Biology major Cynthia A. Stuenkel, class of 1974, didn鈥檛 have a job in her field lined up at the time of graduation, so she opted to accept a position with IBM as a systems engineer and head back home to the Chicago area.
However, Stuenkel, who grew up on a farm in Frankfort, Illinois, soon discovered she was meant to walk a different career path. Choosing instead to pursue medicine, she received her M.D. from the University of Illinois, Chicago, in 1981.
鈥淚 was fortunate to be accepted to the James Scholar Independent Study Program,鈥� she said. 鈥淭his gave me the incredible opportunity to complete medical school clinical rotations throughout Chicago and to take time to conduct an extensive literature review on preeclampsia, a topic of interest. After graduating from medical school, I was accepted for a residency in internal medicine at the University of Chicago hospitals. It was a transformative experience and included new friends from all over the country, an expanded worldview, and a husband, Brian Jaski, a resident two years ahead of me.鈥�
When Jaski headed to Boston and Harvard Medical School for cardiology training at the Brigham and Women鈥檚 Hospital, Stuenkel decided to follow him. The couple married in 1983 and celebrated 37 years of marriage this past October. They first lived in Boston for two years where she completed her residency at the New England Deaconess Hospital and started a fellowship in endocrinology at the Brigham and Women鈥檚 Hospital. Their careers then took them to San Diego where Jaski joined a private practice cardiology group, and Stuenkel completed her training in reproductive endocrinology at the University of California, San Diego (UCSD).
鈥淭he move turned out to be serendipitous for me and led to work with world-class physician scientists Samuel S.C. Yen and Elizabeth Barrett-Connor,鈥� Stuenkel said. 鈥淭hey encouraged my work in women鈥檚 health with a special interest in menopause. I have been affiliated with UCSD in one capacity or another ever since.鈥�
Now residing in La Jolla, a suburb of San Diego, Stuenkel is a clinical professor of medicine at UCSD School of Medicine and an attending physician for their Endocrinology and Metabolism Service. In 1988 at UCSD, she established one of the first menopause clinics in the United States and now lectures nationally and internationally regarding management of health concerns of postmenopausal women, including use of hormone therapy for symptom relief, and strategies for prevention of cardiovascular disease, osteoporosis, and breast cancer.
Throughout the years, Stuenkel has experienced an illustrious career having served as the National Spokesperson for the Endocrine Society鈥檚 Hormone Health Network Menopause Map, chairing the Endocrine Society鈥檚 2015 Clinical Practice Guidelines on Treatment of Symptoms of the Menopause, coauthoring menopause educational materials as a member of the Hormone Foundation鈥檚 Women鈥檚 Health Task Force, and serving as a founding member and past president of the North American Menopause Society (NAMS) and two-term member of the NAMS Board of Trustees.
She was awarded the Leon Speroff Outstanding Educator Award, was instrumental in the development of the first NAMS/APGO (Association of Professors of Gynecology and Obstetrics) menopause curriculum released in 2012, Contemporary Clinical Management of Menopause and served as a clinical investigator in pivotal clinical trials including the Heart and Estrogen/Progestin Replacement Study (HERS), Raloxifene Use for the Heart (RUTH), and Long-Term Interventions on Fractures with Tibolone (LIFT). Stuenkel has authored or coauthored editorials, reviews, and book chapters and appeared in local, national, and international media.
Stuenkel recently took time out of her busy career to answer a few questions for Wittenberg.
Wittenberg: What does your job at UCSD consist of? Do you still teach classes or are you mainly the attending physician for their Endocrinology and Metabolism Service?
Stuenkel: In recent years, my focus is primarily on teaching. A favorite activity includes time with our first- and second-year UCSD medical students working on problem-based learning. I also supervise medical residents and endocrine fellows in our endocrine clinics, and present continuing medical education classes in menopause and women鈥檚 health for academic and practicing physicians in San Diego, across the United States, and internationally. I am often inspired by the Wittenberg motto, 鈥淗aving light, We Pass It On To Others.鈥�
Through my work in professional organizations such as the Endocrine Society, the North American Menopause Society, and the International Menopause Society, I have been privileged to participate in establishing national and international guidelines for treating symptoms of menopause. This topic has remained challenging for the past three decades and requires ongoing evaluation of new research and products to enhance patient care.
