Navigating Menopause: Insights from Dr. Miles E. Mahan, MD, FACOG

By RONALD MOONEYAugust 23, 2023

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Menopause marks a transformative phase in a woman's life, encompassing a range of physical and emotional changes. To shed light on this significant transition, we engaged in a thought-provoking discussion with Dr. Miles E. Mahan, MD, FACOG, a distinguished expert in women's health. Dr. Mahan provides valuable insights into the timing of menopause, prevalent symptoms, treatment options, associated risks, alternative therapies, post-menopausal screenings, and promising breakthroughs on the horizon.

"When it comes to menopause, the age of onset can vary significantly among women," states Dr. Mahan. "While some experience menopause as early as 45, others may not reach this stage until around 53. The average age for menopause is 51."

Hot flashes, a common symptom associated with menopause, affect approximately 40% of women during the perimenopausal and menopausal period. However, Dr. Mahan emphasizes that contrary to popular belief, hot flashes may persist beyond a few years. "Hot flashes can occur for longer periods of time, causing significant discomfort," he says. "In addition, women may also experience difficulty sleeping, mood changes, and vaginal dryness during menopause."

With regards to treatment, Dr. Mahan underscores the importance of personalized approaches. "Gone are the days of a one-size-fits-all approach to menopause treatment," he says. "We now understand the need to tailor treatment options to each individual. While hormone replacement therapy (HRT) was once widely recommended, we now consider various factors to determine the best course of action."

Dr. Mahan further explains, "Not all women require hormones for menopause management. It is crucial to engage in a thorough discussion with your healthcare provider to identify the most suitable treatment for your specific needs. This can range from hormone replacement therapy with estrogen or progesterone, with several options available, to non-hormonal treatments targeting specific symptoms."

Concerns about risks associated with hormonal therapy are often raised, but Dr. Mahan seeks to allay fears by emphasizing the importance of individual risk assessments. "It's essential to evaluate each patient's unique risk factors, such as family history and medical conditions," he states. "While studies have suggested a potential increased risk of breast cancer or stroke, these risks have been overblown. The majority of women can safely and effectively utilize hormone therapy to improve their quality of life."

Determining the appropriate duration of hormone therapy is a common question among women. Dr. Mahan affirms that there is no universal answer. "Decisions about the duration of hormone therapy should be based on individual symptoms and their impact on quality of life," he explains. "Open and ongoing conversations with your physician are essential in determining the best approach for your specific needs. Sometimes, treatment plans may be adjusted to focus on the most problematic symptoms."

For those who cannot or choose not to pursue hormone therapy, alternative treatments are available. Dr. Mahan reveals, "Excitingly, there are new drugs currently being approved or developed for non-hormonal menopause management. Consulting with a physician can help explore these alternatives and determine if they are suitable options for individual patients."

Highlighting the benefits of hormone therapy compared to alternative treatments, Dr. Mahan points to the evidence from studies. "Hormonal therapy has proven to be more beneficial than alternative medicine therapies," he asserts. "Head-to-head comparisons consistently demonstrate the superior efficacy of hormonal therapy in alleviating menopausal symptoms and enhancing quality of life."

Regarding post-menopausal screenings, Dr. Mahan stresses the importance of ongoing healthcare. "Annual exams and mammograms are still necessary for most women, although the frequency of pap smears has changed," he clarifies. "Based on the guidelines from the American Society of Cytopathology (ASCP), the frequency of pap smears may vary depending on an individual's history."

Looking ahead, Dr. Mahan shares promising developments on the horizon. "New non-hormonal treatments are currently being developed, such as the newly approved medication line called Neurokinin 3 (NK3)," he reveals. "One specific drug, Veozah, is set to enter the market and shows great potential in addressing hot flashes. These advancements offer hope and expanded options for women experiencing menopausal symptoms."

Dr. Mahan, provides invaluable insights for women approaching their fifties and experiencing the complex journey of menopause. By understanding the diverse timing, symptoms, treatment options, risks, alternative therapies, and post-menopausal screenings, women can confidently navigate this transformative phase with improved quality of life. Engaging in open conversations with healthcare providers remains crucial in determining the most suitable approach for individual needs, while exciting developments in non-hormonal treatments bring renewed hope for effective menopause management.