Frequently Asked Questions About Menopause
7. Besides hormone replacement therapy, how can I treat hot flashes?
While hormone replacement therapy (HRT) relieves hot flashes for many women, there are other drug treatments that may offer relief. These include both over-the-counter and prescription therapies you may recognize for their more common medical uses. Over-the-counter therapies include various vitamins, ibuprofen products, and soy protein found in foods.
Prescription treatments include:
- low-dose depression drugs fluoxetine (Prozac), paroxetine (Paxil), or venlafaxine (Effexor)
- clonidine, blood pressure medication
- gabapentin, anti-seizure drug
- Brisdelle, a paroxetine formula specifically for hot flashes
- Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes
8. Is hormone replacement therapy safe?
As with all medicines, there are risks and benefits from taking HRT. Results from a large study, the Women's Health Initiative, showed that long-term use of estrogen-progesterone combination therapy caused an increased risk of breast cancer, heart disease, blood clots, and stroke. Estrogen alone did not increase breast cancer or heart disease, but the study also found that therapy with estrogen alone increases the risk of blood clots and stroke.
Using data from this Women’s Health Initiative, the US Preventative Services Task Force (USPSTF) in May of 2012 recommended against using hormone replacement therapy to prevent chronic diseases, including osteoporosis, dementia and heart disease. They weighed any benefits that the hormones may have with their risk of increased heart disease, increased gallbladder disease, slightly increased risk of dementia, and increased breast cancer.
If you are concerned about taking HRT, talk to your doctor; there are other options.
9. What alternative treatments are available for menopause symptoms?
Botanical supplements containing compounds that act like estrogens -- such as soy -- may provide some of the benefits of estrogen in relieving menopausal symptoms, but research results are contradictory. Other botanicals, including black cohosh, have shown some promise for reducing menopausal sweats, or hot flashes. However, more research is needed to define the benefits and risks of these alternative treatments, and you should always check with your doctor before using them.
10. Sex has become painful since menopause. What can I do?
The pain you are experiencing during sex is may be due to vaginal dryness associated with declining estrogen levels during menopause. But always check with your doctor if you have painful intercourse to find out the cause. There are a number of lubricants you can try to relieve the symptoms. Ask your doctor or pharmacist for a suggestion. There are also local estrogen treatments -- cream, tablets, and an estrogen ring -- that treat vaginal dryness. A oral drug taken once a day, Osphena, is also available. The drug makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex.