AUSTIN (Nexstar) — The Texas House of Representatives subcommittee on Maternal Health, Menopause and Access to Evidence-Based Medicine had their second interim hearing Monday where they focused on issues regarding hormone health and menopause. The subcommittee was established in August to extend discussion of women’s health concerns beyond childbearing years into midlife.
A panel of OB/GYNs and menopause specialists delivered testimonies at the hearing and shared their concerns with the subcommittee. A common concern was that physicians often fail to treat root causes of menopause symptoms and instead opt to treat the symptoms themselves. Many menopausal and perimenopausal women seek medical care from multiple providers before being directed to a menopause specialist.
“A recent study found that 60% of women say their clinician dismissed their symptoms, also found that 40% got no guidance on treatment. The treatments exist, but the training is lagging,” said Dr. Mary Claire Haver, a board certified OB/GYN and certified menopause specialist. “Women arrive with a sleeping pill from one doctor, an antidepressant from another, and a referral to a cardiologist for heart palpitation, and nobody asks them about their periods. They treated each symptom on its own, and the cause never really gets named.”
Haver also discussed the lack of comprehensive menopausal training in medical schools.
“I got almost no menopause training in my residency. I got six one-hour lectures in my second year of training and no clinics, no clinical experience whatsoever,” Haver said.
Dr. Jennifer Friedman, an OB/GYN and clinical associate professor at Texas A&M University Family Medicine Residency Program, emphasized the need for menopause education in Texas during the hearing. Friedman created a formal menopause gynecology elective and curriculum at the Texas A&M Family Medicine Residency in 2022 and believes that more physicians need to be trained in menopausal care to adequately address the needs of the population.
“93% of surveyed OB/GYN residency program directors strongly agreed that residents nationwide should have access to standardized menopause curriculum that could be utilized in their programs, yet only 31% have a menopause curriculum in their residency program. And this is obstetrics and gynecology, not the other specialties,” Friedman said
The subcommittee discussed the use of hormone replacement therapy (HRT) to treat perimenopausal symptoms, which replaces the estrogen that the ovaries stop making once menopause begins and is often paired with a progesterone to protect the uterus. Haver says that HRT is a helpful way to treat and mitigate perimenopausal symptoms but says that outdated medical research has left physicians hesitant to recommend HRT to patients in need.
“In February of this year, the FDA began removing the black box warning from hormone therapy labels. But a generation of clinicians trained under that warning and a generation of women were told that hormones were dangerous. So changing a label doesn’t retrain a workforce,” Haver said.
Panelists at the hearing emphasized the need for further research into menopause and perimenopause. The subcommittee will reconvene during the next legislative session beginning in January
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