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If you’re a woman going through menopause you may have chosen to go online for help. If so you may be the victim of a ‘femtech’ company. Wen Shen, a menopause expert at Johns Hopkins, explains.

Shen: Basically they're there to push compounded hormone therapy that are not FDA approved. They're also there to push products, so they're marketing all these skin things and supplements and everything that are not evidence based not FDA approved. So I think this is where over medicalization happens and have they had full consultations like what are the other options.   :30

Shen says a recent series in the Lancet on menopause may exacerbate women turning online for help with menopause symptoms since it seems to discount research and offer facile solutions. She encourages women to seek help from experienced clinicians so a comprehensive approach to their health may be taken. At Johns Hopkins, I’m Elizabeth Tracey.

 Women may be experiencing overmedicalization as they transition through menopause, a recent Lancet series seems to suggest. Wen Shen, a menopause expert at Johns Hopkins, says that’s not her experience, since she sees many women who avoid physicians until symptoms drive them to seek help. Rather she identifies ‘femtech’ companies as one root of the problem. 

Shen: This is where I think the over medicalization should focus on. There are a lot of fem tech companies that are doing telemedicine, where a patient was signed up for an appointment, pay hundreds of dollars to have this consultation not paid by insurance and then they will have the hormones mailed to them. If they should have complications with the hormones then they are told to go see their OBGYN.  :28

Shen says women often struggle to find a knowledgeable clinician when it comes to helping with menopause symptoms but encourages them to keep trying rather than go online. At Johns Hopkins, I’m Elizabeth Tracey.

A recent Lancet series on menopause may result in many more women turning to the internet for help. That’s according to Wen Shen, a menopause expert at Johns Hopkins, who fears the series may have set back progress on bringing awareness to clinicians and women on how to manage symptoms.

Shen: Women who are 50,51 the average age of menopause, are gainfully employed with insurance and with disposable income and who are experiencing these horrible symptoms. If the women are not getting satisfaction from their primary care providers, who don't understand and are dismissing them, they go online. Doctor Google. There are just ridiculous number of sites that offer these women snake oil.  :31

Shen says there are at least a couple of reputable websites that offer evidence-based insights so surf with a skeptical eye while searching for a clinician with experience. At Johns Hopkins, I’m Elizabeth Tracey.

As women transition through menopause, they should be offered conservative approaches that don’t rely on medicines. That’s one interpretation of a recent Lancet series on menopause, and Wen Shen, a menopause expert at Johns Hopkins, says while such an approach offers a beginning, it is not a one size fits all solution.

Shen: There's so much evidence now that menopause, especially in menopause transition is the time of vulnerability for women for mood changes. They do mention cognitive behavioral therapy and mindfulness. Yes, those have been proven to be very effective in clinical trials, I prescribe that for my patients often. For a lot of patients they have already tried many of those options for themselves and they need more help than that.  :32

Wen encourages women to find a clinician who is knowledgeable about menopause if they continue to experience troubling symptoms. At Johns Hopkins, I’m Elizabeth Tracey.

Is menopause overmedicalized? That seems to be one conclusion of a recent series published in the Lancet on this life stage for women. Wen Shen, a menopause expert at Johns Hopkins, begs to disagree.

Shen: It's unfortunate that they came across with that impression because if anything we have been trying so hard to educate women that they don't have to put up with symptoms of menopause, they don't have to suffer. There are definitely actual benefits to being treated for menopause symptoms. We have very sound data for that and that's in this paper I'm so surprised to read where they said there is no data.  :32

Shen notes that many of the studies cited in this series were quite old and that subsequent studies have come to different conclusions. She is especially concerned that women and clinicians may be influenced to dismiss troubling menopause symptoms based on this series. At Johns Hopkins, I’m Elizabeth Tracey.

An injectable drug called omalizumab now may be used to manage severe food allergies, the FDA has decided. Robert Wood, an allergy expert at Johns Hopkins, says the drug will only work if people are taking it.

Wood: This is a therapy that will only work while you're on it. It's like our antihistamine that works while you're on it and then once you stop it it wears off, but is by no means automatically lifelong. If you want lifelong protection it's a lifelong therapy, for the family that is particularly worried about the preschool years they could use it for the preschool years and then stop it when they think their child is old enough and aware enough of their food allergy that they can practice avoidance more successfully. I actually see it rarely being used lifelong, very commonly used for these higher risk periods in people's lives.  :32

Wood says almost everyone tolerates the therapy just fine, even very young children. He’s excited to be able to offer something besides food avoidance and epinephrine in case of a reaction. At Johns Hopkins, I’m Elizabeth Tracey.