School Discussion Assignment, Part 3 - Contraception and HRT

So after posting my post, a fellow student shared her own horror story, which was way worse.

This is not the first horror story I've heard regarding the confusion on this subject and won't be the last until we nail it down with research.

I'm not gonna share her story, of course, but my reply:

Oh no, XXX! I'm so sorry that happened to you! I think that especially with minors, it's imperative to explain everything in detail, the risks and benefits, so they know what they're getting into, but it sounds like that didn't happen.

I guess I could understand somewhat if it's like a general practitioner, like Internal Med or Family Med provider, but OB/GYN people who specialize in this should present it all and let you choose, and realize that some people aren't going to respond the "stereotypical" way and that should be taken more seriously.

It's like confirmation bias that was discussed in the book, right? The tendency for people - including doctors - to push away anything that doesn't support what they already want to believe. Too much cognitive dissonance, gotta push it away lol.

And therein lies the problem - this is one of those less common areas of medicine where docs are going with their gut or their own patient circle rather than actual science, and it's leaving us confused lol.

I think the issue is because we're fairly certain about what happens when you don't have enough estrogen, but confused about what happens if you have too much in different phases of our lives, especially with women who are sensitive to it (and we don't know why that is yet either).

 

Also, there's a lot of focus on estrogen, but not as much on progesterone.

I'm curious as to whether it may turn out like we're finding out about calcium, that dietary supplements in food form may be better than pills (for symptom relief, not contraception, of course).

Specifically, phytoestrogens from plants might be a better alternative than pills.

So we know that Asian women report menopause symptoms less, right?

https://pubmed.ncbi.nlm.nih.gov/12804320/Links to an external site.

And there has been some speculation as to why that is, whether it's cultural differences like less likelihood to report them or access to healthcare, or they genuinely experience less symptoms, and there has been some evidence to support that it may be at least partially diet - because phytoestrogens are found in soy isoflavones (not in your grocery store soy sauce).

Studies on this have been somewhat promising, but inconclusive, but you can bet I ate a ton of miso, tofu, and edamame especially during menopause! lol.

Regardless, I initially thought these horror stories were just local, both because we have a doctor shortage here now, and because we're not exactly a mecca of healthcare here anyway, but when I started digging a few years ago with my experience, I read about the WHI study and and the pushback, and read women's stories elsewhere.

Let's just say women are understandably confused about what to do, as a result, and the patient education experiences are not great.

Lastly, I hope this isn't too controversial to say, but the best resource for me, when young, was Planned Parenthood. People think it's just the abortion place, but it wasn't, most young women going there were either about contraception or their Paps and other exams.

I can't speak for every center, but they educated me completely about everything with pamphlets, diagrams, and took the time to answer any questions you had.

Younger ones or those without adequate health insurance, check it out, it's a great resource and operates on a sliding scale.

And with that, the Gentlelady from Kentucky yields her time (lol).