Wittenberg: Tell me about establishing one of the first menopause clinics in the United States, and what you do there and how this serves the area.
Stuenkel: When I completed my fellowship in reproductive endocrinology at UCSD in 1987, it was clear that menopause, although a universal, natural transition, was an arena in women鈥檚 health that merited more attention. It also matched my professional and personal interests in advancing women鈥檚 health. Women could benefit from a comprehensive approach to relief of symptoms such as hot flashes. This midlife event was also an opportunity to focus on preventive strategies to gear up for the second half of life. With faculty appointments in both the Departments of Medicine and Obstetrics and Gynecology, I started a Menopause Clinic in 1988. We combined patient education with a medical appointment followed by a recommended mammogram or bone density testing all in the same visit. While this approach is now commonly available, at the time, there were only about a half dozen menopause programs in the U.S. It was exciting to have ABC鈥檚 20/20 include our menopause program in a segment in 1990! In the years ahead, I presented weekly women鈥檚 health updates on our San Diego ABC affiliate TV station and appeared on a number of national media outlets.
When our daughter, Katherine Christine (K.C.), was born in 1990, I took some time off to enjoy her and adjust to our new family. Beginning in 1992, I added a new focus on clinical research, an opportunity that again expanded my imagination, expertise, and international network.
Wittenberg: Tell me about your research with women鈥檚 health and other research you may currently be doing.
Stuenkel: Our UCSD clinical research studies evaluated potential preventive strategies for postmenopausal health concerns. We evaluated the effects of menopausal hormone therapy on preventing heart disease, and drugs similar to but different from estrogen called selective estrogen receptor modulators to examine effects on bone, heart, and breast health. We examined additional options including soy protein, statins, and a drug available outside the U.S. called tibolone. These studies started during the heyday of hormones for everyone, the late 1980s and early 1990s. Disappointing findings in some clinical trials, including the Heart and Estrogen/Progestin Replacement Study (HERS), led to a marked decline in prescribing hormone therapy for a number of years. Over the past decade, the pendulum has swung toward the center. We now advocate for selective use of hormone therapy in recently menopausal women primarily for relief of symptoms.
Wittenberg: How has your research changed hormone therapy and helping women with menopause in general?
Stuenkel: One thing I have really enjoyed over the past decade is establishing clinical guidelines and practice recommendations for clinicians both in the U.S. and abroad. Working to present these recommendations to inform practicing clinicians is an ongoing activity. Through the years, one of my ongoing goals has been to mentor junior faculty to focus on menopause in their practices and research. This has been very satisfying. I have just begun contributing to the data and safety monitoring board of a large, ongoing trial of a new form of estrogen for menopausal symptoms not yet available. I was honored to present in 2015 to the Food and Drug Administration regarding safety labeling of an estrogen product and then be invited in 2019 to the National Academies of Sciences, Engineering, and Medicine to summarize the state-of-the-art of menopausal hormone therapy. Finally, I always encourage women to be proactive in understanding their symptoms and health during midlife while making decisions regarding the best course for them in partnership with their healthcare practitioner.
Wittenberg: Why did you choose Wittenberg?
Stuenkel: On the advice of my high school college counselor (also my science teacher), I applied and was accepted to just three schools (Wittenberg, DePauw, and Vanderbilt). After school visits, I chose Wittenberg. I fell in love with the incredibly beautiful campus, especially in the autumn. Wittenberg felt right, reflected our family鈥檚 Lutheran heritage, had friendly students, an excellent academic reputation, and was most generous with financial aid. So Wittenberg, it was! I loved the small classes with professors who knew my name and took a personal interest in my education. I also enjoyed the gamut of Greek life. I pledged Alpha Delta Pi during sorority rush winter quarter of my freshman year after making friends with ADPi sophomores in North Hall. These women are still among my very best friends!
