More than 50 million women in the United States will be over the age of 51, the average age that menopause occurs. Yet in some ways, menopause is the last taboo subject among women, many of whom are hesitant to talk about hot flashes, hormone imbalances, and a type of thinning hair that’s different from that of women in their 20s and 30s. But times are changing.
Menopause is defined as having gone 12 months without a menstrual period. The years leading up to that time may include irregular periods which may or may not be quite heavy, moodiness, fatigue, and weight gain. Most of these changes occur because of changes to the body's production of both estrogen and progesterone, both of which are produced by the ovaries. In addition, many begin to suffer with urinary incontinence, which, while being common, is not a normal part of aging.
Fortunately, there is a multitude of effective treatments that are both hormonal and non-hormonal, but, only about 10% of women seek medical advice during the menopausal period. Many women require no treatment. However, if symptoms are affecting the woman's daily life she should see her doctor. The kind of treatment the patient should have depends on her symptoms, her medical history, as well as her own preferences.
Available treatments include:
1)Herbal Remedies: Soy, Black Cohosh, Relizen: These are non-estrogen compounds that while have not been specifically FDA-approved for the treatment of peri-menopausal symptoms, research studies suggest an improvement in symptoms with minimal side-effects.
2)Paroxetine (Brisdelle): This is the only non-hormonal FDA approved treatment for peri-menopausal symptoms.
3)Hormone replacement therapy (HRT): This is considered to be the most effective treatment to treat the above symptoms.
Hormone therapy can be received by a simple patch on the skin that releases estrogen and progestin. In addition to treating many troublesome menopausal symptoms, HRT also helps to prevent osteoporosis, and lowers colorectal cancer risk. While most formulations of HRT are safe, some may raise the risk of breast, ovarian or uterine cancer . It may additionally raise the risk of coronary heart disease, stroke, and memory loss.
4) Low-dose antidepressants: Effexor, Prozac, Paxil, Celexa, Zoloft
5) Omega 3s : may ease psychological distress and depressive symptoms often suffered by menopausal and peri-menopausal women.
6) Gabapentin (Neurontin):This is effective in treating hot flashes. It is commonly used for treating seizures.
7) Vaginal estrogen: Vaginal estrogen may be applied locally using a tablet, ring or cream. This medication effectively treats vaginal dryness, discomfort during intercourse, as well as some urinary problems. A small amount of estrogen is released and absorbed by the vaginal tissue.
8) Ristela: A novel herbal therapy functions to increase nitric oxide concentrations in the vagina. This leads to the increased blood supply to the vagina which results in increased libido and improved sexual function.
10) Hypnosis and Accupuncture may prove effective for the treatment of hot flashes. Researchers reported in the journal Menopause, in October 2012, that hypnosis can reduce the symptoms of menopausal hot flashes by up to 74%.
For more information, or to find out if any of these treatments are appropriate for you, please feel free to contact Dr. Paul Littman at 973-512-3222.