Menopause is a universal and natural phase that impacts all women and manifests in a variety of often perplexing ways, yet, it remains shrouded in misinformation and inadequate medical support.
This gap in care has left countless women navigating this transition without the guidance and assistance they deserve.
That is why I am authoring Assembly Bill 360 to addresses this pressing issue by mandating that osteopathic and medical doctors complete a survey on menopause training upon renewing their medical licenses. This initiative seeks to ascertain physicians’ training and understanding of menopause to ultimately improve the quality of care for women across California.
Menopause signifies the end of a woman’s reproductive years, typically occurring between the ages of 45 and 55. This transition is accompanied by a decline in estrogen and progesterone levels, leading to various symptoms and potential health risks. Common symptoms include hot flashes, night sweats, mood swings and cognitive changes. Beyond these, menopause can have significant long-term health implications.
For example, the decrease in estrogen levels during menopause can have negative impacts on the cardiovascular system. This loss can lead to increased fat mass, insulin resistance and dyslipidemia, elevating the risk of heart disease. Women with symptoms such as hot flashes may have a particular risk.
Estrogen also plays a crucial role in maintaining bone density. Its decline during menopause accelerates bone resorption, increasing the risk of osteopenia, osteoporosis and fractures. The annual rates of bone mineral density loss are highest starting one year before the final menstrual period and continuing through the two years after it.
The myriad and complex nature of menopause symptoms require a holistic approach to their management. Yet, there has been a persistent knowledge gap among physicians regarding menopause. Menopause education has been notably lacking in medical curricula. Moreover, it very often may not be the focus of a medical practitioner who is a specialist with very little training in the way of managing menopause symptoms. Managing individual symptoms will not necessarily address the totality of a patient’s needs.
Adding to the complexity of managing the effects of menopause is the changing opinions about hormone replacement therapy. It was once the standard for alleviating the effects of hormone deficiencies. However, its application has evolved significantly over the past two decades.
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In 2002, a Women’s Health Initiative study raised alarms by linking HRT to increased risks of heart disease and breast cancer. This report led to a dramatic decline in the use of HRT, leaving many women without effective symptom relief. This widespread apprehension about HRT ended up severely reducing an emphasis on menopause management especially in medical training and practice.
Subsequent analyses have nuanced our understanding of HRT. Current guidelines suggest that HRT can be safe and effective for younger women (typically under 60) or those within 10 years of menopause onset, primarily for managing moderate to severe symptoms and preventing osteoporosis.
Despite these improvements, cultural stigmas surrounding menopause have perpetuated a lack of open discussion and research further hindering the development of comprehensive medical education on the subject. Under AB 360, California can be at the forefront of improving women’s health care in several ways.
The mandatory survey of practitioners will help address the gaps in understanding and improve care for women navigating this stage of life. With better-informed doctors, women are more likely to receive accurate diagnoses and effective treatments, reducing the prevalence of untreated symptoms and improving quality of life.
Improved menopause management can lead to a decrease in the need for multiple consultations and unnecessary treatments, resulting in cost savings for both patients and the health care system.
Menopause should not be a journey fraught with confusion and inadequate care. By passing AB 360, California can take a significant step toward ensuring that all women receive the health care they deserve and improve health care outcomes.
It’s time to bridge the gap in menopause education and set a precedent for comprehensive women’s health.
Assemblymember Diane Papan, D-San Mateo, represents the 21st Assembly District including Bayside communities of San Mateo County.
(1) comment
A little bit of menopause education: if Diane Papan and friends are experiencing issues with peri-menopause or menopause the medical community and regular people recommend biking.
quote: "Cycling is one of the things we most want to learn when we are kids: Get on two wheels, balance ourselves, and pedal away. Nothing compares to that first time we can ride down the driveway alone, without any hands steadying us. In that moment, we achieve something special: a feeling of freedom, of autonomy. As we age, cars replace bikes as transportation while other sports and activities replace the exercise we got. Our memories of good times on two wheels fall into the rear-view mirror. It may be many years and we could be in peri-menopause before we even consider riding a bike again. But when we return to it, there are instant memories of why we loved it so much. This time we vow not to forget this time."
San Mateo women are waiting for Diane Papan to wake up to the "news" that bicycling helps with mental health, physical health.
But here is the thing Diane, women want safety through bike lanes before they make the healthy switch. You have failed them by opposing bike lanes whenever they have been suggested. You have been holding women back and increased health care cost unnecessarily.
https://mymenowell.com/blogs/bossa-blog/why-cycling-is-great-for-movement-in-peri-menopause
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