Treatments for Menopausal and Perimenopausal Symptoms
Need relief from midlife mood swings, hot flashes, and sleep trouble? Learn how to treat, manage, and cope with menopausal symptoms.
Yoga, hormone therapy, and acupuncture are three ways to help treat menopausal symptoms.iStock (3)
Treating and Managing Symptoms Related to Midlife Hormone Flux: What to Know
Mood swings, hot flashes, and many of the symptoms of perimenopause and menopause are treatable. When you consult with a physician, bring a list of your experiences so far, and what you have done to cope. Also, check with your doctor before taking herbs and supplements, because some can interfere with your current medications, or are not recommended for women who have had breast cancer.
Medical Treatments for Symptoms of Menopause and Perimenopause
1. Hormone Therapy (HT)
Most menopause symptoms (hot flashes, insomnia, night sweats, osteoporosis, mood swings, decreased libido) are caused by declining levels of estrogen, a group of hormones produced by female reproductive hormones. HT (aka hormone replacement therapy or HRT) is exactly what it sounds like — increasing estrogen levels via oral medication, skin patches, or vaginal creams, rings, or gels. It can contain estrogen alone or estrogen and progestin together. There has been controversy about HT in the past concerning its connection to a heightened risk for breast cancer and cardiovascular disease. While there is no one-size-fits-all recommendation (every woman should discuss the pros and cons with her healthcare team), a study published in the Journal of the American Medical Association (JAMA) in September 2017 found no appreciable difference in mortality between women who took estrogen only, estrogen and progestin in combination, or a placebo. (1)
2. Gamma Aminobutyric Acid (Gabapentin)
Gamma-aminobutyric acid, or GABA, is a neurotransmitter that sends chemical messages through the brain and the nervous system, and is involved in regulating communication between brain cells.
Gabapentin levels have been shown to be lower in postmenopausal women, leading to symptoms of depression. GABA was originally a seizure medication, and taking it may alleviate depression symptoms. (2) It is also effective in reducing hot flashes and improving sleep, and since it does not contain reproductive hormones, can be used by women with breast cancer. (3) It can carry significant side effects such as blurred vision, sleepiness, nausea, dizziness and tremors.
3. Catapres (Clonidine)
Another nonhormonal option, clonidine is usually used to reduce high blood pressure. But research has shown that it can have some effect in reducing hot flashes. Side effects include dizziness, sleepiness, dry mouth and constipation. (4)
4. Bioidentical Hormones
Bioidenticals are compounds that closely resemble the chemical and molecular structure of human hormones. Many false and misleading statements have been made out about these compounds, such as that they are safer and more effective than HT. The U.S. Food and Drug Administration (FDA) approved a new bioidentical combination drug called Bijuva (estradiol and progesterone) for hot flashes this past October.
A note of caution: One way that bioidentical hormones are prescribed and made available is through a compounding pharmacy. The North American Menopause Society and the Endocrine Society recommend caution when using compounded drugs. (5) The concern is mainly about bioidenticals that are custom compounded by pharmacists following a doctor’s script. These have no FDA oversight, and there is no evidence that they are superior to regular hormone therapy or bioidenticals that have FDA approval. “NAMS supports the actions of the U.S. Congress, FDA, and other scientific organizations that have warned about the potential harm from compounded bioidentical hormones,” reads a statement on the North American Menopause Society's website. (6)
5. Antidepressants
Some classes of antidepressants — notably selective serotonin reuptake inhibitors (SSRIs) — not only aid in mood stabilization but can also help reduce hot flashes (7) Antidepressants are considered nonhormonal medical treatments for symptoms related to perimenopause and menopause.
Related Treatments Midlife Women May Need: Osteoporosis Medications
To prevent further bone loss, experts recommend that women get the recommended doses of calcium and vitamin D. Your doctor may prescribe one of these osteoporosis medications:
Risedronate (Actonel, Atelvia), ibandronate (Boniva), alendronate (Binosto, Fosamax): Prevents bone deterioration.
