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Did you know that if you’re a middle-aged woman, you have only a small window of opportunity between the beginning of perimenopause and the start of menopause to start estrogen replacement therapy to protect not only your brain but also your bones and cardiovascular system? I did not, until I dug into the science, because as a woman who was diagnosed with a stage 0 breast lump, I was scared off like so many of us from the results of the Women’s Health Initiative, which got blasted out all over the news and initially showed a link between estrogen replacement therapy and breast cancer, but guess what? That study had so many flaws, its findings are little more than useless and possibly harmful. Worse, women like me without uteri show a decrease in breast cancer with estrogen replacement therapy. But this information never made it either into the headlines or into our gynecologists’ offices. I had to find it in scientific publications such as The Lancet online. In fact, get this: Our medical system barely trains gynecologists in menopausal medicine. A recent study found that only 20 percent of ob-gyn residency programs in the U.S. provide any menopause training. Yes, any. Which means that 80 percent of all gynecological residents in school today are getting no training whatsoever in post-reproductive women’s health. These are people whose job it is to know everything going on in our ladyparts, but they have not been taught the basic tenets of how to care for either us or our plumbing after we stop menstruating. And by “us” I mean 30 percent of all women alive on earth at any given moment. Half of my middle-aged female friends deal with chronic urinary tract infections. Oh, well, we think, throwing up our hands in defeat and consuming far too many antibiotics than are rational or safe or even good for the future safety of humanity. It took Dr. Rachel Rubin, a urologist in Washington, D.C., reaching out to me over Twitter to explain that UTIs in menopausal women do not have to be recurrent. They can be mitigated with, yes, vaginal estrogen. Not once was I ever
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