It's a cold November evening, but in the Downeast town of Milbridge, a small group of women have ventured out to a menopause support group. They're here to share things they don't always feel they can elsewhere.
"It was just isolating sometimes," says Elizabeth Chamberlain. "And it's hard to talk about. How do you bring up I had the worst night sweats in my life last night? Like, nobody wants to hear about that."
At 31, Chamberlain is still two decades away from the average age for menopause. But she tells the women sitting in a circle of sofas and chairs at the nonprofit Women for Health Rural Living that she experienced menopauselike symptoms in her 20s while getting treatment for endometriosis.
"It was probably like, the hardest two years of my life. And knowing that I have to do that again is kind of a little scary," Chamberlain says.
Others in the group lament that doctors have been dismissive of their menopause symptoms.
"I can't stand it when someone says, 'You're a woman, that's why you're tired all the time.' You just want to punch them," jokes Theresa Oleksiw.
Oleksiw is 62, and says many of her symptoms have persisted for more than a decade.
"And I think if I had hormone replacement therapy, my life could have been so much better," she says.
The U.S. Food and Drug Administration recently announced that it's removing black box safety warnings from hormone replacement therapy as a treatment for menopause. The agency says tens of millions of women have been denied effective treatment for more than two decades because of flawed data behind the warning.
"That was just a very poorly executed release of the information that ended up scaring, you know, literally millions of women and at least hundreds of thousands of providers," says Dr. Kyrsten Sutton, an OB-GYN at Northern Light Mayo Hospital in Dover-Foxcroft.
The black box warnings were based on a study that found hormone replacement therapy for menopause caused an increased risk of heart attack, stroke and breast cancer. But in the years since, a growing consensus of doctors and researchers have criticized the study's findings, saying they were misinterpreted and wrongly applied to all forms of hormone therapy.
"So we all got scared of providing menopause care," says Sutton, "and basically were telling women they had to just get through it."
Sutton recently became a certified menopause practitioner to better help her patients, and she prescribes hormone replacement therapy. She says further research has found that its benefits to alleviate menopause symptoms generally outweigh the risks for women under the age of 60.
"You know, you feel like a hero because you're making them feel better," Sutton says. "And a lot of them have been like, 'Oh, I feel like I have more energy. I feel like I can focus better. I feel like I'm sleeping better. I feel like I'm more confident in my life. I'm not sweating when I'm in front of people at work.'"
Kelly Nichols, an OB-GYN at MaineHealth in Portland, also supports the removal of the safety warnings. But she cautions that hormone therapy is not a panacea.
"It's not a green light that estrogen is safe and effective for every person and for every indication," she says.
It is something to discuss with providers, Nichols says. Women don't have to suffer in silence.
Which is one of the reasons why women come to the menopause support group in Milbridge.
"I think women just want answers," says Wendy Oram-Smith. She says she's not sure what the shift in hormone replacement therapy means for her.
"So this is bringing up for me, just like a little bit more confusion," she tells the group.
Oram-Smith says she's been experiencing menopause symptoms for five years, such as brain fog and neuropathy. She says it's even stirred anxiety and depression that had been under control. Oram-Smith is also a breast cancer survivor, and says when she's asked providers about hormone replacement therapy, she hasn't gotten many answers.
"My experience has been some really good physicians just don't want to talk about it," she says.
But the women here are hopeful that's changing. Because, as group leader Nicole French says, "Menopause is having a moment."
