‘It’s the wild, wild West’: Philadelphia menopause care providers see fallout from quick online hormone prescriptions

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If you’re a woman over 40, chances are, you’re getting bombarded online with ads for a wide variety of hormone products, available after a quick online check-in with a health care provider. The promise is fast relief for lots of symptoms related to menopause or perimenopause, everything from weight gain and brain fog to insomnia and hot flashes.

While perhaps a welcome new trend for women dealing with a barrage of disruptive symptoms, local menopause experts are raising the alarm bells, saying that these treatments are not always indicated or even safe.

“It’s the wild, wild West,” said Dr. Robyn Faye, an OB-GYN and certified menopause practitioner with Jefferson Health in Philadelphia.

“Women are going online because they’re so desperate for information,” she said. “‘I don’t feel like myself, my family hates me, I hate myself and fix me.’”

But during quick online appointments, Faye worries patients are getting prescriptions, but not always sound or correct advice.

Faye recently saw a patient who had tried to get immediate answers for her menopause-related symptoms while waiting for her appointment.

“She went online, she wasn’t asked the proper questions, and she had medical history, family history that would have precluded from taking estrogen and progesterone, she was given it, and she really should not have been on it,” Faye said. She explained that the patient has a high risk for cardiovascular disease and taking hormones could increase that risk further.

Hormones help many patients feel and function better

Generally, hormone therapy is considered safe and effective for many women going through perimenopause or menopause.

“We love it,” Faye said, “but you have to be the right patient to take it.”

People with an elevated risk of breast cancer, heart disease, a history of blood clots or stroke should not take hormones. Hormones are also not advised for women over the age of 60, or who are more than 10 years past their last menstrual period.

For patients who are cleared for using hormones, the relief and benefit is often great. Estrogen can help prevent osteoporosis, and hormone therapy is highly effective in managing hot flashes, night sweats and sleep disruptions.

“Once terrible hot flashes and night sweats are managed, people usually sleep better,” said Dr. Arina Chesnokova, an OB-GYN at Penn Medicine who’s also a certified menopause practitioner. “As a result of that their cognition gets better, as a result of that their mood gets better, they’re more interested in their partners potentially, so their sex lives get better.”

Chesnokova added that sleep improvements can also lead to better cognition and focus.

Not a miracle drug or anti-aging potion

Many women report a general improvement in well-being with hormone therapy.

However, Faye and Chesnokova emphasized that hormones are not a cure-all or a miracle drug.

“You might go back to the gym because you’re finally feeling better, but they’re not going to make you lose weight,” Faye said. “It’s not going to make your face all of a sudden that of a 20-year-old. It’s not going to make your body that of a 20-year-old.”

There can also be uncertainty around the quality of the prescription products.

“For now, the advice is to stay away from the barrage of advertising that’s online because you just don’t know what you’re getting,” Chesnokova said.

General wisdom for women in menopause

While acknowledging the difficulty in securing appointments with menopause-educated providers, both physicians recommend finding health care professionals who can thoroughly weigh the pros and cons of hormone therapy with their patients. Strategies like healthy nutrition and exercise can also alleviate symptoms.

Join Maiken Scott at a free event, Reimagining Menopause, for a candid conversation with Dr. Faye and Dr. Chesnokova on Oct. 21 at WHYY, 150 N. Sixth Street, Philadelphia, PA 19106. Mix and mingle at 5 p.m. Panel discussion begins at 6 p.m.