Woman in Menopause Prescribed Antidepressants for Additional Treatment
Understanding Perimenopause and the Misdiagnosis of Mental Health Conditions
Leslie Ann McDonald, a 46-year-old online fitness coach in the Philadelphia area, found herself in a cycle of exhaustion and confusion. She often skipped her weightlifting routine and would drop her daughter off at school before heading back to bed. Her body ached, she struggled to sleep, and her brain felt foggy. Despite not feeling depressed, her doctor prescribed an antidepressant. She even sought therapy, but it wasn’t until a decade later that she received the correct diagnosis: perimenopause.
McDonald’s experience is not uncommon. Many women going through menopause or perimenopause are prescribed antidepressants like Zoloft, Prozac, or Wellbutrin, even though these medications may not address the root cause of their symptoms. According to recent studies, more than a third of women experiencing menopause or perimenopause are prescribed these drugs, with usage doubling during these years. However, many health experts now argue that the majority of these women never needed antidepressants in the first place.
The Role of Hormone Therapy in Menopause Treatment
Perimenopause, the transitional phase leading up to menopause, is marked by fluctuating hormone levels, which can cause a range of symptoms including anxiety, fatigue, and brain fog. These symptoms are often misinterpreted as signs of depression, leading to the prescription of antidepressants instead of addressing the hormonal imbalance directly.
Hormone therapy, particularly estrogen, is considered the most effective treatment for managing menopause symptoms. Yet, medical schools have historically provided limited training on menopause, contributing to a lack of understanding among healthcare providers. This gap in education has led to delayed or incorrect diagnoses, leaving many women without proper care.
A recent push by doctors and researchers on a Food and Drug Administration (FDA) panel aimed to update warnings about topical estrogen treatments. Currently, these medications carry warnings about potential breast cancer risks and their use in preventing cardiovascular disease or dementia. However, proponents argue that these warnings are outdated and may be deterring women from seeking necessary treatment.
The Impact of Misinformation and Medical Training
The Women’s Health Initiative (WHI) study from 2002 linked hormone therapy to increased risks of breast cancer, heart attacks, and strokes. However, subsequent research has shown that these risks were primarily associated with older women starting hormone therapy after menopause. As a result, the use of hormone therapy dropped significantly over the years.
Despite this, the North American Menopause Society still recommends hormone therapy as the first-line treatment for menopause symptoms. Experts emphasize that hormone therapy should be considered early, especially for women experiencing severe symptoms such as brain fog, mood changes, and hot flashes.
Changing Perspectives on Menopause Care
As more Gen X and older millennial women enter menopause, they are advocating for better treatment options. They are no longer willing to endure the same challenges their mothers faced. Menopause has also become a significant area of focus in healthcare, with over 40% of U.S. women in some stage of menopause or perimenopause. For many, this period can last one-third of their lives, making it a critical health concern.
Experts like Dr. Heidi Flagg, an OB-GYN and menopause specialist, stress the importance of educating both clinicians and patients about the role of hormones in menopause. “We are doing women a disservice by not talking to them about a natural hormone that will improve their mood and sexual function,” she says.
What Women Can Do
Until more healthcare providers receive proper training, women must take an active role in their health. Experts recommend finding a provider who specializes in menopause or perimenopause, as certified by organizations like The Menopause Society. Early intervention is crucial, as many women begin experiencing perimenopause in their 30s.
Educating oneself about menopause and its symptoms is also essential. Pairing medication with lifestyle changes such as nutrition and exercise can help alleviate symptoms. Sharing experiences with other women and discussing concerns with healthcare providers can lead to more accurate diagnoses and effective treatment plans.
A Call for Better Healthcare Education
With the growing awareness of menopause as a significant health issue, there is a push for better education and policy changes. Three states have already passed menopause-related laws, and more are considering similar legislation. The Menopause Society has launched a $10 million training program to equip over 25,000 healthcare workers with the knowledge needed to treat menopause effectively.
For women like Leslie Ann McDonald, the journey to finding the right treatment was long and challenging. But her story highlights the importance of self-advocacy and the need for a shift in how menopause is understood and treated in the medical community.