This week: why the heart warning on estrogen was never about women your age, and why younger Black women face a wider uterine cancer survival gap.
Also: the weighted vest your feed keeps insisting will save your bones, and a case of shingles at 43.
Apparently finding a doctor who knows menopause is part of menopause.
One woman's symptoms started with hot flashes and sleep disturbances. Then came the injuries — snapped hamstring, tendonitis in her elbow and shoulder, and finally Achilles pain — all tracked on a 28-day cycle. Her doctor pushed back on HRT at first, then relented. But when the doctor insisted oral estrogen carries the same risk as transdermal estrogen, that was enough. She found another provider.
What to ask: Ask your provider how much menopause training they’ve had. If you’re getting hormone tests instead of treatment for your symptoms — or you just feel unheard or dismissed — the Menopause Society has a directory of certified practitioners.
The heart warning on estrogen applies to women 70 and older, not you.
A recent analysis of the Women’s Health Initiative study (yes, THAT Women’s Health Initiative) looked at cardiovascular risk by age. The only real increase showed up at 70 and older. The FDA has since pulled the black box warning for heart disease, breast cancer, and dementia off estrogen labels, though manufacturers are updating them one product at a time, so yours may still have it.
What to ask: If heart disease was the reason you were told HRT isn’t an option, ask whether this changes that answer.
Black women under 65 have a wider uterine cancer survival gap. Insurance doesn’t explain it.
Black women are nearly twice as likely as white women to die from uterine cancer. Researchers assumed insurance was the reason, so they looked at patients at Kaiser Permanente, where everyone is covered. The gap was still there, and larger in women under 65. The reason was tumor type. Older Black women were twice as likely as older white women to get an aggressive tumor. Younger Black women, three times. Nobody knows why yet.
What to ask: When does abnormal bleeding stop being something I should watch and become something that needs investigating?
You don’t really need a weighted vest for bone loss.
There is always another thing to buy to optimize midlife health. This week it’s weighted vests. They’re not useless. They’re also not a fix for osteoporosis, despite what your feed tells you.
What to ask: Before you spend $150 on a vest, ask what strength training you should be doing, and how heavy it needs to get to protect your bones.
Just so you know, 43 is not too young for shingles.
A 43-year-old woman recently learned the hard way that if you’ve had chickenpox or the chickenpox vaccine, the virus is still there and can come back. Current policy doesn’t recommend a routine shingles vaccine until you’re at least 50 — unless you’re immunocompromised. Then it starts at 19. No one really knows why younger people are getting shingles. Chronic stress may be to blame. Because telling someone to calm down if they’re worried about getting shingles is really going to work out well.
What to ask: If you develop unexplained burning or nerve pain followed by a rash or blisters, ask whether it could be shingles — even if your ID says you aren’t near 50.
That's your list for the next time someone says, ‘Any questions?’
Know someone in the “wait, what the hell is happening” years? Forward this to her.
See you next Friday. — Trista