Featured Post from ChristianaCare

New Trends and Treatments in Menopause Care

Hormone therapy, complementary therapy and lifestyle options to consider

Oct 18, 2024

4 min

Janice Tildon-Burton, M.D.


CaptionResizeWrap TextRemove

If you’re in your 40s and you menstruate, you may already be experiencing the effects of menopause: the point in life when your menstrual cycle stops permanently, which arrives for most people around the age of 50. This hormonal shift comes with numerous symptoms, some of which are manageable with at-home care and others—like intense mood swings, hot flashes or trouble sleeping—may need medical attention.


Menopause has officially happened when a year has passed since your last period. The roughly two to eight years before that, when periods become irregular and fertility decreases, is known as perimenopause. Some people experience perimenopause in their 30s and some as late as their early 50s, but most reach perimenopause in their late 40s.


Menopause is a naturally occurring life change, not a disease, and not everyone requires treatment for it. Many people seek medical help to deal with their symptoms. There are many new trends in menopause care, from hormones to drugs to supplements and beyond, and navigating them may feel overwhelming.


What’s safest for managing side effects? Should I buy over-the-counter treatments or seek more involved care from a health care provider—or both?


Read on for answers to these and other important questions on how best to treat menopause symptoms.


Is hormone therapy right for me?


Menopause happens to everyone who menstruates, and it’s important to bring up any symptoms of menopause as they occur at your annual primary care checkup. A gynecologist with special training or interest in the transition from ages 40 to 55 is an ideal specialist to seek additional care and treatment from, especially if you’d like to explore medical treatments like hormone therapy.


Hormone therapy in the form of prescribed estrogen and progestin (both reproductive hormones that exist in the body naturally) has been used since the 1980s to treat the symptoms of menopause. A decline in estrogen is the culprit for many menopause symptoms, so adding estrogen back into the body through hormone therapy helps to diminish symptoms.


Not all people who go through menopause need hormone therapy, but it has numerous positive side effects, including the lessening of some symptoms and lowering the risk of osteoporosis, a loss of bone density that can be exacerbated by natural estrogen decreasing over time as we age. These therapies can be administered in a cream, a patch, or even through low-dose birth control pills. However, hormone therapies can carry an increased risk of some cancers, including breast cancer.


Non-hormonal, complementary medicine and lifestyle options


Non-hormonal options to treat menopause symptoms are growing in popularity and represent an alternative to hormone therapies. Some of these include:


  • Be sure to consult your provider before adding any new drugs or supplements to your daily routine.
  • There are also many popular and effective options for treating menopause symptoms that come from Eastern and herbal medicine traditions. These include acupuncture, which has been shown to help with hot flashes and night sweats, as well as herbal supplements that often accompany treatment from a trained acupuncturist. A main downside to acupuncture can be cost, as the treatment is rarely covered by insurance.
  • Eating mindfully and exercising regularly both also have proven benefits to treat menopause symptoms and to keep our bodies healthy more broadly as we age. This includes getting enough vitamin D and calcium through diet in order to keep bones strong as hormone levels change and to limit caffeine and alcohol consumption.


Challenges in menopause care


Despite the progress made in menopause treatment over the past years, there are still a few main challenges that you may face in menopause care. These include:


Stigmas surrounding speaking openly about symptoms, especially sexual side effects like vaginal dryness and changes in libido that can affect intimacy. It’s important for you to feel empowered to discuss all symptoms with your provider.


The increased availability of at-home tests, purchased online, for menopause and perimenopause. While these tests may be helpful in showing a snapshot of your hormone levels on a given day, more information is needed to diagnose menopause and perimenopause correctly, and at-home results can often be misinterpreted. It’s best to conduct these sorts of tests under the care of your provider, who can place them in the appropriate context.


It can be hard to find the time needed to diagnose and treat menopause symptoms in a clinical setting, especially because it often takes time and communication outside of an office setting to ensure diagnosis and treat symptoms properly. Seeking out a provider who specializes in menopause care helps a great deal to expedite this process and get you the care you need.


Not everyone experiences menopause the same way: for some people, symptoms are mild enough that at-home remedies will meet their needs.


But for those with more intense symptoms—or anyone hoping for clinical support during this challenging time—working closely with a gynecologist will bring you relief and greater insight.

Connect with:
Janice Tildon-Burton, M.D.

Janice Tildon-Burton, M.D.

OB/GYN

Dr. Janice Tildon-Burton is an OB/GYN in Delaware with 30 years of experience in Delaware.

High-Risk PregnancyWomen's HealthMenopauseGynecologyObsterics

You might also like...

