Hope Jensen wants to change the narrative about menopause
When Hope Jensen was studying to become a nurse practitioner, she bought textbooks on reproductive endocrinology in hopes she’d learn about women’s health in ways her coursework wasn’t providing.
This was around 2007. Five years earlier, the Women’s Health Initiative, the largest National Institutes of Health study ever focused on women’s health, shared findings that claimed that hormone replacement therapy increased a woman’s chances of developing breast cancer. The study, which has been described as faulty by some critics, resulted in many women fearing using hormone replacement therapy to manage their menopause symptoms, despite it being an effective treatment.
As Jensen read about the experiences of women during menopause and understood the scarcity of options to improve those experiences, she had one thought — she didn’t want this to happen to her.
She’s now working every day to ensure other women in their midlives don’t feel the same way. Jensen is a family nurse practitioner specializing in menopause care. She is a certified menopause practitioner through the Menopause Society and operates With Hope Direct Primary Care.
“I absolutely do not want women to think ‘Oh my god, this is awful,’ when they hear the word menopause,” Jensen said. “It can also be a really empowering time of your life where you can start to say, ‘I’m going to do some things for my health that are going to benefit me in the long run.’ Symptoms can be really bothersome and uncomfortable, and know that there’s treatment there. But also think of it as a time where you’re going to take charge of your health.”
Fearless sat down with Jensen to talk about her care model, how caring for menopause has evolved and four ways she believes women can change the narrative around this midlife transition.
Jensen advised that her general advice is not a substitute for a specific medical care plan. She recommends you consult your health care provider to find treatment options that work for you and your medical history.
1. Establish good provider-patient relationships
Around the same time Jensen was beginning her nurse practitioner practice, she also noticed an alarming trend across health care.
“There wasn’t a lot of pressure to see a certain number of patients. As the years went by, that just slowly started to change. There was more pressure to see more patients in less amount of time,” she said.
Jensen saw patients becoming frustrated with how little time they had to discuss their issues with their providers. Providers weren’t able to dig deep into causes and missed opportunities to try different solutions.
Jensen decided to approach this issue differently by opening a clinic that used the direct primary health care model. This model uses a membership-based service, which is a monthly fee that covers all of the care they receive from Jensen. She’s able to take on a smaller patient load that gets direct access to her.
“I can give them much more personalized care. They get more access and longer visits. It’s really bringing the service back into health care,” Jensen said.
Since this model of service isn’t used widely in Iowa, Jensen encouraged patients to search for a primary care provider that takes their needs seriously.
“Finding a primary care provider has become incredibly difficult all over the state. Patients want to be listened to when they feel like something’s not quite right,” Jensen said.
2. Don’t miss your yearly check-up with your doctor
“Probably 15 years ago is when we started changing the guidelines for pap smears and saying you don’t need to come in for a pap smear every year. As soon as women heard, ‘Oh I don’t need to come in every year for my pap smear?’ they said “OK, then I’m not coming in.’ And it was really bad because these are the years we really need women to start coming in regularly,” Jensen said.
Jensen said that when many women in their 30s, 40s and 50s are juggling career and family obligations, they start to put their own health on the back burner. That means key health indicators, like weight and different blood tests, aren’t being measured.
It leaves women and their providers with an incomplete understanding of how their health changes as they age. But those regular checkups provide opportunities to build a relationship with your provider and learn more about yourself.
“It’s important to advocate. Ask questions about your health. Know where your numbers are. Ask for copies of your lab work. Ask what they mean so you know what’s happening with your body,” Jensen said.
3. Understand your health history and risk factors
Those yearly checkups and having a good grasp on your medical history may also help your health care provider find the most effective ways to manage your menopause symptoms.
Jensen explained that prevention of the conditions that often occur around the same time as menopause should begin early.
“I want to increase awareness about knowing your medical history. Know what your risk factors are for certain diseases. Know what your cholesterol numbers are. Know what your blood pressure is. All of that is really important because when women are in their menopause transition is when we start to see risk for diabetes, heart disease and increasing risk for stroke,” Jensen said. “What we do now when you’re in your late 30s, 40s and 50s really relates how healthy you’re going to be in your 50s, 60s and 70s.”
Jensen also recommends patients ask their mothers about their experience with menopause.
“If you have access to your mom, ask her what her menopause experience was like, because that is very predictive of what your menopause experience will be like,” Jensen said.
4. Know you don’t have to just “suck it up” and deal with your menopause symptoms
Menopause happens when a woman’s hormones begin to decrease, typically from ages 45-55. The most common symptoms of menopause are irregular menstrual bleeding, abnormalities in body temperature and genitourinary symptoms.
The symptoms are uncomfortable for most women. Jensen wants them to know that they don’t have to accept symptomsas they are.
“Women are finally realizing that they do not have to suffer in silence with these symptoms,” Jensen said.
Jensen explained that patients have the option of both hormonal and nonhormonal treatments to manage their symptoms. Hormonal treatments include estrogen and progesterone therapy, which are now considered less risky than they were when the Women’s Health Initiative was released. Non-hormonal treatments could include antidepressant medications or behavioral therapy to help with mood changes and brain fog.
Patients should consult with their medical provider to see what treatments would work best for them. There are still risks with hormonal treatments, and your medical history plays a big part in what your doctor will recommend.
But the most important thing, according to Jensen, is that you talk to someone about your symptoms.
“At my time of entry into practice, there was this thought that there wasn’t much to do for [menopause], and you just need to suck it up and suffer,” Jensen said. “Opening up the conversation is what needs to happen. More and more practitioners are learning about menopause. I’m really positive that we’re going to have more access to practitioners talking about women in their midlife transition.”
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