Education as the missing element in the misdiagnosis of menopause symptoms

As the CEO of a company breaking new ground in our collective understanding of hormone optimisation, I am continuously confronted with evidence of the profound impact menopause education can have on women’s health.

At Biote, we currently have approximately 6,400 US providers in our network, primarily family practitioners and OB/GYNs, and are training hundreds more each month to understand the complexity of hormones.

With only 20 per cent of OB/GYN residency programmes providing menopause training – and those mostly through elective courses – there is a huge gap in professional health education that has had a deleterious impact on women for generations.

Furthermore, this gap in medical school syllabi is mirrored in the curriculums of public elementary schools where girls learn about the onset of menstruation in health class but are not taught about the natural end of this phase.

Social media, innovative tools, and an inquiring new generation of women have brought us to a key point in time where consumer awareness and desire for knowledge has never been higher.

Unfortunately, this hasn’t been matched by strides in medical education. Providers come to us hungry for information.

What is so complicated about menopause?

What the average person knows about menopause is often limited to the knowledge that menstruation ends and hot flashes begin.

In reality, perimenopause and menopause symptoms potentially span a decade or more with unpredictable symptoms that appear, evolve, or manifest sporadically.

Over 30 symptoms are associated with menopause, but their severity and frequency varies for each individual and can be influenced by family history, lifestyle factors and concurrent conditions.

Further, the range of menopause symptoms spans women’s physical, emotional, cognitive and mental wellbeing and many overlap with signs of other conditions. For example, fatigue, anxiety, sleep and mood disturbances are all potential symptoms of menopause but are also associated with depression.

Unfortunately, it is quicker and easier for providers to treat menopause symptoms with a short-term band-aid solution.

True treatment requires providers to understand a complex topic and treat the root cause through a personalised and long-term care plan.

How we work to close the gap

Our network providers have performed over three million hormone replacement therapy pellet procedures to date, collecting data that helps inform providers since they often have not received education about menopause in medical school.

Our clinical decision support software analyses lab results, patient history, symptomology and other relevant information to guide providers as they diagnose and treat, enabling them to get the optimal personalised dosage for each individual patient. There are no easy, specific guidelines so having access to robust, real-life data is incredibly helpful.

Last year we released a retrospective study of real-world data involving 2,337 patients over nine years that found that women treated with testosterone pellet therapy had a nearly 36 per cent lower incidence of invasive breast cancer compared to expected age-adjusted rates.

A recent patient case study showed a remarkable reversal of osteoporosis in a patient after one year of pelleted testosterone therapy.

Studies have shown a correlation between low hormone levels and conditions such as heart disease and breast cancer with emerging research pointing to a link to cognitive diseases such as Alzheimer’s and dementia.

Collectively, we must put our focus on more studies, on more research, and on getting those studies to providers where they can help patients.

The provider ecosystem 

In addition to educating providers about the wide range of ways that symptoms of hormonal imbalance can present, training that addresses what patients look for in treatment, how to ask patients the right questions, and how to listen is also important.

Soft skills are crucial in fine-tuning a treatment that must be tailored to the individual to achieve optimal results.

Empathy has tremendous importance when you consider that many patients suffering from menopause symptoms have already been ignored, dismissed, or misdiagnosed – sometimes for years – before finding a provider that understands how to treat them effectively.

Because various staff members will interact with patients differently, we believe in training not just the provider but the full staff, from the front desk to mid-level clinicians.

They are the ones asking initial questions and helping patients, developing relationships and being privy to comments that patients might not feel are important or are hesitant to share with their provider. We need to get the entire healthcare ecosystem to new levels. 

The view from the tip of the iceberg

Striving for a higher level of understanding is difficult in a category where there are not yet established mainstream treatments.

However, providers who decide to invest the time and effort to learn about hormone optimisation say that it has truly altered their practice.

Treating the root cause and balancing hormones gives their patients great outcomes and long-term results, improving overall health and happiness.

Terry Weber is the CEO of the preventative healthcare company Biote.