Check out some other posts from ChristianaCare

3 min

Expanding Comprehensive Cancer Services to Middletown, Delaware

ChristianaCare’s Helen F. Graham Cancer Center & Research Institute is expanding access to high-quality, comprehensive cancer care for residents in Middletown and nearby communities. These services will be offered at the new Middletown Health Center, now under construction and expected to open in May 2027. “Our vision is to expand and grow our services throughout the region so that more patients can access high-quality cancer care close to home,” said Thomas Schwaab, M.D., Ph.D., Bank of America Endowed Medical Director of the Helen F. Graham Cancer Center & Research Institute. “By bringing our full cancer-care team and advanced technology to Middletown, we can provide highly precise, coordinated treatment while maintaining the same high standard of care our patients expect.” The cancer care services offered at the Middletown Health Center will reflect the same high-quality, comprehensive care provided at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute in Newark. Patients will have access to specialists across all major cancer types, supported by the Graham Cancer Center’s participation in the National Cancer Institute Community Oncology Research Program (NCORP), which brings advanced treatments and clinical trials directly to the community. In Middletown, this means coordinated multidisciplinary treatment planning, advanced radiation therapy, infusion services, consultations with oncologists and surgeons, nurse navigation, supportive care, clinical trial participation and both in-person and virtual visit options. Advanced Technology Enhances Precision and Comfort When services open in Middletown, patients will have access to advanced radiation therapy using the Varian TrueBeam linear accelerator, one of the most sophisticated radiation therapy systems available. TrueBeam delivers highly precise, image-guided treatments for a wide range of cancers, allowing physicians to target tumors more accurately while minimizing radiation to healthy tissue. “The TrueBeam system represents a major step forward in how we deliver radiation therapy,” said Adam Raben, M.D., chair of Radiation Oncology at ChristianaCare. “Treatments that once took 30 minutes can now be completed in just a few minutes, with real-time imaging ensuring precision. This means better tumor control, fewer side effects and a more comfortable experience for patients.” A Growing Community with Expanding Health Care Needs Middletown is one of Delaware’s fastest-growing communities, with its population projected to rise 8% by 2029, nearly twice the statewide rate, according to the US Census Bureau. Since 1990, the town’s population has grown more than 550%, and the number of residents age 65 and older has increased 24% since 2020, driving demand for accessible, high-quality health care. With continued growth and an aging population, cancer service demand in Middletown is expected to increase by 11% over the next decade, according to health care forecasts from Sg2, a Vizient company, underscoring the need for expanded local care options. Expanding Access to Meet Future Cancer Care Demand By expanding services in Middletown, ChristianaCare is responding to both the region’s population growth and the increasing need for cancer care. The new site will help patients receive timely diagnosis and treatment while reducing travel time and improving coordination with the full Graham Cancer Center team. “As our community grows, so too does the need for locally accessible, state-of-the-art cancer services,” said Schwaab. “This expansion represents a pivotal investment in the health of the Middletown—Odessa—Townsend corridor and beyond.” $92 Million Investment in Middletown’s Health The $92.3 million Middletown Health Center reflects a deep investment in the health and vitality of the state. It is part of ChristianaCare’s larger plan, announced in July 2025, to invest more than $865 million in Delaware over the next three years. In addition to cancer care, the Middletown Health Center will offer a full range of services, including primary and specialty care, women’s health, behavioral health, cardiovascular care, pediatrics, neurology, imaging, diagnostics and lab testing. The center’s healing environment will also include walking trails and abundant natural light, making high-quality, convenient and coordinated care more accessible and welcoming for patients and families. The 87,000-square-foot Health Center will be located at 621 Middletown Odessa Road, next to ChristianaCare’s existing freestanding emergency department.

3 min

ChristianaCare Launches Organoid Core to Personalize Cancer Treatment

ChristianaCare’s Cawley Center for Translational Cancer Research has unveiled a first-of-its-kind organoid core in a community cancer center program. The new laboratory facility within the Helen F. Graham Cancer Center & Research Institute grows and tests living, patient-derived tumor models, giving doctors and researchers a faster, more precise way to identify the therapies most likely to work for each patient. This innovation could change how cancer is treated in Delaware and serve as a model for community centers nationwide. There are only a handful of organoid core centers, or “tumor-on-a-chip” programs, in the United States, and ChristianaCare’s is the first within a community cancer center setting. What the Organoid Core Does Tumor organoids are tiny, three-dimensional cultures grown from a patient’s tumor tissue. They preserve the genetic and molecular traits of the original tumor, making them far more accurate than traditional cell lines. “These mini-tumors enable researchers to screen drugs faster, identify new biomarkers and discover which treatments are most likely to work for each patient,” said Thomas Schwaab, M.D., Ph.D., Bank of America Endowed Medical Director of ChristianaCare’s Helen F. Graham Cancer Center and Research Institute. “This core is a bridge between the lab and the clinic. By growing living tumor models from cells of individual patients, we can test real-world drug responses and tailor treatments for them in ways that were not possible before.” How It Advances Patient Care The organoid core strengthens the Cawley Center's research capabilities by enabling drug screening and biomarker discovery. It will bank organoids representing the wide variety of tumors seen in the community, giving scientists a realistic system for testing therapies. ChristianaCare treats more than 70 percent of cancer patients in Delaware, giving researchers unique access to treatment-naïve samples. These are tumor tissues that have not yet been exposed to chemotherapy or other therapies. Studying them provides a more accurate picture of how cancer behaves naturally and how it might respond to new treatments. Bringing a new cancer drug to patients is expensive and risky. Estimates show it can cost $1.3 to $2.8 billion, with up to a third spent on preclinical development, and only about one in 10 compounds ever reach human trials. Traditional mouse models often fail to fully mimic human tumors, making early testing less reliable. By using organoid screening, the Cawley Center can test therapies more accurately, reduce costs and failure rates and move promising treatments into clinical trials faster. Combined with existing tissue collection programs, clinical trial infrastructure and community partnerships, these resources create a direct pathway to bring lab discoveries to patients faster. Turning Point in Translational Research “Our goal is to shorten the distance between discovery and treatment,” said Nicholas J. Petrelli, M.D., director of the Cawley Center. “Too many promising drugs fail because early models do not capture the complexity of real tumors. The organoid core helps solve that problem. We can now test therapies in models that reflect the patients we actually serve.” “This is a turning point for translational research in community health,” said Jennifer Sims Mourtada, Ph.D., associate director at the Cawley Center. “Organoid technology lets us study cancer in a way that feels personal. We are not just looking at data points. We are studying living models of a patient’s tumor, which can reveal how that person’s cancer might behave or respond to treatment. This approach brings science closer to the people it is meant to help.” Looking Ahead In the coming months, the organoid core will focus on building a diverse biobank of tumors common in Delaware. Plans include collaborations with academic institutions, shared access for external researchers, and development of immune-tumor co-culture models. By combining advanced technology, strong community partnerships and direct patient access, ChristianaCare and the Cawley Center are showing how translational cancer research can thrive in a community setting, making breakthroughs not only in the lab but also in patients’ lives.

