Laughter, Learning a Good Combo at Menopause Lecture

How many Assembly sessions on serious topics start with entertainment, crazy lyrics and a singalong? Very few, but that's exactly what transpired Thursday at "Menopause: Celebration or Catastrophe."

The session started with 20 minutes of jolly good fun led by cast members from Menopause the Musical^(TM), a celebration of womanhood. Presenters then delved into a dilemma FPs face all too often in their practices: how to discuss the moving target of menopause and hormone replacement therapy with patients.

Presenters Barbara Kostick, M.D., Fremont, Calif., and Barbara Apgar, M.D., Ann Arbor, Mich., both FPs, urged physicians to stay tuned to this topic because it's a huge quality-of-life issue for many women.

A story related by Kostick brought laughter from the full house and also made her point: "A reporter asked a 104-year-old woman the best thing about being 104 and she responded, 'no peer pressure and no hot flashes.'"

Much of the presentation focused on interpreting data from the Women's Health Initiative Study, a trial that was terminated early because the health risks of continuing the study exceeded the benefits.

Every year we see changes and new recommendations that come from mining the data in the WHI study, said Kostick.

But while physicians try to base treatment decisions on evidence gleaned from studies, patients are looking in drug stores, health food stores and on the Internet for alternative (and untested) treatments such as compounded formulations, natural hormones and special diets.

When it came time for questions, one FP stepped to the mike and said, "Women come in saying, 'This is what I want.'" He admitted that it's hard for him to say no.

Apgar said it's important to be honest with patients.

"They may not appreciate it at the time, but I try to be respectful and considerate and say 'as a scientist, I just don't have the evidence to support that.'"