more case of the medical establishment trying to “cure” menopause with medication – the prescription pad should be the last line of defense, not the first.