Treatment Options for Menopause
Menopause is a normal part of life which occurs naturally and is not considered to be a disease that requires treatment. However, treatment of associated symptoms is possible if these become severe.
The treatment options include:
Hormone therapy (HT), also known as hormone replacement therapy (HRT) or postmenopausal hormone therapy (PHT), consists of estrogens or a combination of estrogens and progesterone. Symptoms of menopause related to declining estrogen levels such as hot flashes and vaginal dryness can be controlled by HT. Women has an increased risk for heart attack, stroke, and breast cancer with this therapy. Estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer. However estrogen therapy alone is associated with an increased risk of developing endometrial cancer (cancer of the lining of the uterus) in postmenopausal women who have not had their uterus surgically removed.
Hormone therapy is available both in oral (pill) and transdermal form. Since transdermal hormone products do not have effects on the liver, this has become the preferred form for most women.
Hormone therapy can be used if the balance of risks and benefits is favorable for the individual woman.
Oral contraceptive pills are another form of hormone therapy. Women in perimenopause are often prescribed oral contraceptive pills to treat irregular vaginal bleeding.
Women in the menopausal transition tend to have bleeding when given estrogen therapy. Therefore, oral contraceptives are often given to women in the menopause transition to regulate menstrual periods, relieve hot flashes, as well as to provide contraception.
There are also local hormonal treatments for the symptoms of vaginal estrogen deficiency which can be applied directly to the vagina. This include the vaginal estrogen ring (Estring), vaginal estrogen cream, or vaginal estrogen tablets. Sometimes local and oral estrogen treatments are combined for this purpose.
Selective serotonin reuptake inhibitors (SSRIs) and related medications can be used for controlling the symptoms of hot flashes. However, antidepressant medications may be associated with side effects, including decreased libido or sexual dysfunction.
The antiseizure drug gabapentin (Neurontin) and clonidine (Catapres), a drug used to treat high blood pressure can also be used for treatment of hot flashes.
Depending on individual needs, some medication may be recommend to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Vitamin D supplements can be prescribed to help strengthen bones.
Isoflavones are chemical compounds found in soy and other plants that are phytoestrogens, or plant-derived estrogens. Genistein and daidzein are two types of isoflavones found in soy beans, chick peas, and lentils, and are considered to be the most dynamic estrogens of the phytoestrogens.
These compounds may help relieve hot flashes and other symptoms of menopause. Women who have had breast cancer and do not want to take hormone therapy (HT) with estrogen sometimes use soy products for relief of menopausal symptoms.
These hormones come from plant sources. The term "bioidentical" indicates that the hormones in the product are chemically identical to those your body produces. But there is no scientific evidence that bioidentical hormones works better than traditional hormone therapy in easing menopause symptoms.