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<\/p>\nWomen are receiving incorrect treatment or delayed treatment because medical schools still don\u2019t provide enough training in menopause. Misinformation about estrogen therapy also contributes.<\/p>\n
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Woman in menopause prescribed antidepressants in medical blunder<\/p>\n
Leslie Ann McDonald knew something was wrong when she started skipping workouts and sleeping after school drop-offs.<\/p>\n
unbranded – Newsworthy<\/p>\n
Leslie Ann McDonald was so tired she often skipped lifting weights.<\/p>\n
She would drop her daughter at school and go back to bed. Her body ached. She struggled to sleep. Her brain felt foggy.<\/p>\n
Her doctor prescribed an antidepressant, even though the then 36-year-old insisted she wasn\u2019t depressed. She even went to therapy.<\/p>\n
It took 10 years to get a correct diagnosis: Perimenopause<\/a>. The online personal trainer and coach needed hormone therapy.<\/p>\n More than a third of women going through menopause<\/a> or perimenopause are prescribed Zoloft, Prozac, Wellbutrin or other common antidepressants. Their use among women doubles during these years<\/a>. More women\u2019s health experts now say the vast majority never needed them. The antidepressants treat their symptoms, rather than the cause, and could make things worse.<\/p>\n \u201cI thought, \u2018I don\u2019t feel depressed, but I feel terrible,\u2019\u201d says McDonald<\/a>, 46, an online fitness coach in the Philadelphia area. \u201cI was miserable and willing to try anything, even if I didn\u2019t think that\u2019s what I needed.\u201d<\/p>\n Women are receiving incorrect treatment or delayed treatment because medical schools still don\u2019t provide enough training in menopause. Misinformation about estrogen therapy also contributes.<\/p>\n A new push by doctors and researchers last week on a Food and Drug Administration panel pushed the agency to remove what they say are outdated warnings on topical menopause treatments that contain estrogen. Now such medications contain a warning of the possibility of breast cancer, and that they aren\u2019t to be used to prevent cardiovascular disease or dementia, and that it increases the risk of strokes, blood clots and probable dementia.<\/p>\n The FDA has yet to rule on the change, but proponents say this delay leads to more women missing needed treatment.<\/p>\n \u201cThese women aren\u2019t mentally unstable, they aren\u2019t depressed,\u201d says Maryon Stewart<\/a>, who conducted a survey of more than 1,000 women in the UK about their menopause experience. \u00a0She also leads Femmar Corp<\/a>, a company that pushes for lifestyle changes to help with menopause. \u201cIt\u2019s tragic what women go through to try to feel better.\u201d<\/p>\n Beyond fertility and menopause: <\/strong>See why the ovary is central to women\u2019s health and longevity<\/a><\/p>\n The push for better perimenopause treatment<\/p>\n When women describe symptoms of perimenopause \u2013 including increased anxiety, fatigue and brain fog \u2013 doctors often first prescribe antidepressants.<\/p>\n That\u2019s because most doctors \u2013 even gynecologists \u2013 didn\u2019t receive adequate training on menopause during medical school, according to a study in the Journal of The Menopause Society.<\/a> Less than one-third of the almost 100 obstetrics and gynecology residency program directors recently surveyed said they received training in their residencies.<\/p>\n It\u2019s also because a 2002 Women\u2019s Health Initiative (WHI) study<\/a>\u00a0linked hormone therapy to slightly higher risks of breast cancer, heart attack and stroke in postmenopausal women. It was later found that the risks were mostly found in women who were older when they started hormone therapy<\/a>.<\/p>\n Use of hormone therapy dropped from about 40% in 1999 to about 5% in 2020, according to the Journal of the American Medical Association<\/a>.<\/p>\n Menopause: Symptoms, stages and treatment plans<\/p>\n Menopause typically starts around age 45 but can vary widely among individuals.<\/p>\n Hormone therapy is the most effective treatment for menopause, and is the first recommendation, according to the North American Menopause Society.