EP 83: North American Menopause Society (NAMS) - Are You Listening?????
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- Опубліковано 10 вер 2024
- “If you’re already a board-certified OBGYN, why would you pay to become NAMS certified?”
Many physicians turn to the North American Menopause Society (NAMS) for guidance on menopause-related issues. Every few years, they release a position statement outlining their stance on relevant treatment options, and lately, I’ve been getting a lot of questions about their recent statements.
For the next couple of episodes, I’ll be doing a deep dive into different aspects of NAMS and their position statements. Today, I’m starting by critically examining their 2022 hormone therapy position statement and 2023 nonhormone therapy position statement.
In this conversation, I discuss why I question their funding, their focus on certain symptoms, their positions on the use of compounded bioidentical hormone therapy, my skepticism about NAMS certification, and more. Enjoy the episode!
Episode Highlights
- Why I’m talking about NAMS
- The potential influence of big pharma as the primary funding source for NAMS
- Highlights from NAMS’ 2022 Hormone Therapy Position Statement
- The problem with relying heavily on the Women’s Health Initiative and the emphasis on addressing a few specific symptoms
- NAMS' stance on compounded bioidentical hormone therapy and why I disagree with their assessment
- Skin and hair effects of estrogen therapy
- The problem with NAMS’ definition of quality of life
- How hormone replacement therapy affects common menopause symptoms and the risk of cardiovascular disease
- Risks and benefits of hormone therapy and different types of cancer
- Discussion of financial relationships and conflicts of interest within NAMS
- NAMS 2023 nonhormone therapy position statement
Resources
Dr. Tassone's Practice | www.drshawntas...
The Hormone Balance Bible | tassonemd.com/...
Hormone Archetype Quiz | tassonemd.com/...
Disclaimer
This podcast and website represent the opinions of Dr. Shawn Tassone and his guests. The content here should not be taken as medical advice and is for informational purposes only. Because each person is so unique, please consult your health care professional for any medical questions.
I'm really glad I found your site. I come away informed but sad. Sad because I could be in a very different health position if my doctor, who is well known and well respected in my area, had bothered to keep up with the current data for his menopausal patients. But when a doc makes big bucs to deliver a baby, what value is there to keeping ahead of the curve for his older clients? Not much, evidently.
Thank you again. I suffered DIC after my third vaginal birth, emergency hysterectomy. Kept my ovaries, lost one two years later due to a cyst. I was totally unprepared for complications with my third childbirth, and totally unsupported with my descent into hormonal deficiency afterwards. I'm menopausal and denied HRT. At 61 I may as well be 81. I feel 81.
We have GOT to get to this man!!!!
392$ May very well be the best $$$
We
Ever
Spend!!!
Thank you, I agree there is so many other symptoms that are dismissed.
It helped me find a MD for my HRT. Alot of practitioners will not put you on HRT telling you it causes cancer. So, it is good for lay people to find a Dr. who will prescribe. My ob/gyn turned out to be a great doctor.
They try so hard to put you off taking hormones. And the least excuse to stop it. It's social control of women's bodies, and women in general, is what it is. Are they terrified we'll feel good? 😊xx
I am so grateful for your channel. I have already had a really bad experience with several NAMS providers, thinking it was something I could trust. It has taken several years to find good care and the right meds.
I have to go out of network and pay out-of-pocket for the services of HRT because the system I was in started making me reduce my dosage without testing,etc. A whole lot of really bad things started happening to me as a result. I really like that in the new system I get bloodwork done yearly and can discuss what that means for me and if any changes need to happen as I age. They also had me get the calcium scan before increasing my dosage at 59 after Kaiser was pulling me off for a few years. I am now 64. It’s expensive but worth it. I’m tall and lean and quite frankly I’d be fragile without the HRT support. Anyhow, individualized care is good. Wish it was more available and less costly.
Thank you very much for this info.
Its helpful because doctors are woefully unaware of most of this and its a breath of fresh air to get your perspective. You're so right that doctors default with women is that its all in their head
Dr. Tassone, on the point of hormones after the age of 70 or 10yrs post-menopause, I’m hearing the main reason for pause is cardiac related. What about receptors? I’ve heard two camps: one that says the reason is if a woman hasn’t been on HRT >10yrs post-meno that her receptors die off and the hormones will be free-floating/not taken up. On the other hand, I’ve heard from others that the receptors will eventually restore function over time, and that Bioidenticals are still safe and recommended for menopausal symptoms. What is your research/experience on receptors so long after menopause? Thank you 🙏
That receptor theory is completely ludicrous completely risdiculous
Really? Receptors “dying off” (my words but essentially the point) when not needed came from an Ob/Gyn with double PhD in reproductive endocrinology. Would you say more? What actually happens? Thank you 🙏
I appreciate your frankness and sense of humor.
I am so discouraged.
