Menopause Treatments - HRT
While menopause is a natural stage of life, some symptoms may be alleviated through medical treatments. Hormone replacement therapy (HRT) is one of the best menopause treatments, but certain forms appear to pose significant health risks. Some drugs afford limited relief from menopausal hot flashes. A woman and her doctor should carefully review her symptoms and relative risk before determining whether the benefits of HRT or other treatments outweigh the risks.
Available options for the treatment of Menopause.
Hormone therapy
Hormone replacement therapy (HRT) is a system of medical treatment for surgically menopausal, perimenopausal and postmenopausal women, based on the assumption that it may prevent discomfort and health problems caused by reduced circulating estrogen, progesterone and testosterone. HRT may be by patches, tablets, creams, troches, IUDs, vaginal rings, gels or, more rarely, by injection.
Oral contraceptive pills
Oral contraceptive pills are another form of hormone therapy often prescribed for women in perimenopause (early menopause) to treat irregular vaginal bleeding. Women in the menopausal transition tend to have considerable breakthrough bleeding when given estrogen therapy. Therefore, oral contraceptives are often given to women in menopause transition to regulate menstrual periods, relieve hot flashes, as well as to provide contraception.
Local (vaginal) hormone treatments
There are also local (meaning vaginal) hormonal treatments for the symptoms of vaginal estrogen deficiency. Local treatments include the vaginal estrogen ring, vaginal estrogen cream , or vaginal estrogen tablets. Local and oral estrogen treatments are sometimes combined for this purpose.
Other pharmaceutical therapies
Antidepressant medications: The class of drugs known as selective serotonin reuptake inhibitors (SSRIs) and related medications have been shown to be effective in controlling the symptoms of hot flashes in up to 60% of women. However, antidepressant medications may be associated with side effects , including decreased libido or sexual dysfunction.
Other medications : Other prescription medications have been shown to provide some relief for hot flashes, although their specific purpose is not the treatment of hot flashes. All of these may have side effects, and their use should be discussed with and monitored by a doctor. Some of these medications that have been shown to help relieve hot flashes include the antiseizure drug gabapentin (Neurontin) and clonidine , a drug used to treat high blood pressure.
Alternative medical therapies
It should be noted that medical non-hormone treatments provide less than complete relief, and each has side effects.
Plant estrogens (phytoestrogens, isoflavones)
Isoflavones are chemical compounds found in soy and other plants that are phytoestrogens, or plant-derived estrogens. They have a chemical structure that is similar to the estrogens naturally produced by the body, but their effectiveness as an estrogen has been estimated to be much lower than true estrogens.
Vitamin E
Some women report that vitamin E supplements can provide relief from mild hot flashes, but scientific studies are lacking to prove the effectiveness of vitamin E in relieving symptoms of menopause. Taking a dosage greater than 400 international units (IU) of vitamin E may not be safe, since some studies have suggested that greater dosages may be associated with cardiovascular disease risk.
Black Cohosh
Black cohosh is an herbal preparation that has been popular in Europe for the relief of hot flashes. However, there have still been very few scientific studies done to establish the benefits and safety of this product. Research is ongoing to further determine the effectiveness and safety of black cohosh.
Other alternative therapies
There are many supplements and substances that have been advertised as "natural" treatments for symptoms of menopause, including licorice , dong quai , chasteberry, and wild yam . Scientific studies to prove the safety and effectiveness of these products have not been performed.
Non-pharmaceutical therapies
In women for whom oral or vaginal estrogens are deemed inappropriate, such as breast cancer survivors, or women who do not wish to take oral or vaginal estrogen, there are varieties of over-the-counter vaginal lubricants. However, they are probably not as effective in relieving vaginal symptoms as replacing the estrogen deficiency with oral or local estrogen.
Obvious measures, such as drinking cold liquids and removing excess clothing layers when hot flashes strike, and avoiding hot flash triggers such as spicy foods, may supplement or supplant the use of medications for some women.
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