<\/p>\n \u201cClinicians can be defensive and women can be gaslit and misdiagnosed,\u201d says Heidi Flagg<\/a>, an OB-GYN, menopause specialist and clinical assistant professor at NYU Grossman School of medicine. \u201cWith perimenopause, hormone therapy should always be considered first. We see a profound change in women with their brain fog and feelings of depression and improvements in hot flashes and other symptoms.\u201d<\/p>\n Flagg and other doctors say that if there are major depressive symptoms, they will work with a psychiatrist to see if antidepressants may help in addition to hormone therapy for perimenopause. For the small number of women who cannot take estrogen due to a history of breast cancer or other reasons, doctors do recommend antidepressants as a treatment option.<\/p>\n \u201cWe are doing women a disservice by not talking to them about a natural hormone that will improve their mood and sexual function,\u201d Flagg says.<\/p>\n Perimenopause symptoms also can mirror those for anxiety and depression says Dr. Sameena Rahman<\/a>, an OB-GYN and sex and menopause specialist in Chicago.<\/p>\n “You have this roller coaster of hormones happening during midlife where so many other things are happening,” Rahman says. “It can be confusing for clinicians and patients.”<\/p>\n How doctors hope to change treatment of perimenopause<\/p>\n As more Gen X and older millennial women begin menopause and perimenopause, they are sharing their stories and demanding better treatment. They are not OK with experiencing it like their mothers did. Menopause also has become big business, with\u00a0more than 40%<\/a>\u00a0of U.S. women in perimenopause, menopause or are postmenopausal. And most women are in worse health during menopause, which can last\u00a0one-third of women\u2019s lives<\/a>.<\/p>\n \u201cWe have a gender health gap,\u201d Dr. Mary Claire Haver<\/a>, author of \u201cThe New Menopause,” says. \u201cWomen are ready to be advocates for themselves. They want better choices than their mothers have, and they are embracing it.\u201d<\/p>\n Three states recently have passed menopause laws ranging from continuing education requirements to mandated insurance coverage. And one in four states have introduced legislation around menopause care and education.<\/p>\n The Menopause Society<\/a> recently launched a $10 million training program to help train more than 25,000 healthcare workers in menopause and perimenopause.<\/p>\n What women in perimenopause should do<\/p>\n Until more doctors – from general practitioners to gynecologists are educated, experts say that women need to educate themselves and become their own advocates.<\/p>\n \u201cI felt so miserable, I was falling asleep at dinner,\u201d McDonald said. \u201cThey tested me for Lyme disease. I went to the doctor so many times, complaining about it. And it\u2019s like doctors make you feel like you\u2019re crazy or making it up.\u201d<\/p>\n McDonald spent several years on antidepressants before pushing for an evaluation of her hormone levels. She was later put on a low dose of estrogen and within two weeks felt better.<\/p>\n \u201cYou really have to be your own advocate,\u201d she says.<\/p>\n It’s time we talk about perimenopause and menopause<\/p>\n The hormonal and physical changes that come with menopause are rarely discussed openly. Why not?<\/p>\n How to treat perimenopause<\/p>\n Find a provider who specializes in perimenopause or menopause. The Menopause Society, which certifies them, offers a list<\/a>.<\/p>\n Find a provider early. Women often experience perimenopause at 35, so many will be in perimenopause of menopause for half of their lives, Stewart says.<\/p>\n Educate yourself before you meet with your provider, Flagg says.<\/p>\n Pair any medication with lifestyle changes such as nutrition and exercise to alleviate symptoms, Stewart says.<\/p>\n Talk to other women about it. Share your experience with providers.<\/p>\n \u201cOur job is now to educate our mothers and daughters,\u201d McDonald says. \u201cWe went through this, so they don\u2019t have to.\u201d<\/p>\n Laura Trujillo is a national columnist focusing on health and wellness. She is the author of “Stepping Back from the Ledge: A Daughter’s Search for Truth and Renewal,” and can be reached at ltrujillo@usatoday.com.<\/p>\n![](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/07\/75673882007.jpg\"\/)
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