From September 27th to September 30th, 2023, The Menopause Society hosted its annual meeting, a professional medical conference that gathers some of the top minds, healthcare professionals and brands in the perimenopause/menopause care space. The event focuses on discussing product innovations, new scientific developments and key topics specifically impacting the perimenopausal and menopausal woman.
Bonafide’s Chief Medical Officer, Dr. Alyssa Dweck, was in attendance this year, along with other members of the Bonafide Sales, Marketing and Research & Development teams. Read on for more on Dr. Dweck’s first-person account of the event, along with some of the key takeaways she observed.
Menopause is Having More Than a Moment
The Menopause Society, formally known as the North American Menopause Society (NAMS), convened in Philadelphia recently, with a record number of attendees since the start of COVID. It was amazing to see how the reach of this conference has extended significantly and is more inclusive than ever of multiple medical disciplines – OBGYNs, internal medicine and family practice providers, urologists and urogynecologists, nurse practitioners, pelvic floor physical therapists and mental healthcare providers were all in attendance for a common cause. Ms. Susan Dominus, staff writer from The New York Times and Author of the provocative piece “Women Have Been Misled About Menopause” gave the Keynote Address to an incredibly engaged audience.
What remains clear is that the burden of menopause symptoms is significant, with downstream negative effects impacting mood, sleep, productivity, and physical and emotional wellbeing. A large percentage of people remain untreated – why is this?
In no particular order, here are some of the pearls of wisdom and take-home messages I personally found relevant to this year’s conference.
Hormone Replacement Therapy (HRT) is Indicated for Menopause Symptom Management
Now frequently referred to as menopause hormone therapy (MHT), hormone therapy is back on the map after the reevaluation and reinterpretation of the data from the Women’s Health Initiative (WHI) study, done in 2002.
MHT remains an option for those suffering with vasomotor symptoms (VMS) of menopause, including hot flashes and night sweats. For those who are candidates, a non-oral and ‘natural’ estrogen, with or without progesterone, is preferred, with a periodic reevaluation of risks, benefits, and alternatives done at regular intervals. Initiation of MHT is typically considered for those who are within 10 years of the onset of menopause and prior to age 60, in most cases.
Speakers at The Menopause Society meeting reiterated risk factors for an increased duration and severity of VMS from previous published SWAN study data, including: smoking, black ethnicity, age of onset of menopause being less than 44 years old, and a BMI of greater than 30.
Shared decision making between patients and their healthcare provider was emphasized; since there really is no one size fits all solution when it comes to managing menopause symptoms.
Alternatives to MHT were also addressed. For those who are unable or unwilling to consider MHT, other pharmacologic options, including the newly approved NK3 antagonist, antidepressants and other prescription medications were reviewed. Lifestyle changes, such as a focus on nutrition, exercise, stress reduction and weight management were all also highlighted.
Genitourinary Syndrome of Menopause (GSM)
Often referred to colloquially as vaginal dryness, this common symptom set was front and center. While vaginal estrogen has been considered the standard of care, an independent study done by the NYU Grossman School of Medicine, was presented, and highlighted results comparing the use of a 5 mg hyaluronic acid vaginal insert (in the form of Bonafide’s Revaree®) to estradiol vaginal cream, over 12 weeks in people with GSM. Findings supported equal efficacy with both management options, which is exciting news for those who cannot or would rather not use hormones. This data emphasized that there is a viable, safe, non-drug, and non-hormonal option available for the management of GSM. This is especially important in light of recent commentary released regarding increased recurrent breast cancer risk in those using vaginal estrogen in those on aromatase inhibitors.
Menopausal Hot Flashes Can Be Linked to Alzheimer’s Disease Risk
First the good news: 40% of dementia cases are preventable. Smoking, obesity, diabetes, and cardiovascular disease are modifiable risk factors. With that said, 2 out of 3 people with Alzheimer’s Disease, are women. Research indicates that menopausal hot flashes are associated with memory. One study suggests a potential association between hot flashes while sleeping and an increased risk of Alzheimer’s. From that same study, Stephanie Faubion, MD, MBA and Medical Director of The Menopause Society was quoted saying: "Given the adverse effect on quality of life and financial burden of Alzheimer’s Disease, it's important that we learn as much as possible about potential causes and warning signs so we can be proactive before the onset of Alzheimer’s Disease."
Breast Health is Still Top of Mind
Breast cancer screening recommendations are being modernized. AI (Artificial Intelligence) generated risk prediction models and precision medicine were discussed. Screening guidelines are also being shaped by dense breasts, a risk factor for breast cancer.
Precision Oncology is Here
Genetics testing conducted via a simple blood test for multi-cancer early detection, while still not mainstream, is out of its infancy and could change the face of cancer screening from the currently available, invasive tests. Cell free DNA for cancer screening is not just for prenatal diagnosis anymore.
Don’t Forget About Colorectal Cancer Screenings
The incidence of colorectal cancer (CRC) has doubled since 1990, with 1 in 5 patients being diagnosed in the 20–54-year-old age group. 1 in 4 patients receive clinician recommendation for CRC screenings.
45 is the new 50! The U.S. Preventive Services Task force (USPSTF) now recommends CRC screenings at age 45. This will prevent 29,400 CRC cases and 11,100 CRC deaths over the next 5 years.1 Newer screening techniques are also on the horizon.
Menopause Testing Has Gone Over the Counter (OTC)
Even though the standard definition of menopause is a clinical one, defined as 12 consecutive months without menstruation, after age 40, with no other cause, many remain curious about the timeline of their own menopause journey.
Enter the Clearblue menopause testing kit.
This recently launched, over-the-counter urine test is meant to be used as a companion to traditional healthcare provider support in the management of perimenopause and menopause symptoms.
Most importantly, the thirst for credible, valid, thought provoking and scientifically based knowledge is palpable, and the opportunity for education is vast.
- Siegel RI., et al. JNCI 2017, 109(8):322.