DALLAS (AP) -- Women suffering through the hot flashes, night sweats, mood changes and sleep problems that can come with menopause -- all while looking in the mirror and noticing signs of aging -- are being bombarded with products.
More open conversations about menopause and the period leading up to it -- called perimenopause -- are happening at the same time that marketing has been supercharged by social media. Women are being confronted by lotions and serums and light masks that promise to rejuvenate their faces and necks, dietary supplements claiming to do everything from boost moods to ease hot flashes and gadgets promising to help with symptoms.
"The marketing has gotten very, very aggressive. It's pervasive," said Dr. Nanette Santoro, an OB-GYN professor at the University of Colorado Anschutz.
Santoro and other physicians say that before spending lots of money on products that make big promises, it's important for women to talk to their doctors about what has actually been proven to help -- and what could be harmful.
"It really pays to be very, very, very skeptical," Santoro said.
A flood of marketing
As menstruation winds down, women's levels of estrogen and progesterone drop. In some women, the symptoms can include hot flashes, night sweats, mood changes, vaginal dryness and sleep problems.
Dr. Angela Angel, an OB-GYN with Texas Health Presbyterian Hospital Dallas, said that in the past, doctors would ask women around the age of 50 during their yearly exam if they were noticing any symptoms. But now, she said, patients are making separate appointments and initiating the conversations.
And at those appointments, she said, many patients tell her they've already tried something. "They're coming to see me because it's not effective or because it's caused some other side effect," Angel said.
Her hospital has recently started a menopause support group led by doctors and, at the request of participants, an upcoming session will focus on helping women navigate through the marketing onslaught.
Products aimed at women in that stage of life include everything from bracelets and rings claiming to help ease hot flashes to cooling blankets and bedding.
Santoro said her advice to patients is to "balance what you're going to spend over whether this might help you."
"If it's a bracelet that's going to cost you $20, it's not a big expenditure. It might provide some improvement," Santoro said. "Things that are not well tested might still work but if you want something that works -- come back, I'm not going anywhere and I'll give you evidence based treatment."
Santoro said dietary supplements have not been proven in multiple, well-done studies to alleviate hot flashes, but many are low cost with a low potential for harm. She said if a patient wants to try something they see online, it’s important to at least tell their doctor so they can be monitored while taking it -- or warned off.
Doctors note that most of the time over-the-counter products like dietary supplements, shampoos or skin care that are advertised for menopausal women aren't different from regular products for that purpose ingredient-wise.
And some products could have side effects.
Advice from doctors
Dr. Monica Christmas, director of the menopause program at the University of Chicago Medicine, said there's not one symptom everyone gets. Some women get few or none, she said, while others are extremely impacted by a variety of symptoms. What's most important, she said, is seeking medical help.
Doctors say that hormone therapy prescribed by a doctor can help with symptoms, as can prescriptions for nonhormonal medication. Some women are advised to avoid hormone therapy because they have had certain medical issues.
"Not everybody needs hormone therapy, not everyone is a candidate for hormone therapy, not everybody should be on hormone therapy," Angel said.
Regular exercise and a healthy diet can help a lot, doctors say. That can help with weight loss, which is associated with reducing hot flashes and night sweats.
And Santoro notes that avoiding alcohol is a good step for someone with hot flashes since it can make them worse.
"Many of the symptoms actually get better over time, so sometimes it really is just a matter of lifestyle modifications and self-care and getting through this most tumultuous time frame," Christmas said.
For Brandi McGruder, a 49-year-old school librarian from Dallas, it clicked that she was in perimenopause last year when she went out to dinner for her birthday. When she and her friends entered the steakhouse, she was freezing cold. About 20 minutes later, she was burning up.
She said she made an appointment with her doctor, who prescribed an estrogen patch, which helped. McGruder said she’s seen the advertisements for products aimed at women her age, but her first stop was her doctor.
McGruder said that while she doesn’t like the way the symptoms have driven home that she’s getting older, she’s also embracing this time in her life. Her advice: “Laugh. It’s OK. Reach out to others experiencing what you are going through; don’t take it so serious.”
Concerns about skin
There are changes with skin that come both with time as one ages, and during menopause as skin gets less thick because of a loss of collagen and some of the hyaluronic acid that supports skin, said Dr. Melissa Mauskar, a dermatologist and associate professor at UT Southwestern Medical Center in Dallas.
Mauskar said using a prescribed retinoid or an over-the-counter retinol can help. Both assist with the production of collagen and reduce the appearance of wrinkles.
She said good over-the-counter moisturizers can be found at drugstores. Her advice is to look for ones with ceramides, which help keep skin hydrated.
"But you don’t want to have anything that has too many additive ingredients -- just because it’s natural and a botanical does not mean it’s better," Mauskar said. "A lot of those actually are contact allergens that can make people more sensitive."
Ingestible collagen is among the products being marketed to women, but she warns that studies are mixed and ingesting it "doesn't mean that it's going to make its way to your skin and plump up your face" -- even though products claim it will. Light masks, she said, won’t hurt and some studies show they could help, but they won’t make a difference overnight. She said seeing any improvements from them would likely take daily use for many years.
She said sun damage is one of the biggest reasons patients have more wrinkles, so consistent use of sunscreen is a must for all ages.
"I think there's a lot of new fancy things coming out and targeted to perimenopause, menopause patients," Mauskar said,"but sometimes the tried and true things that we at least have the science for I think still are my kind of gold standard for my patients."