Why We Need to Rethink Menopause Care, with Natasha Bhuyan, M.D.

Natasha Bhuyan, M.D.

Credit: One Medical

Menopause is often reduced to hot flashes and night sweats, but according to Natasha Bhuyan, M.D., vice president at One Medical and a family physician specializing in reproductive health, this life stage is much more complex and deeply misunderstood.

In a conversation centered on menopause care, Bhuyan sheds light on the historical neglect of menopause in medical research and training, the wide-ranging symptoms that patients experience and the need for personalized, holistic treatment. She emphasizes that open communication, both in the exam room and at home, is essential — and that women deserve to feel heard, supported and empowered to seek the care that works best for them.

Why do you think menopause has been such a neglected topic in both mainstream medicine and our broader culture?

Natasha Bhuyan, M.D.: Overall, medical research on topics that impacted women was lacking until only a few decades ago. In fact, women were often excluded from many medical studies for years. As a result, we have limited data about topics like menopause. This is not taught widely in medical education. As a result, many physicians who are menopause experts actually sought out education on their own or through specialty training. However, that trend is changing. More and more primary care physicians are well-versed in menopause care. Rather than referring out to a specialist, patients are able to get care from their own primary care physician while also addressing their other holistic health concerns.

Many people think of menopause as just hot flashes and night sweats — but what are some of the lesser-known symptoms or impacts?

NB: Menopause can impact our entire health and so many different systems. Symptoms have a wide range that people don’t even realize, including headaches, joint pain, fatigue, mental health, changes in sleep quality and more. I also see perimenopause as an area that is often overlooked. People might still have periods, but they are dealing with symptoms that are similar to menopause. They also deserve treatment and support.

Can you talk about how menopause may affect relationships and intimacy — and how women and their partners can navigate these changes together?

NB: From a physical perspective, menopause can impact vaginal tissue, sometimes causing dryness, as well as reduced libido. However, the changes are much deeper than physical. Partners may not understand what women are going through. Often, with these changes, we see a lack of communication when really, partners should be leaning in more to learn and support through these changes.

What are the biggest gaps you see in medical education or care when it comes to menopause?

NB: Many of the risks regarding hormones were overstated or not correctly interpreted. As a result, many providers are reluctant to prescribe hormones, even though they might be the right treatment option. I also think that menopause requires a thoughtful and tailored personalized approach to care.… This is not a condition where you can standardize the treatment regimen for everyone. It takes time for physicians to understand the individual person, and the right treatment path for them.

Are there specific questions women should ask their doctors if they suspect they’re in perimenopause or menopause?

NB: The most important thing is that people are comfortable bringing up their concerns with their doctor. And if they feel dismissed, they should not hesitate to seek another physician. They should ask their doctor what their philosophy and approach is to menopause care.

What gives you hope when it comes to the future of menopause care and support?

NB: It’s really inspiring to see patients themselves speaking out and asking of better from the medical community. It’s also very helpful that people are openly sharing their stories to normalize the experience.