Dr. Phillip Sarrel explains why only a select few are trained in menopausal healthcare.
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The question of the training that physicians receive in today’s society is a very difficult question. The time involved in training a specialist, remember that in menopause healthcare you would have the gynecologist as one of the people in society who should be able to provide menopause healthcare, but you also have the family practitioner, you have the nurse practitioner, you certainly have the physician's associate, you have an array of healthcare providers. There was a time in the 90s when everybody in all of those fields I just mentioned, including family practice and the general practitioner, were offered and attending continuing education courses to learn about menopause, listening to the woman, evaluating the woman, trying to make a decision about giving hormones or not, and how to monitor her response. But then, along came the Women’s Health Initiative study, which had a very detrimental effect. Everything stopped. That study seemed to indicate no one should be given anything. I have heard some esteemed colleagues say, “Any doctor who would give a woman hormone therapy after menopause is out of their mind,” when in fact, that’s not what the study showed. The study showed very clearly there’s a specific prescription that’s a problem, and studies with others, and especially of estrogen alone, show just the opposite. But the impact on medical education has been profound. So whereas it used to be a regular thing to be teaching physicians about the menopause, since the Women’s Health Initiative the topic hardly gets into the curriculum.
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