10 Menopause Myths the Experts Can't Stand
Menopause can produce symptoms in many parts of the body, and sometimes in unexpected ways, said Rebecca Thurston, an assistant dean for women's health research and a professor of psychiatry at the University of Pittsburgh.
We asked gynecologists, endocrinologists, urologists and other experts about the biggest menopause misconceptions they had encountered. Here's what they want patients to know.
Myth 1: It's just hot flashes.
Hot flashes are a menopausal hallmark: Up to 80 percent of women have them. But numerous lesser-known symptoms are also linked to menopause, including insomnia, mood changes, brain fog, vaginal dryness, joint pain and more.
That's largely because menopause is driven by changing levels of estrogen, which affects all tissues. During perimenopause, the years leading up to one's final menstrual period, estrogen fluctuates wildly. After menopause, it settles at a low level.
Unfortunately, many people don't know the full range of symptoms this process can cause, said Dr. JoAnn Manson, an endocrinologist and professor at Harvard Medical School. That means they may not realize a symptom is menopause-related, which can mean missing out on helpful treatments.
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Durie-Salmon Stage System stages of multiple myeloma The Durie-Salmon Stage System assigns stages by looking at: level of kidney function level of blood calcium hemoglobin concentration amount of M protein in blood and urine presence of bone lesions in imaging studies Stage Criteria I • hemoglobin level > 10 g/dL • serum calcium level < 10.5 mg/dL • a normal bone structure or solitary bone plasmacytoma assessed with conventional radiography • low rate of M-component production (IgG level < 5 g/dL; IgA level < 3 g/dL • Bence Jones protein level < 4 g/24 h II Neither stage I nor stage III III One or more of the following: • hemoglobin value < 8.5 mg/dL • serum calcium level > 12.5 mg/dL • advanced lytic bone lesions assessed with conventional radiography • high M-component production rate (IgG value > 7g/dL; IgA value > 5 g/dL; Bence Jones protein > 12 g/24 h) RISS stages of multiple myeloma The RISS assigns stages by looking at: amount of albumin in blood amount of LDH in blood amount of beta-2 microglobulin in blood gene abnormalities of multiple myeloma Below we break down the RISS stages for multiple myeloma and their treatments: Stage 0 multiple myeloma Stage 0 is sometimes called smoldering multiple myeloma or asymptomatic multiple myeloma. At this stage, there are often no symptoms. Clinical criteria for Stage 0 include: blood counts, calcium levels, and kidney function are all normal no bone or organ damage no evidence of amyloid protein buildup serum monoclonal protein greater than or equal to 30 g/L, urinary monoclonal protein greater than or equal to 500 mg per 24 hours, or clonal bone marrow plasma cells 10–60% Stage 0 multiple myeloma treatment Treatment isn't typically needed at this stage. Instead, careful monitoring and regular testing are used to watch for progression. Stage 1 multiple myeloma Multiple myeloma needs to meet certain criteria. This includes: albumin levels greater or equal to 3.5 g/dL serum beta-2 microglobulin less than 3.5 mg/L cytogenetics that are not classed 'high risk' normal LDH levels You might notice symptoms such as bone pain and weakness in your arms and legs at this stage. Stage 1 multiple myeloma treatment Drug therapies are the primary treatment for multiple myeloma. These therapies aim at destroying multiple myeloma cells and include options such as: proteasome inhibitors chemotherapy steroids antibodies immunomodulatory drugs (IMiDs) b-cell maturation antigen (BCMA)-targeted therapies A treatment plan for stage 1 multiple myeloma might include one or a combination of these drug therapies. You might also have treatments such as radiation therapy or a stem cell transplant, depending on your individual treatment plan. Stage 2 multiple myeloma Stage 2 multiple myeloma needs to meet certain criteria. This includes: beta-2 microglobulin between 3.5 mg/L and 5.5 mg/L cytogenetics are either not high risk or have a risk level that is undefined it's not stage 1 or stage 3 By stage 2, symptoms might be more advanced, including loss of appetite or stomach pain. Stage 2 multiple myeloma treatment Treatment options in stage 2 are the same as the treatment options in stage 1. Drug therapies can be used alone or in combination with options such as radiation therapy or a stem cell transplant. In stage 2, higher doses or more potent drugs might be used. Stage 3 multiple myeloma Stage 3 is the most advanced stage of multiple myeloma. To be classed stage 3, multiple myeloma needs to meet these criteria: cytogenetics are considered high risk serum beta-2 microglobulin equal or greater to 5.5 mg/L high levels of LDH Stage 3 multiple myeloma treatment Treatment by stage 3 is more aggressive to slow and stop the cancer from spreading further. Additional treatments with drug therapies are typically still part of treatment plans. A stem cell transplant might also be an option. You and your team can discuss if this is an option for you. RISS stages for multiple myeloma Bottom line Multiple myeloma is a blood cancer that affects plasma cells. Doctors use certain staging systems to discuss how far multiple myeloma has spread. As multiple myeloma advances, stages increase from 1 to 3. Often, later stages require more aggressive treatment.
