Nonhormonal Strategies for Treating Menopausal Symptoms at the 27th Annual Fall Scientific Meeting
On Thursday, October 8, at the 27th Annual SMSNA Fall Scientific Meeting, Aleece Fosnight, MSPAS, PA-C, CSE, MSCP, IF, HAES, explained the evidence supporting interventions that can be individualized for each menopausal person. Fosnight invited attendees to consider menopausal sexual function differently. All systems interact to create sexual function, and nonhormonal strategies can help target the "bottleneck" that may be preventing satisfying sex. She emphasized that menopause care is outcome-specific and that not every nonhormonal treatment will be beneficial for everyone.
Fosnight encouraged providers to ask better questions when taking a patient's history. Was there a medication change? Are there new or existing symptoms? What kind of distress may be causing problems, and which symptoms do not need to be addressed immediately? She explained that if an intervention is beneficial to the patient, it should be considered in treatment recommendations. For example, sleep is important for everyone, but weight gain is not a concern for every woman. Fosnight also reminded attendees that nonhormonal pharmacological treatments should be prescribed for specific conditions, such as hypoactive sexual desire disorder and genitourinary syndrome of menopause.
Fosnight encouraged providers to let what is truly bothering their patients guide treatment decisions. Pelvic floor therapy may work for one woman, but not for everyone. Improving sleep may also benefit some women without making a noticeable difference for others. Her final recommendation for providers was to ask what changed, find the bottleneck, match the intervention, and measure what matters. Outcomes should reflect the patient's specific goals.
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