Menopause medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Rahmah Al-Edresi, M.D.[2]

Overview

While perimenopause is a natural stage of life when the symptoms are severe, this may be alleviated through medical treatments that include Hormone therapy(HT), non-hormonal therapy, and complementary or alternative therapies.Hormonal therapy (HT) provides the best relief, but hormone therapy should only be used for the shortest duration of time and at its lowest effective dose, as it increases the relative risk of uterine cancer ,ovarian cancer, breast cancer, thromboembolism, and coronary heart disease, especially in women who start HT after menopause. Some other drugs afford limited relief from hot flashes. A woman and her doctor should carefully review her symptoms and relative risk before determining whether the benefits of HT or other therapies outweigh the risks.

Medical therapy

Hormonal replacement therapy(HRT)

Selective Estrogen Receptor Modulators (SERMs)

Other forms of hormone therapy:

Adverse effects:


Non Hormonal therapy:

Non hormonal therapy includes serotonin-norepinephrine reuptake inhibitors(SNRIs), selective serotonin reuptake inhibitors (SSRIs), clonidine, and gabapentin.

Complementary and alternative therapies:

Other therapies:

  • Individual counseling or support groups may be helpful to handle sad, depressed, or confusing feelings women may be having as their bodies change.
  • Vaginal moisturizers such as Vagisil or Replens and lubricants, such as K-Y Jelly or Astroglide can help women with thinning vaginal tissue, dryness, and decrease the pain that may be present during intercourse.
  • Moisturizers and lubricants are different products for different types of issues. Some women feel dry apart from sex and they may do better with moisturizers all the time. Those who just need lubricants are fine just using the lubrication products during intercourse. Low-dose vaginal estrogen is generally a safe way to take estrogen to solve vaginal thinning and dryness problems while only minimally increasing the levels of estrogen in the blood.
  • Drinking cold liquids and removing excess clothing layers when hot flashes strike, and avoiding hot flash triggers such as spicy foods maybe relieve some symptoms for some women.



References

  1. 1.0 1.1 Kaunitz AM, Manson JE (2015). "Management of Menopausal Symptoms". Obstet Gynecol. 126 (4): 859–876. doi:10.1097/AOG.0000000000001058. PMC 4594172. PMID 26348174.
  2. Bansal R, Aggarwal N (2019). "Menopausal Hot Flashes: A Concise Review". J Midlife Health. 10 (1): 6–13. doi:10.4103/jmh.JMH_7_19. PMC 6459071. PMID 31001050.


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