Oregon Evidence-Based Practice Center Researchers Help Reshape National Debate On Menopause

03/24/05    Portland, Ore.

Research presented at a National Institutes of Health conference


How menopause is recognized and treated in the United States and around the world may have taken a dramatic turn following the release of findings of a state-of-the-science conference held this week. Heidi D. Nelson, M.D., M.P.H., researcher at the Oregon Evidence-based Practice Center based at Oregon Health & Science University, led the research that contributed to those findings.

Last year Nelson was named principal investigator of a project to review and analyze existing evidence about menopause-related symptoms and the risks and benefits of treatments for those symptoms. This project was sponsored by the U.S. Agency for Healthcare Research and Quality and was commissioned by a National Institutes of Health Consensus Development Conference.

Nelson believes one of the most profound findings from the research involves mood and depression, which are routinely linked to menopause. Her analysis found that of the 14 studies on this specific issue, only two associated mood and depression with menopause; the other dozen studies did not find an association.

 "If a physician understands that menopause and depression don't go hand in hand, then the physician will appropriately treat that woman for depression, and not assume that hormonal therapy will solve the problem," said Nelson, associate professor of medicine (medical informatics and clinical epidemiology, and general internal medicine and geriatrics) OHSU School of Medicine; and medical director of Providence Women's Health.

Nelson worked with six co-investigators at the Oregon Evidence-based Practice Center at OHSU. They rigorously examined more than 10,000 abstracts of studies about symptoms attributed to menopause - from hot flashes to depression - and their treatments - including hormonal, non-hormonal and alternative medicine therapies. The researchers found that many studies and papers offered inadequate evidence for their findings, and yet those findings are commonly accepted, such as the association between depression and menopause.

Nelson presented the findings of the evidence review at the National Institutes of Health State-of-the-Science Conference on Management of Menopause-Related Symptoms held in Maryland on March 21 to 23. Nelson said the three-day consensus development conference helped establish what the medical and scientific community knows and does not know about menopausal symptoms and treatments, which will shape the future research agenda for menopause and will contribute to the better health of women as they age.

Nelson's co-investigators at the Oregon Evidence-based Practice Center were Elizabeth Haney, M.D., Jill Miller, M.D., Anne Nedrow, M.D., and Christina Nicolaidis, M.D., of OHSU; and Linda L. Humphrey, M.D., and Kim Vesco, M.D., of the Portland VA Medical Center.