How Primary Providers Can Prevent the Broader Health Impacts of VMS
Panelists discuss how emerging therapies demonstrate promising efficacy data while highlighting the adverse metabolic and cardiovascular consequences associated with untreated vasomotor symptoms (VMS).
Episode 4
The following transcript has been edited for clarity, style, and length.
Tara K. Iyer, MD: I think a key question here is, “who's hearing about vasomotor symptoms (VMS) symptoms first?”. It may be gynecology, but it may also very often be primary care. It's essential for primary care physicians to ask the right questions. It's not just the patients with severe hot flashes and night sweats who need help—every woman going through this transition should be asked about symptoms, educated on potential adverse effects, and informed about available treatment options.
Alexa Fiffick, DO, MBS, MSCP: That's a great point. As family physicians, we often see patients presenting with climbing lipid levels, increasing blood pressure, and early signs of insulin resistance. It’s easy to look at these issues in isolation, but they’re often interconnected with symptoms like fatigue, poor sleep, mood disturbances, and irregular or absent periods.
As the first point of contact for many patients, primary care providers must recognize these patterns and initiate discussions about perimenopause and menopause. With new medications emerging that have fewer severe side effects, it’s crucial to consider how treating these symptoms can positively impact a patient's overall health. One significant area of concern is the obesity epidemic—Dr. Iyer, what are your thoughts on this?
Iyer: Absolutely. As you know, I'm board-certified in obesity medicine and work as an attending physician at the Center for Weight Management and Wellness. I frequently discuss the link between menopause and weight gain with my patients. Nearly every woman in my menopause and midlife clinic lists weight changes as a top concern. They often say, "I haven’t changed my eating or exercise habits, but I’m gaining weight—especially around my midsection."
There are multiple factors at play: aging, hormonal transitions, and the loss of estrogen, which impacts body composition. These changes can also trigger vasomotor symptoms like hot flashes and night sweats, particularly those that disrupt sleep. Sleep is vital—without it, mood worsens, energy levels drop, and making sustainable lifestyle changes becomes much harder.
Addressing menopausal symptoms isn't just about alleviating discomfort—it’s about setting patients up for long-term success. Treating symptoms early can help women maintain healthier lifestyles, improving overall well-being and reducing the risk of long-term adverse health outcomes. That’s why this is such an essential conversation to have with every patient.