Zoledronic acid (Reclast): Given once a year by IV, for people who have trouble taking the above medicines orally
Denosumab (Prolia): Antibody injection given twice a year
Raloxifene (Evista): Mimics estrogen
Teriparatide (Forteo): An injectable that contains a bone-building agent (8)
Complementary and Alternative (CAM) Remedies for Perimenopausal and Menopausal Symptoms
Ask your doctor about incorporating these modalities into your overall regimen.
1. Acupuncture
Preliminary studies show that acupuncture may help relieve vasomotor symptoms (hot flashes and night sweats). Research published in February 2017 in Menopause found that “the majority of women may experience a significant reduction in menopause-related VMS frequency after eight weeks of acupuncture treatment, and that there is a subgroup of women who are likely to experience an especially rapid and strong clinical response to acupuncture.” (9)
2. Hypnotherapy
In a position paper, published in Menopause in November 2015, the North American Menopause Society notes that studies have shown that clinical hypnotherapy can aid in the reduction of hot flashes and night sweats, but cautions that the current studies have been very small. (10)
3. Yoga
It looks like this ancient practice can help with a variety of menopause symptoms: It lowers the risk of cardiovascular disease, hot flashes, and night sweats, and improves sleep, mood, and cognitive function. (11) A study published in the Spring 2016 issue of Geriatric Rehabilitation discovered that a 12-minute daily yoga program actually reversed bone loss from osteoporosis. (12)
4. Mindful Meditation
Mindfulness, the practice of staying in the moment, focusing on the “now,” and avoiding judgment, has been shown to reduce the degree of distress that women feel from hot flashes, night sweats, and stress, according to research published in Menopause. (13) Also, deep, controlled breathing when you feel a hot flash coming on signals your body to relax.
RELATED: Mindfulness May Help Improve Menopause Symptoms
Strategies for Coping With Specific and General Menopausal Symptoms
1. To Cope With Hot Flashes, Dress in Layers
You’re hot, then you’re cold, and then you’re hot again. Instead of changing outfits several times a day, pile on layers (camisole, T-shirt, cardigan) that can easily be removed and put back on. Avoid fabrics that don’t breathe, such as polyester and rayon.
RELATED: The Link Between Stress and Menopause
2. To Cope With Vaginal Dryness, Use Vaginal Lubricants and Moisturizers
If your vagina or vulva is getting dry and irritated, stop using soap to clean there; clean water works just as well. If sexual penetration is painful because of dryness, try an over-the-counter lubricant or moisturizer. Use lubricants right before sexual activity; avoid oil-based ones, which can cause irritation and cause condom failure. Apply moisturizers as a regular healthcare regimen. (14)
3. To Cope With Menopausal Health Risks, Eat a Bone-Healthy Diet
Add calcium and vitamin D to your plate: Low-fat dairy, canned salmon, sardines and shrimp, eggs, fortified juice, and leafy green vegetables help protect against osteoporosis. Check with your physician before taking vitamin C supplements, because they can interact with some medications, according to a study published in the Journal of Nutrition in Gerontology and Geriatrics in November 2018. (15)
4. To Cope With Various Symptoms, Avoid Caffeine, Alcohol, Sugar, and Spicy Foods
These ingredients and foods can trigger mood swings, night sweats, and hot flashes. Alcohol can increase your risk of cardiovascular disease and osteoporosis. (16)
5. Quit Smoking
Cigarettes can not only cause an earlier onset of menopause, but also increase the intensity of symptoms and the risk of developing cardiovascular disease and osteoporosis. (16,17)
6. Strengthen Your Pelvic Floor
Pelvic floor muscle exercises specifically designed for you by a physical therapist with special training in women’s pelvises can improve your strength and tone, relax tight muscles, and overcome embarrassing “leaking,” vaginal prolapse, and sexual dysfunction. (18)
7. Get Regular Exercise
All different kinds of exercise are important! Two to three times a week for at least a half hour, work in:
Aerobics to protect your heart and work off unwanted weight
Weight-bearing exercises to strengthen bones
Strength-training to prevent loss of muscle mass
Stretching to loosen stiff muscles and tendons
As a bonus: Regular exercise is known to improve your mood and help minimize depression. If you don’t know where to start, see a trainer who can create an appropriate workout plan for you.