3 min

ChristianaCare Gene Editing Institute Achieves CRISPR Breakthrough That Reverses Chemotherapy Resistance in Lung Cancer

In a major step forward for cancer care, researchers at ChristianaCare’s Gene Editing Institute have shown that disabling the NRF2 gene with CRISPR technology can reverse chemotherapy resistance in lung cancer. The approach restores drug sensitivity and slows tumor growth. The findings were published Nov. 13, 2025 in the online edition of Molecular Therapy Oncology. This breakthrough stems from more than a decade of research by the Gene Editing Institute into the NRF2 gene, a known driver of treatment resistance. The results were consistent across multiple in vitro studies using human lung cancer cell lines and in vivo animal models. “We’ve seen compelling evidence at every stage of research,” said Kelly Banas, Ph.D., lead author of the study and associate director of research at the Gene Editing Institute. “It’s a strong foundation for taking the next step toward clinical trials.” Potential Beyond Lung Cancer The study focused on lung squamous cell carcinoma, an aggressive and common form of non-small cell lung cancer (NSCLC) that accounts for 20% to 30% of all lung cancer cases, according to the American Cancer Society. It’s estimated that over 190,000 people in the U.S. will be diagnosed in 2025. While the research centered on this cancer type, the implications are broader. Overactive NRF2 contributes to chemotherapy resistance in several solid tumors, including liver, esophageal and head and neck cancers. The results suggest a CRISPR-based strategy targeting NRF2 could help resensitize a wide range of treatment-resistant tumors to standard chemotherapy. “This is a significant step toward overcoming one of the biggest challenges in cancer therapy — drug resistance,” Banas said. “By targeting a key transcription factor that drives resistance, we’ve shown that gene editing can re-sensitize tumors to standard treatment. We’re hopeful that in clinical trials and beyond, this is what will allow chemotherapy to improve outcomes for patients and could enable them to remain healthier during the entirety of their treatment regimen.” Targeting a Master Switch for Resistance The research zeroed in on a tumor-specific mutation, R34G, in the NRF2 gene, which acts as a master regulator of cellular stress responses. When overactive, NRF2 helps cancer cells withstand chemotherapy. Using CRISPR/Cas9, the team engineered lung cancer cells with the R34G mutation and successfully knocked out NRF2. This restored sensitivity to chemotherapy drugs such as carboplatin and paclitaxel. In animal models, tumors directly treated with CRISPR to knockout NRF2 grew more slowly and responded better to treatment. “This work brings transformational change to how we think about treating resistant cancers,” said Eric Kmiec, Ph.D., senior author of the study and executive director of the Gene Editing Institute. “Instead of developing entirely new drugs, we are using gene editing to make existing ones effective again.” Editing Reaches Threshold Levels One of the most promising discoveries was that disrupting NRF2 in just 20% to 40% of tumor cells, was enough to improve the response to chemotherapy and shrink tumors. This insight is particularly relevant for clinical use, where editing every cancer cell may not be feasible. To test therapy in mice, the researchers used lipid nanoparticles (LNPs), a non-viral method with high efficiency and low risk of unintended, off-target effects. Sequencing confirmed that the edits were highly specific to the mutated NRF2 gene, with minimal unintended changes elsewhere in the genome. “The power of this CRISPR therapy lies in its precision. It’s like an arrow that hits only the bullseye,” said Banas. “This level of specificity with minimal unanticipated genomic side effects offers real hope for the cancer patients who could one day receive this treatment.”

View all posts
Powered by