Denying hormones at 60 AND this crazy " pap smears are now only covered by insurance every 5 years so we cant do it " garbage. If you feel things going on, you should be getting exams and tests - period.
Good to know.
Wonderful. Exactly as I have been lecturing for the last 25 years. Challenging the current dogmatic narrative. NAMS serves no good purpose. Or maybe they are simply "captured." You say progestin or progestigen (Provera) when the text over reads "progesterone." Very confusing to the uninitiated.
And this proves, most unfortunately, most physician are not critical thinkers. Rarely challenge the current narrative.
Precious Videos Sir thanks for Sharing 🙏🏻⚜️🙏🏻you should tour US 🇺🇸
That’s EXACTLY what I did!!
Took Mary Haven's advice and have an appointment with a NAMS doc Tuesday.
Keeping me awake whether I’ve done the right thing🤦♀️.
I’m also afraid insurance won’t reimburse with your practice!
But, I have a gut feeling I need to cancel
And just go with you!!
NAMS certification doesn’t mean they are a good doctor
Yes. Due to not being independently wealthy, I am financially forced into working with providers covered by my insurance. Someone else said it above. NAMS certified is a possible provider over all the other providers that are just flat out saying NO.
Well I didn’t go with my gut,
Went to a NAMS doctor.
She treated me like SHIT! Wouldn’t even LOOK at my labs! Brown beat me to taker statin and anti depressant, I refused, picked up my purse and walked out weeping! I felt so worthless.
I brought my labs home,
Compared them to
What Dr
Tassone says are optimal,
Yep,
In the basement! I bit the financial bullet and did my tele
Health with him Tuesday! I’m on some
New hormones, looking forward to a new
Life!!!
Just do it!
I agree !!! Women are treated so unfairly
Menopause Barbie, a doctor here on UA-cam says that If you let 7 years pass from menopause that you will not benefit from circulating hrt because your receptors close up. My head is spinning. I never believed that would be a thing.
Yeah I heard that too, And my heart sank. So I started watching a whole bunch of other UA-cam doctors including Felice Gersh, who believes you're never too old to start HRT. The receptors are always there. When you're older it just takes them longer to start responding.
Thank you so much for all the information you continue to provide!
I have a question that I’ve not seen addressed before and would value your input. I am almost 70 and generally very fit. I went on hrt as soon as I started getting perimenopause symptoms and remained o it for a good number of years. After the WHI study my drs started frightening me into getting off and eventually I weaned myself off. I also used those dreaded OTC creams which did seem to help but they became different to acquire and I stopped them several years ago. I convinced my dr to let me have hrt and I was given an estrogen patch and progesterone pill. I bled a lot and felt so bloated that I went off. I really want to try again for a number of issues such as libido and insomnia. I have fantastic husband and marriage but so long to get my libido back. In your opinion does this “ten year windowl” mean when you’ve never been on hrt?
Thank you so much for your time!
😂. I love your frankness! Please get licensed in NC! ❤
Another UA-cam menopause doctor claims that there is a minimal effective dose of E2 that is heart and bone protective and doses below that would do nothing beyond relief from hot flashes. And that dose is the equivalent of the dose used in the WHI.
What say you? And can you base your answer on your personal experience with patients?
Thank you!
Everyone is different on dosing
@@ShawnTassoneMDPhDWould you please do a podcast on GSM-and specifically, talk about how you treat patients who have been without hormones for many years and have significant problems tolerating the SEs of vaginal estrogens (ie, burning, nerve irritation)? How do you handle these patients? Do you switch to compounded estradiol, do you ever use compounded vaginal testosterone because of the existence of androgen receptors in the pelvis, do you believe Intrarosa is AS EFFECTIVE as vaginal estrogen? These are questions that I don’t see doctors talk about much. They go on and on about how vaginal estrogens are great and the end all be all, and totally ignore the fact that there are tons of us who simply cannot tolerate the SEs of these drugs because of advanced GSM and very fragile, painful tissues. In my case, estradiol cream burns like hell and sets off nerve zapping and spasming. Estring makes me feel like I have a perpetual UTI. Imvexxy is ok, but after 3 years has done virtually nothing for my GSM. Tried Intrarosa for 3 mos but it, too, made me feel like I had a daily UTI. I’m exhausted and angry. My doctor doesn’t know where to turn next to help me. Why must some of us have so many problems with these drugs? We are the forgotten ones.
Ty for listening.
I'm not sure what the equivalent of the WHI dose is in terms of bioidentical oestradiol, would be good to know. I suspect the current standard doses we are prescribed are lower than that. I've heard that these current doses may help slow down bone loss by regulating osteoclasts, but not high enough to build any new bone by osteoblasts. Would love to know more about this too (as I'm a coeliac) 😊xx
@@anne-louisegoldie the patch equivalent is .05
@@healthyteddy thank you 😊xx
Thanks you for your help.