Yoga, hormone therapy, and acupuncture are three ways to help treat menopausal symptoms.iStock (3)
Treating and Managing Symptoms Related to Midlife Hormone Flux: What to Know
Mood swings, hot flashes, and many of the symptoms of perimenopause and menopause are treatable. When you consult with a physician, bring a list of your experiences so far, and what you have done to cope. Also, check with your doctor before taking herbs and supplements, because some can interfere with your current medications, or are not recommended for women who have had breast cancer.
Medical Treatments for Symptoms of Menopause and Perimenopause
1. Hormone Therapy (HT)
Most menopause symptoms (hot flashes, insomnia, night sweats, osteoporosis, mood swings, decreased libido) are caused by declining levels of estrogen, a group of hormones produced by female reproductive hormones. HT (aka hormone replacement therapy or HRT) is exactly what it sounds like — increasing estrogen levels via oral medication, skin patches, or vaginal creams, rings, or gels. It can contain estrogen alone or estrogen and progestin together. There has been controversy about HT in the past concerning its connection to a heightened risk for breast cancer and cardiovascular disease. While there is no one-size-fits-all recommendation (every woman should discuss the pros and cons with her healthcare team), a study published in the Journal of the American Medical Association (JAMA) in September 2017 found no appreciable difference in mortality between women who took estrogen only, estrogen and progestin in combination, or a placebo. (1)
2. Gamma Aminobutyric Acid (Gabapentin)
Gamma-aminobutyric acid, or GABA, is a neurotransmitter that sends chemical messages through the brain and the nervous system, and is involved in regulating communication between brain cells.
Gabapentin levels have been shown to be lower in postmenopausal women, leading to symptoms of depression. GABA was originally a seizure medication, and taking it may alleviate depression symptoms. (2) It is also effective in reducing hot flashes and improving sleep, and since it does not contain reproductive hormones, can be used by women with breast cancer. (3) It can carry significant side effects such as blurred vision, sleepiness, nausea, dizziness and tremors.
3. Catapres (Clonidine)
Another nonhormonal option, clonidine is usually used to reduce high blood pressure. But research has shown that it can have some effect in reducing hot flashes. Side effects include dizziness, sleepiness, dry mouth and constipation. (4)
4. Bioidentical Hormones
Bioidenticals are compounds that closely resemble the chemical and molecular structure of human hormones. Many false and misleading statements have been made out about these compounds, such as that they are safer and more effective than HT. The U.S. Food and Drug Administration (FDA) approved a new bioidentical combination drug called Bijuva (estradiol and progesterone) for hot flashes this past October.
A note of caution: One way that bioidentical hormones are prescribed and made available is through a compounding pharmacy. The North American Menopause Society and the Endocrine Society recommend caution when using compounded drugs. (5) The concern is mainly about bioidenticals that are custom compounded by pharmacists following a doctor’s script. These have no FDA oversight, and there is no evidence that they are superior to regular hormone therapy or bioidenticals that have FDA approval. “NAMS supports the actions of the U.S. Congress, FDA, and other scientific organizations that have warned about the potential harm from compounded bioidentical hormones,” reads a statement on the North American Menopause Society's website. (6)
5. Antidepressants
Some classes of antidepressants — notably selective serotonin reuptake inhibitors (SSRIs) — not only aid in mood stabilization but can also help reduce hot flashes (7) Antidepressants are considered nonhormonal medical treatments for symptoms related to perimenopause and menopause.
Related Treatments Midlife Women May Need: Osteoporosis Medications
To prevent further bone loss, experts recommend that women get the recommended doses of calcium and vitamin D. Your doctor may prescribe one of these osteoporosis medications:
Risedronate (Actonel, Atelvia), ibandronate (Boniva), alendronate (Binosto, Fosamax): Prevents bone deterioration.
Zoledronic acid (Reclast): Given once a year by IV, for people who have trouble taking the above medicines orally
Denosumab (Prolia): Antibody injection given twice a year
Raloxifene (Evista): Mimics estrogen
Teriparatide (Forteo): An injectable that contains a bone-building agent (8)
Complementary and Alternative (CAM) Remedies for Perimenopausal and Menopausal Symptoms
Ask your doctor about incorporating these modalities into your overall regimen.
