It is the mission of the Maine Center for Resilience and Survivability (MCRS) to improve the health and wellbeing of law enforcement officers in Maine. To fulfill that mission we are embarking on a somewhat epic journey to help shine a light on a significant segment of suffering known only to female police officers – perimenopause and menopause.
According to some researchers, menopause affects 51% of the population directly yet only a small minority of these women receive evidence-based treatment, and most healthcare professionals receive little or no specific training about menopause. There is an old saying that if men had ovaries and all the associated symptoms, there would be cures for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).
It is our goal to go CODE 3 towards a new enlightenment of this pernicious problem and help women in uniform strengthen their resilience!
The problem we want to address is the need for an accurate diagnosis and appropriate treatment by a competent physician who is knowledgeable of the most recent research on hormone replacement therapy (HRT).
SEEKING HELP AND THE STIGMA OF APPEARING LESS THAN BULLETPROOF
A first problem to overcome is the cultural stigma that begins with “Cops solve problems they don’t have problems”. Female police officers can feel a need to appear stronger, more resilient or equally as indestructible as their male counterparts. Ig a woman goes to a physician with complaints of depressed moods, mood instability, a lack of motivation or little interest in life she will likely be offered a prescription for antidepressants and “taking meds” for some law enforcement officers, can make them feel “less than”.
DIAGNOSTIC COMPLEXITIES
Unfortunately, there can be significant symptom overlaps between one diagnosis and another and there can be a number of physiological problems producing similar or even identical symptoms. These factors make finding the exact cause for the symptoms presented by the patient, that is, an accurate diagnosis, quite difficult. If the diagnosis is depression, then you can bet a box of donuts there will be a prescription offered for a serotonin specific reuptake inhibitor (SSRI) antidepressant. But what if the SSRI trial doesn’t help? Increase the dosage, add another medication, or try a different antidepressant? When does the physician say it’s time to look at hormone levels? For too many women the answer is NEVER. There is no argument here, it’s a complex challenge to come up with the right treatment but it’s too important not too.
MEDICAL MISGIVINGS ABOUT HRT
Unfortunately, there are some healthcare professionals who are not current on the HRT literature, and they are still informed by outdated data. Some Docs hold onto the idea that the risks associated with HRT outweigh any benefits despite the data showing exactly the opposite conclusions. Let’s try to sort out the facts.
HOW DID WE GET HERE?
The history of hormone replacement therapy (HRT) started in the 1960s, with an increase in popularity in the 1990s. Then came the first clinical trials of HRT and chronic postmenopausal conditions. That was followed by the announcement of the first results of the Women’s Health Initiative (WHI) in 2002, which was interpreted as HRT had more detrimental than beneficial effects, and the use of HRT use dropped. HRT was essentially shelved at that point, but that unfortunate decision was based almost entirely on one clinical trial that was poorly evaluated.
To summarize one article on the history of HRT from 2019: The negative results of the study received wide publicity, creating distress among some users and new guidance for doctors on prescribing HRT. The media ran with the message that HRT had more risks than benefits for all women. Fortunately, a reanalysis of the WHI trial was performed, and new studies showed that the use of HRT in younger women or in early postmenopausal women had a beneficial effect on the cardiovascular system, reducing coronary disease and all-cause mortality. Unfortunately, the public opinion and that of too many healthcare providers on HRT has not evolved, leading to important negative consequences for women’s health and quality of life.
In the next segment on this topic, we will probe deeper into the details and offer some support and encouragement to our women in blue!
PLEASE NOTE: Nothing on this site is meant as medical advice only information to help you seek more information from your trusted healthcare professional.