Women^`s Health, Obstetrics and Female Reproductive System

Biography

Biography: Natasha Iyer

Abstract

Statement of the Problem: From menarche to menopause, women experience hormone fluctuations and a variety of mental-emotional and physical symptoms that affect their quality of life, relationships and the ability to be productive. Other than hot flashes and night sweats, a common presenting complaint of women in the menopause is anxiety, and sleep disturbance. Other complaints like increasing fatigue, genitourinary symptoms, weight gain and low libido during menopause are often unexplained or ineffectively treated. The WHI, 10 years later; has confirmed concrete benefits to HRT for women. Should we be expanding our thinking and approach to HRT in younger and older women by looking at augmenting levels of progesterone and other hormones to treat women more comprehensively? Progesterone is a neurosteroid. Its metabolites have a significant positive effect on the brain and neurochemistry. Are we missing an important part of treating women adequately, when we think ‘no uterus-no progesterone’? Other hormones like DHEA and pregnenolone have data supporting the positive effects on menopausal women. From bone to mood, to anxiety and sleep: hormone replacement therapy needs a rethink beyond ‘hot flashes and bone’ and our traditional approach to estrogen only, and estrogen and progesterone with an intact uterus. More important too, is the distinction between progestin and progesterone, a critical difference to pay attention to in clinical practice.