1. Acupuncture
Preliminary studies show that acupuncture may help relieve vasomotor symptoms (hot flashes and night sweats). Research published in February 2017 in Menopause found that “the majority of women may experience a significant reduction in menopause-related VMS frequency after eight weeks of acupuncture treatment, and that there is a subgroup of women who are likely to experience an especially rapid and strong clinical response to acupuncture.” (9)
2. Hypnotherapy
In a position paper, published in Menopause in November 2015, the North American Menopause Society notes that studies have shown that clinical hypnotherapy can aid in the reduction of hot flashes and night sweats, but cautions that the current studies have been very small. (10)
3. Yoga
It looks like this ancient practice can help with a variety of menopause symptoms: It lowers the risk of cardiovascular disease, hot flashes, and night sweats, and improves sleep, mood, and cognitive function. (11) A study published in the Spring 2016 issue of Geriatric Rehabilitation discovered that a 12-minute daily yoga program actually reversed bone loss from osteoporosis. (12)
4. Mindful Meditation
Mindfulness, the practice of staying in the moment, focusing on the “now,” and avoiding judgment, has been shown to reduce the degree of distress that women feel from hot flashes, night sweats, and stress, according to research published in Menopause. (13) Also, deep, controlled breathing when you feel a hot flash coming on signals your body to relax.
RELATED: Mindfulness May Help Improve Menopause Symptoms
Strategies for Coping With Specific and General Menopausal Symptoms
1. To Cope With Hot Flashes, Dress in Layers
You’re hot, then you’re cold, and then you’re hot again. Instead of changing outfits several times a day, pile on layers (camisole, T-shirt, cardigan) that can easily be removed and put back on. Avoid fabrics that don’t breathe, such as polyester and rayon.
RELATED: The Link Between Stress and Menopause
2. To Cope With Vaginal Dryness, Use Vaginal Lubricants and Moisturizers
If your vagina or vulva is getting dry and irritated, stop using soap to clean there; clean water works just as well. If sexual penetration is painful because of dryness, try an over-the-counter lubricant or moisturizer. Use lubricants right before sexual activity; avoid oil-based ones, which can cause irritation and cause condom failure. Apply moisturizers as a regular healthcare regimen. (14)
3. To Cope With Menopausal Health Risks, Eat a Bone-Healthy Diet
Add calcium and vitamin D to your plate: Low-fat dairy, canned salmon, sardines and shrimp, eggs, fortified juice, and leafy green vegetables help protect against osteoporosis. Check with your physician before taking vitamin C supplements, because they can interact with some medications, according to a study published in the Journal of Nutrition in Gerontology and Geriatrics in November 2018. (15)
4. To Cope With Various Symptoms, Avoid Caffeine, Alcohol, Sugar, and Spicy Foods
These ingredients and foods can trigger mood swings, night sweats, and hot flashes. Alcohol can increase your risk of cardiovascular disease and osteoporosis. (16)
5. Quit Smoking
Cigarettes can not only cause an earlier onset of menopause, but also increase the intensity of symptoms and the risk of developing cardiovascular disease and osteoporosis. (16,17)
6. Strengthen Your Pelvic Floor
Pelvic floor muscle exercises specifically designed for you by a physical therapist with special training in women’s pelvises can improve your strength and tone, relax tight muscles, and overcome embarrassing “leaking,” vaginal prolapse, and sexual dysfunction. (18)
7. Get Regular Exercise
All different kinds of exercise are important! Two to three times a week for at least a half hour, work in:
Aerobics to protect your heart and work off unwanted weight
Weight-bearing exercises to strengthen bones
Strength-training to prevent loss of muscle mass
Stretching to loosen stiff muscles and tendons
As a bonus: Regular exercise is known to improve your mood and help minimize depression. If you don’t know where to start, see a trainer who can create an appropriate workout plan for you.
0 Response to "Treatments for Menopausal and Perimenopausal Symptoms"
Posting Komentar