Surgeons didn't used to wash their hands, so...

... a lot of this might not age well, you know?

Photo by Sean Horsburgh on Unsplash

There is a shift in the menopause conversation coming, or it’s trying to.

How do I know this, when we know so little?

For starters, we has so little in the way of research: one-tenth of the studies on menopause that we have on pregnancy (94k versus 1.1 million, according to a PubMed search), and only 6k on perimenopause.

My golden rule here, which is too nuanced to ever blow up on social media, is ‘let’s not be too certain about anything’.

Because critical thinking, common sense and our own intuition tells us we can’t.

For starters: Most of the menopause studies look at HRT as a whole, without subdividing out bioidentical hormones.

And this doesn’t seem like such a big deal when it comes to estrogen, but we are starting to see that it can make a difference with progesterone (and the class of synthetics that mimic it, progestogens).

As a naturopath I’m going to be speaking with soon said recently, wisely, until we have big randomized trials that only look at bioidenticals, “we are at sea”. As The Menopause Society medical director Dr Stephanie Faubion told the New York Times this summer, on the heels of the study that showed a link between HRT use and dementia, “we lump hormone therapy into a single group, and we really shouldn’t”.